Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors.
BACKGROUND
Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality.


OBJECTIVE
Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program.


METHODS
Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment.


RESULTS
About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years (P<0.001), body mass index (BMI) <23.5 (P=0.007), Mini-Mental State Examination <20 (P=0.004), Barthel Index <65 (P=0.002), hemoglobin <7.69 mmol/L (P=0.017), serum protein <70 g/L (P=0.008), albumin <32 g/L (P=0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49;P<0.001), history of falls (OR =2.55; 95% CI =1.05-6.19;P=0.039), age (OR =1.14; 95% CI =1.05-1.23;P=0.001), and BMI (OR =0.91; 95% CI =0.83-0.99;P=0.034).


CONCLUSIONS
Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.
Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Katarzyna
K
Mazur
Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Krzysztof
K
Wilczyński
Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Jan
J
Szewieczek
D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D003693:Delirium / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011044:Poland; D011446:Prospective Studies; D012307:Risk Factors
body mass index; comprehensive geriatric assessment; delirium; falls; geriatric inpatients
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