Falls in hospital: a case-control study

Abstract

Aims: Falls among inpatients are common. The method used by The Norwegian Patient Safety Campaign to measure the adverse events is the Global Trigger Tool, which does not look at the causation for falls. This study was aimed at investigating major risk factors for falls in the hospital setting.

Methods: This retrospective case-control study was conducted at Telemark Hospital in Norway, in the period from September 2012 to August 2014. A total of 842 patients from three wards were included, whereof 172 cases had experienced one or more fall(s) during hospitalisation and 670 random controls had not fallen. Data were analysed according to a pragmatic strategy.

Results: Compared with patients who did not fall, patients who fell were 21 times more likely to have poor balance (OR = 21.50, 95% CI: 10.26-45.04) and 19 times more likely to have very poor balance (OR = 19.62, 95% CI: 9.55-40.27), twice as likely to be men (OR = 1.82, 95% CI: 1.24-2.68), and 50% increased probability of fall with every 10 year increase of age (OR = 1.51, 95% CI: 1.34-1.69). Furthermore, the patients who fell were more likely to use antidepressant drugs (OR = 3.85, 95% CI: 1.09-13.63), antipsychotic drugs (OR = 3.27, 95% CI: 1.94-5.51), anxiolytic/hypnotic drugs (OR = 1.80, 95% CI: 1.22-2.67) and antiepileptic drugs (OR = 1.13, 95% CI: 1.11-4.06) than patients who did not fall.

Conclusions: During hospital stay, patients who fell had a higher risk profile than patients who did not fall. Clinicians should work to improve patients' safety and reduce the risk of falls by accurately assessing balance and mobility as a form of primary prevention. We recommend that a review of the patient medications should be conducted upon falling, as a form of a secondary preventive strategy against falls.

Keywords: antidepressants; balance; drugs; falls; hospital.