title: Is it possible to identify risks for injurious falls in hospitalized patients?
abstract: BACKGROUND
  Patient falls are among the most commonly reported adverse hospital events with more than one million occurring annually in the United States; approximately 10% result in serious injury. A retrospective study was conducted to determine predictors and outcomes of fall injuries among a cohort of adult hospitalized patients.
  
  
  METHODS
  Data were obtained regarding patients who sustained an initial fall in hospital during a 26-month period from 16 adult general medical and surgical units in an urban university-affiliated community hospital. Data on intrinsic (individual) factors, extrinsic (environmental) factors, and situational activities were collected via nurse and patient interviews, patient examinations, and audits of incident reports and electronic health records. Fall injuries were classified as none/any for analyses. Unadjusted odds ratios [ORs] and 95% confidence intervals [CIs] for each of the variables of interest with fall injury were generated using logistic regressions.
  
  
  RESULTS
  The 784 patients had a median age of 63.5 years (range, 20 to > 90 years), 390 (50%) were women, and 526 (67%) were black. Some 228 (29%) fallers sustained injury; patients who were white (OR: 2.23; 95% CI: 1.62, 3.08), or were administered a selective serotonin reuptake inhibitor (OR: 1.04; 95% CI: 1.04, 2.67), two antipsychotic agents (OR: 3.26; 95% CI: 1.20, 8.90), an opiate (OR: 1.59; 95%; CI: 1.14, 2.20), or a diuretic non-antihypertensive agent (OR: 1.53; 95% CI: 1.03, 2.26) were more likely to sustain an injury. Home-based wheelchair use was protective of fall injury (OR: 0.20; 95% CI: 0.05, 0.84). Seventy-nine percent of the patients had been designated as "high" fall risk within 24 hours before the fall.
  
  
  CONCLUSIONS
  Few variables were able to distinguish patients who sustained injury after a hospital fall, further challenging clinicians' efforts to minimize hospital-related fall injury.
authors.affiliation: Vanderbilt University School of Nursing, Nashville, Tennessee, USA. Lorraine.c.mion@vanderbilt.edu
authors.forename: Lorraine C
authors.initials: LC
authors.lastname: Mion
authors.forename: A Michelle
authors.initials: AM
authors.lastname: Chandler
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Waters
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
authors.forename: Lori A
authors.initials: LA
authors.lastname: Kessler
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Miller
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Shorr
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control*