Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness

David Basic,1 Tabitha J Hartwell2 1Department of Geriatric Medicine, Liverpool Hospital, Sydney, NSW, Australia; 2Department of Geriatric Medicine and Rehabilitation, Shoalhaven District Memorial Hospital, Nowra, NSW, Australia Purpose: To examine the association between falls in hospital and new...

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Autores principales:	Basic D, Hartwell TJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	aged inpatients falls nursing homes Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/d63c79f06f2a40c1acede3bb259efbe4
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spelling	oai:doaj.org-article:d63c79f06f2a40c1acede3bb259efbe42021-12-02T05:51:41ZFalls in hospital and new placement in a nursing home among older people hospitalized with acute illness1178-1998https://doaj.org/article/d63c79f06f2a40c1acede3bb259efbe42015-10-01T00:00:00Zhttps://www.dovepress.com/falls-in-hospital-and-new-placement-in-a-nursing-home-among-older-peop-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998David Basic,1 Tabitha J Hartwell2 1Department of Geriatric Medicine, Liverpool Hospital, Sydney, NSW, Australia; 2Department of Geriatric Medicine and Rehabilitation, Shoalhaven District Memorial Hospital, Nowra, NSW, Australia Purpose: To examine the association between falls in hospital and new placement in a nursing home among older people hospitalized with acute illness.Materials and methods: This prospective cohort study of 2,945 consecutive patients discharged alive from an acute geriatric medicine service used multivariate logistic regression to model the association between one or more falls and nursing home placement (primary analysis). Secondary analyses stratified falls by injury and occurrence of multiple falls. Demographic, medical, and frailty measures were considered in adjusted models.Results: The mean age of all patients was 82.8±7.6 years and 94% were admitted through the emergency department. During a median length of stay (LOS) of 11 days, 257 (8.7%) patients had a fall. Of these, 66 (25.7%) sustained an injury and 53 (20.6%) had two or more falls. Compared with nonfallers, fallers were more likely to be placed in a nursing home (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.37–3.00), after adjustment for age, sex, frailty, and selected medical variables (including dementia and delirium). Patients without injury (OR: 1.83, 95% CI: 1.17–2.85) and those with injury (OR: 2.35, 95% CI: 1.15–4.77) were also more likely to be placed. Patients who fell had a longer LOS (median 19 days vs 10 days; P<0.001).Conclusion: This study of older people in acute care shows that falls in the hospital are significantly associated with new placement in a nursing home. Given the predominantly negative experiences and the financial costs associated with placement in a nursing home, fall prevention should be a high priority in older people hospitalized with acute illness. Keywords: aged, inpatients, falls, nursing homesBasic DHartwell TJDove Medical Pressarticleagedinpatientsfallsnursing homesGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1637-1643 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	aged inpatients falls nursing homes Geriatrics RC952-954.6
spellingShingle	aged inpatients falls nursing homes Geriatrics RC952-954.6 Basic D Hartwell TJ Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness
description	David Basic,1 Tabitha J Hartwell2 1Department of Geriatric Medicine, Liverpool Hospital, Sydney, NSW, Australia; 2Department of Geriatric Medicine and Rehabilitation, Shoalhaven District Memorial Hospital, Nowra, NSW, Australia Purpose: To examine the association between falls in hospital and new placement in a nursing home among older people hospitalized with acute illness.Materials and methods: This prospective cohort study of 2,945 consecutive patients discharged alive from an acute geriatric medicine service used multivariate logistic regression to model the association between one or more falls and nursing home placement (primary analysis). Secondary analyses stratified falls by injury and occurrence of multiple falls. Demographic, medical, and frailty measures were considered in adjusted models.Results: The mean age of all patients was 82.8±7.6 years and 94% were admitted through the emergency department. During a median length of stay (LOS) of 11 days, 257 (8.7%) patients had a fall. Of these, 66 (25.7%) sustained an injury and 53 (20.6%) had two or more falls. Compared with nonfallers, fallers were more likely to be placed in a nursing home (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.37–3.00), after adjustment for age, sex, frailty, and selected medical variables (including dementia and delirium). Patients without injury (OR: 1.83, 95% CI: 1.17–2.85) and those with injury (OR: 2.35, 95% CI: 1.15–4.77) were also more likely to be placed. Patients who fell had a longer LOS (median 19 days vs 10 days; P<0.001).Conclusion: This study of older people in acute care shows that falls in the hospital are significantly associated with new placement in a nursing home. Given the predominantly negative experiences and the financial costs associated with placement in a nursing home, fall prevention should be a high priority in older people hospitalized with acute illness. Keywords: aged, inpatients, falls, nursing homes
format	article
author	Basic D Hartwell TJ
author_facet	Basic D Hartwell TJ
author_sort	Basic D
title	Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness
title_short	Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness
title_full	Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness
title_fullStr	Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness
title_full_unstemmed	Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness
title_sort	falls in hospital and new placement in a nursing home among older people hospitalized with acute illness
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/d63c79f06f2a40c1acede3bb259efbe4
work_keys_str_mv	AT basicd fallsinhospitalandnewplacementinanursinghomeamongolderpeoplehospitalizedwithacuteillness AT hartwelltj fallsinhospitalandnewplacementinanursinghomeamongolderpeoplehospitalizedwithacuteillness
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Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness

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