Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors

Katarzyna Mazur, Krzysztof Wilczyński, Jan Szewieczek Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Background: Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortal...

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Autores principales:	Mazur K, Wilczyński K, Szewieczek J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	falls geriatric inpatients comprehensive geriatric assessment delirium body mass index Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/cb898fee41f84e4d806460359f119180
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spelling	oai:doaj.org-article:cb898fee41f84e4d806460359f1191802021-12-02T00:38:19ZGeriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors1178-1998https://doaj.org/article/cb898fee41f84e4d806460359f1191802016-09-01T00:00:00Zhttps://www.dovepress.com/geriatric-falls-in-the-context-of-a-hospital-fall-prevention-program-d-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Katarzyna Mazur, Krzysztof Wilczyński, Jan Szewieczek Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland 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 (x̅ ± 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).Conclusion: 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. Keywords: falls, geriatric inpatients, comprehensive geriatric assessment, delirium, body mass indexMazur KWilczyński KSzewieczek JDove Medical Pressarticlefallsgeriatric inpatientscomprehensive geriatric assessmentdeliriumbody mass indexGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 1253-1261 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	falls geriatric inpatients comprehensive geriatric assessment delirium body mass index Geriatrics RC952-954.6
spellingShingle	falls geriatric inpatients comprehensive geriatric assessment delirium body mass index Geriatrics RC952-954.6 Mazur K Wilczyński K Szewieczek J Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
description	Katarzyna Mazur, Krzysztof Wilczyński, Jan Szewieczek Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland 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 (x̅ ± 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).Conclusion: 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. Keywords: falls, geriatric inpatients, comprehensive geriatric assessment, delirium, body mass index
format	article
author	Mazur K Wilczyński K Szewieczek J
author_facet	Mazur K Wilczyński K Szewieczek J
author_sort	Mazur K
title	Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_short	Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_full	Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_fullStr	Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_full_unstemmed	Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_sort	geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/cb898fee41f84e4d806460359f119180
work_keys_str_mv	AT mazurk geriatricfallsinthecontextofahospitalfallpreventionprogramdeliriumlowbodymassindexandotherriskfactors AT wilczynskik geriatricfallsinthecontextofahospitalfallpreventionprogramdeliriumlowbodymassindexandotherriskfactors AT szewieczekj geriatricfallsinthecontextofahospitalfallpreventionprogramdeliriumlowbodymassindexandotherriskfactors
_version_	1718403582308384768

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors

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