[Falls in the geriatric department: responsibility of the care-giver and the hospital].
During a 4-year prospective study there were 94 falls in 60 patients hospitalized in our geriatric department, mostly in dependent women. There was a "responsibility group," in which 19 of the falls occurred (20.2%). These included 14 while the patient was being cared for by nurses or relatives, and 5 due to defective fixation of bed side-walls. In the comparison group there were 75 falls while the patient was alone. Risk of falling was increased by cardiovascular conditions, including low blood pressure and arrhythmias, and by dementia, paralysis and low score for activity of daily living (ADL). Impulsiveness of patients was an important cause, making falls unpredictable and difficult to prevent even while under proper care. Diazepam (Assival, Valium) in those with a low ADL (27.5 +/- 16.5) and a relatively high mental test (7 +/- 2.1) seemed dangerous in the responsibility group, possibly due to increased impulsiveness. Nitrazepam (Numbon) appeared to be dangerous in ambulatory patients of the comparison group when both ADL and mental tests were relatively high (53.5 +/- 17.5 and 8.2 +/- 2.3, respectively). Mean ADL (33.7 +/- 20.8) in all patients decreased after falls by -2.8 +/- 9.4 (p < 0.00001). In the responsibility group it decreased by -5 +/- 13.2 (p < 0.16), and after falls during visits of relatives, by -14 +/- 7.1 (p < 0.23). In the comparison group it decreased by -1.9 +/- 7.1 (p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Shats
V
V
Geriatric Dept., Rebecca Sieff Government Hospital, Safed.
Kozacov
S
S
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications; D017028:Caregivers; D003704:Dementia / Q000150:complications; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D005853:Geriatrics; D006748:Hospital Departments; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors