Affiliations: Department of Internal Medicine, Division of Hospital Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA | Department of Internal Medicine, Division of Epidemiology, University of New Mexico School of Medicine, Albuquerque, NM, USA
Note: [] Address for correspondence: J. Rush Pierce Jr., MD, MPH, Department of Internal Medicine, MSC 10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, New Mexico, USA. Tel.: +1 505 925 0660; Fax: +1 505 925 0680; E-mail: jrpierce@salud.unm.edu
Abstract: OBJECTIVE: Identify factors that predict fall-related injury in hospitalized adults. DESIGN: Retrospective records review. SETTING: 435-bed university hospital. PARTICIPANTS: Inpatients with reported falls in 2010. RESULTS: Medical records were available for 286/293 (98%) of reported falls in 251 patients. 25% (63/286) of falls were associated with injury, 4% (11/286) with serious injury. Compared to all fallers, patients with injury did not differ by gender or age. In univariate analysis, patients who reported hitting their head, had pre-fall confusion, or who received narcotics within 24 hours before falling were more likely to suffer injury (estimated odds ratios 6.04, 2.00 and 5.1, respectfully). In multivariate analysis, receiving a narcotic prior to falling was the strongest predictor of injury (estimated odds ratio 5.38; 95% confidence intervals 2.07–13.98, p < 0.001). CONCLUSIONS: In this single-institution study, 25% of patients who fell suffered injury and 4% serious injury. Neither age nor gender predicted fall-related injury. Recent narcotic administration was the strongest predictor of injury. Strategies to prevent fall-related injury in the hospital should target patients receiving narcotics. When evaluating inpatients who have fallen, providers should be especially vigilant about injury in patients who have pre-fall confusion, hit their head, or have received recent narcotics.
Keywords: Falls, hospital, injury, narcotics, patient safety
