title: Characteristics associated with falls among the elderly within aged care wards in a tertiary hospital: a retrospective.
abstract: BACKGROUND
  Falls are the most frequently reported adverse events in inpatient settings. We conducted a retrospective case-control study of inpatient falls within aged care wards in a tertiary hospital to investigate the associated characteristics of elderly patients suffering from falls and fall-related characteristics.
  
  
  METHODS
  Consecutive retrospective cross-sectional design spanned July 2006 to December 2008.
  
  
  METHODS
  Information on all aged care inpatients who suffered from 1 or more falls was extracted from Incident Information Management System (IIMS). Further details about the particular admission(s) were obtained from patients' medical records, e.g., patients' characteristics and circumstances surrounding the falls. Randomly selected aged care patients who did not suffer from a fall and who were discharged from the hospital in the same period served control group. Characteristics among patients with single fall and recurrent falls, as well as non-fallers were compared.
  
  
  RESULTS
  Of the 438 falls evaluated, 71.9% occurred in patients' room and 18.9% in patients' bathroom/toilet. The common activities were moving/transferring and taking shower/toileting, respectively, 70.3%, 12.1% while occurring falls; and time of falls had a high peak during 9:00-11:00 a.m. Many were unassisted while falling. The common contributing factors for fall were intrinsic factors. Patients with recurrent falls were more likely to have lower Mini-Mental State Examination (MMSE) score. Logistic regression analysis showed length of stay longer than five weeks, dementia and stroke were independent risk factors for recurrent falls; and living in hostel/nursing home preadmission, needing assistance with mobility, cognitive impairment, stroke, incontinence and arthritis/osteoporosis were independent risk factors for fall.
  
  
  CONCLUSIONS
  In an aged care ward, falls are independently associated with recurrent factors. Cognitive impairment/dementia was a strong risk factor for falls, and main causes leading to fall were intrinsic factors. For patients with cognitive impairment/dementia and behavioral disorder providing special and effective interventions is of paramount importance for reducing the incidence of fall in an aged care ward in hospital settings.
authors.affiliation: Department of Rehabilitation, Beijing Geriatric Hospital, Beijing 100095, China.
authors.forename: Xue-Li
authors.initials: XL
authors.lastname: Chen
authors.forename: Yun-Hu
authors.initials: YH
authors.lastname: Liu
authors.forename: Daniel K Y
authors.initials: DK
authors.lastname: Chan
authors.forename: Qing
authors.initials: Q
authors.lastname: Shen
authors.forename: Huong
authors.initials: H
authors.lastname: Van Nguyen
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors