title: Risk of falling and hypnotic drugs: retrospective study of inpatients.
abstract: BACKGROUND
  Falls and related injuries remain a concern for patient safety in many hospitals and nursing care facilities. In particular, reports examining the relationship between accidents and drugs with a sedative effect have been increasing; however, the analysis of correlation between the background factors of fall accidents and the detailed therapeutic category of drugs is insufficient.
  
  
  OBJECTIVE
  Our objective was to estimate fall risk following the administration of hypnotics in inpatients within an acute hospital. We assessed the relationship between falls and hypnotic drugs compared with other medicines.
  
  
  METHODS
  An inpatient population-based study was carried out at Gunma University Hospital, where all inpatients admitted between 1 October and 31 December 2007 were included. Over a 3-month follow-up period, all reports of falling accidents from ward medical staff were investigated.
  
  
  CONCLUSIONS
  Falls occurred in 1.8% of males and 1.3% of females in the study population (n = 3,683). The mean age of patients who experienced falls (64.7 ± 19.5 years) was significantly higher than that of patients who did not (56.2 ± 20.2 years). Multivariate analysis revealed the following drugs as high-risk factors for falling: hypnotics (odds ratio [OR] 2.17, 95% CI 1.44-3.28), antiepileptics (OR 5.06, 95% CI 2.70-9.46), opioids (OR 3.91, 95% CI 2.16-7.10), anti-Alzheimer's (OR 5.74, 95% CI 1.62-20.3), anti-Parkinson's (OR 5.06, 95% CI 1.58-16.24), antidiabetics (OR 3.08, 95% CI 1.63-5.84), antihypertensives (OR 2.24, 95% CI 1.41-3.56), and antiarrhythmics (OR 2.82, 95% CI 1.36-5.86). Multivariate logistic regression analysis of hypnotics, brotizolam, zopiclone, and estazolam revealed a significant association with an increased risk of inpatient falling accidents, while zolpidem, triazolam, flunitrazepam, and nitrazepam did not.
  
  
  CONCLUSIONS
  The present findings suggest that the risk of falling accidents in hospitals differs according to the type of hypnotic drug administered. The appropriate selection of hypnotic drugs, therefore, might be important for reducing the number of patient falls.
authors.affiliation: Department of Pharmacy, Gunma University Hospital, 3-39-15 Showamachi, Maebashi, Gunma 371-8511, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Obayashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Araki
authors.forename: Katsunori
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nojima
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hara
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nakamura
authors.forename: Koujirou
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006993:Hypnotics and Sedatives; D055553:Prescription Drugs