title: Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unit.
abstract: 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.
authors.affiliation: 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
authors.forename: Laura
authors.initials: L
authors.lastname: Corsinovi
authors.forename: Mario
authors.initials: M
authors.lastname: Bo
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Ricauda Aimonino
authors.forename: Renata
authors.initials: R
authors.lastname: Marinello
authors.forename: Federico
authors.initials: F
authors.lastname: Gariglio
authors.forename: Cristina
authors.initials: C
authors.lastname: Marchetto
authors.forename: Laura
authors.initials: L
authors.lastname: Gastaldi
authors.forename: Laura
authors.initials: L
authors.lastname: Fissore
authors.forename: Mauro
authors.initials: M
authors.lastname: Zanocchi
authors.forename: Mario
authors.initials: M
authors.lastname: Molaschi
mesh_terms: 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