Background: Falls represent growing problem among older people worldwide. According to US emergency department data, the estimated number of fall-related hospitalizations in older adults increased 50%. At today, we do know much on where, how, and why an older hospital inpatient falls. However, when falls occur is not often reported. We aimed to explore the recent literature on in-hospital falls, to evaluate how frequently the epidemiological studies reported time of events. Methods and Results: Relevant papers published from 2009 to 2011 were searched across the PubMed database. The following Medical Subject Heading (MeSH) terms were used: "Aged”, “Aged, 80 and over", and "Accidental Falls". Systematic reviews, meta-analyses, controlled trials, cohort studies, case-control studies and transversal studies were considered for inclusion. Out of 320 references, we considered 15 studies (3314 cases). Settings were included psychiatric or psychogeriatric, rehabilitation, either stroke, orthopaedic, trauma, geriatric, medicine, nephrology and hemodialysis, intensive care unit, long term care, palliative care and hospice. The lowest number of cases per study was 17 and highest 657. Eight studies (53%, 1749 cases) contained report on time of falls, although the method of time reporting was not homogenous. Discussion: Falls are among the most common and severe adverse events for hospitalized older patients, and more often fall events occur during the night. Daytime or nighttime preferred peaks of events may underly different causes. The majority of diurnal/morning falls occur in patients' room and bathroom/toilet, in relation with daily common activities, i.e., moving/transferring and taking shower/toileting. Bathroom, however, represents a risk also during night hours, due to the use of antihypertensive medications (in particular thiazide diuretics) and sedatives. It is possible that different risk windows may be present in a same setting, and prevention strategies need a deep knowledge of all the potential risk factors. Adding precise indication of time of falls to the minimum data set, could provide useful additional information and help prevention efforts.
Time of Occurrence of In-Hospital Falls: A Systematic Mini Review
MANFREDINI, Roberto;FABBIAN, Fabio;PALA, Marco;
2012
Abstract
Background: Falls represent growing problem among older people worldwide. According to US emergency department data, the estimated number of fall-related hospitalizations in older adults increased 50%. At today, we do know much on where, how, and why an older hospital inpatient falls. However, when falls occur is not often reported. We aimed to explore the recent literature on in-hospital falls, to evaluate how frequently the epidemiological studies reported time of events. Methods and Results: Relevant papers published from 2009 to 2011 were searched across the PubMed database. The following Medical Subject Heading (MeSH) terms were used: "Aged”, “Aged, 80 and over", and "Accidental Falls". Systematic reviews, meta-analyses, controlled trials, cohort studies, case-control studies and transversal studies were considered for inclusion. Out of 320 references, we considered 15 studies (3314 cases). Settings were included psychiatric or psychogeriatric, rehabilitation, either stroke, orthopaedic, trauma, geriatric, medicine, nephrology and hemodialysis, intensive care unit, long term care, palliative care and hospice. The lowest number of cases per study was 17 and highest 657. Eight studies (53%, 1749 cases) contained report on time of falls, although the method of time reporting was not homogenous. Discussion: Falls are among the most common and severe adverse events for hospitalized older patients, and more often fall events occur during the night. Daytime or nighttime preferred peaks of events may underly different causes. The majority of diurnal/morning falls occur in patients' room and bathroom/toilet, in relation with daily common activities, i.e., moving/transferring and taking shower/toileting. Bathroom, however, represents a risk also during night hours, due to the use of antihypertensive medications (in particular thiazide diuretics) and sedatives. It is possible that different risk windows may be present in a same setting, and prevention strategies need a deep knowledge of all the potential risk factors. Adding precise indication of time of falls to the minimum data set, could provide useful additional information and help prevention efforts.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
