Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unit.
We aimed to identify fall incidence, predictors and characteristics and to investigate hospitalization outcomes for elderly inpatients. In 340 men and 280 women consecutively admitted to a Acute Geriatric Ward of a University Hospital the following variables were evaluated: demographics, clinical history, main disease responsible for hospitalization, comorbidity (cumulative illness rating scale: CIRS 1 and 2) gait and balance deficit (Tinetti's scales), cognition/function (short portable mental status questionnaire: SPMSQ); activities of daily living: ADL; instrumental activities of daily living: IADL; delirium (confusion assessment method: CAM), drugs administered during hospitalization. Overall 80 falls occurred in 70 patients. The incidence rate of falls was of 6.0 per 1000 patient-days with 2.0 falls per bed/year. Age (relative risk=RR=1.050; 95% confidence interval=CI=1.013-1.087), delirium (RR=3.577; 95% CI 1.096-11.672), diabetes (RR=5.913; 95% CI 1.693-20.644), balance deficit (RR=0.914; 95% CI 0.861-0.970) and polypharmacy (RR=1.226; 95% CI 1.122-1.340) were independently predictive of falling. Fallers had a prolonged length of stay (LOS) (35.5+/-47.8 days vs. 23.2+/-27.2; p=0.01) and more frequent nursing home placements (12.9% vs.5.6%; p<0.005). The knowledge of falling predictors might help in planning specific preventive strategies to improve the patients' global health status and to reduce the costs of medical care.
Corsinovi
Laura
L
Section of Geriatrics, Department of Medical and Surgical Disciplines, Ospedale San Giovanni Battista-Molinette, Corso Bramante 88, I-10126 Torino, Italy. laura.corsinovi@unito.it
Bo
Mario
M
Ricauda Aimonino
Nicoletta
N
Marinello
Renata
R
Gariglio
Federico
F
Marchetto
Cristina
C
Gastaldi
Laura
L
Fissore
Laura
L
Zanocchi
Mauro
M
Molaschi
Mario
M
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000208:Acute Disease; D000368:Aged; D002391:Catchment Area, Health; D005260:Female; D006299:Health Services for the Aged; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies