title: The incidence of falls in intensive care survivors.
abstract: BACKGROUND
  Falling among adults in acute care is an important problem with falls rates in tertiary hospitals ranging from 2% to 5%. Factors that increase the risk of falling, such as advanced age, altered mental status, medications that act on the central nervous system and poor mobility, often characterise individuals who survive a prolonged intensive care unit (ICU) admission.
  
  
  OBJECTIVE
  To measure the incidence of falls and describe the characteristics of fallers among intensive care survivors.
  
  
  METHODS
  A comprehensive retrospective chart review was undertaken of 190 adults who were intubated and ventilated for ≥ 168 h and survived their acute care stay. Using a standardised form, several variables were extracted including falls during hospitalisation and risk factors such as age, severity of illness, and length of stay in intensive care and hospital.
  
  
  RESULTS
  Thirty-two (17%, 95% confidence interval 11.5-22.2%) patients fell at least once on the in-patient wards following their ICU stay. Compared with non-fallers, fallers were younger (53.2 ± 17.9 vs. 44.1 ± 18.3 years; p=0.009) and had a shorter duration of inotropic support in ICU (84 ± 112 vs. 56 ± 100 h; p=0.040). The majority of fallers were aged less than 65 years (84%). Both fallers and non-fallers had similar APACHE II scores (20 ± 8 vs. 21 ± 7; p=0.673), length of stay in intensive care (14.2 ± 8.7 vs. 14.0 ± 9.7 days; p=0.667) and hospital length of stay (43.9 ± 33.1 vs. 41.0 ± 38.8 days; p=0.533).
  
  
  CONCLUSIONS
  Falling during hospitalisation is common in intensive care survivors. Compared with non-fallers, fallers were younger and required inotropes for a shorter duration. Those who survive a prolonged admission to an ICU may benefit from specific assessment of balance and falls risk by the multidisciplinary team.
authors.affiliation: School of Physiotherapy and Institute for Health and Rehabilitation Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia. shane.patman@nd.edu.au
authors.forename: Shane M
authors.initials: SM
authors.lastname: Patman
authors.forename: Diane
authors.initials: D
authors.lastname: Dennis
authors.forename: Kylie
authors.initials: K
authors.lastname: Hill
mesh_terms: D018806:APACHE; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors