Predictors of serious injury among hospitalized patients evaluated for falls.
BACKGROUND
Inpatient falls are common and result in significant patient morbidity.


OBJECTIVE
To identify predictors of serious injury being found on imaging studies of inpatients evaluated after a fall.


METHODS
Retrospective study.


METHODS
: An 1171-bed urban academic medical center.


METHODS
All inpatients who fell on thirteen medical and surgical units from January 1 to December 31, 2006.


METHODS
Patient characteristics, circumstances surrounding falls, fall-related injuries, and length of stay were collected through review of incident reports and computerized medical records. Primary outcome of fall-related injury was determined by evidence of injury on imaging studies within two weeks of the fall. Univariate and multivariate logistic regression were used to calculate adjusted odds ratios (ORs) for injury after an inpatient fall.


RESULTS
A total of 513 patients had 636 falls during the study time period. Fall incidence rate was 1.97 falls per 1,000 patient days. 95 patients (19%) fell multiple times (range, 2-6 events); 74% of the falls occurred in patients who were previously assessed as being "at risk" by the nursing staff. Multivariate analysis, adjusting for age and sex, found evidence of trauma after a fall (OR = 24.6, P < 0.001) and ambulatory status (OR = 7.3, P < 0.01) to be independent predictors of injury being found on imaging studies.


CONCLUSIONS
Inpatient falls are common despite high-risk patients being identified. After adjusting for age and sex, evidence of trauma and ambulatory status were independent predictors of an injury being found on imaging studies after an inpatient fall.
Bradley
Sara M
SM
The Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York 10029, USA. Sara.Bradley@mssm.edu
Karani
Reena
R
McGinn
Thomas
T
Wisnivesky
Juan
J
D000046:Academic Medical Centers; D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005544:Forecasting; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City; D016017:Odds Ratio; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D055815:Young Adult