Risk of Home Falls Among Older Adults After Acute Care Hospitalization: A Cohort Study.

IF 0.7 4区 医学 Q4 CRITICAL CARE MEDICINE
Journal of Trauma Nursing Pub Date : 2024-11-01 Epub Date: 2024-11-07 DOI:10.1097/JTN.0000000000000816
Christy M Adams, Daniel J Tancredi, Janice F Bell, Sheryl L Catz, Patrick S Romano
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引用次数: 0

Abstract

Background: Acute care hospitalization has been associated with older adult home falls after discharge, but less is known about the effects of hospital- and patient-related factors on home fall risk.

Objectives: This study compares the effects of hospital length of stay, medical condition, history of falls, and home health care on period rates of home falls after discharge from acute care hospitalization.

Methods: This was a retrospective cohort study comparing period rates of home injury falls among older adults (age ≥ 65) occurring after discharge from an acute care hospitalization. Data were collected from state health care utilization administrative records between January 1, 2016, and December 31, 2018. We used log-linear Poisson regression to model post-discharge injury fall incidence rates as a function of days since discharge and patient-level covariates.

Results: A total of 736,230 older adults were included in the study cohort. Absolute risk for post-discharge home falls was 7%. Fall rates were highest the first week after discharge at 0.05 per 100 person-days, with a period incidence rate 74.29 times higher than the >90-day discharge period. Fall risk increased with age, with the highest risk in the ≥85 age group. Fall risk increased for a 2-day hospital stay but decreased for 5- to 30-day stays, compared to a 1-day length of stay. Discharge to home health care and history of falls were associated with increased risk.

Conclusions: Older adults are at highest risk for a home fall the first 7 days after discharge from acute care hospitalization. These findings describe patient-related risk factors that acute care hospitals can use to develop geriatric-specific discharge guidelines intended to reduce home fall risk during the early care transition to home.

老年人急性护理住院后家中跌倒的风险:一项队列研究
背景:急诊住院治疗与老年人出院后在家跌倒有关,但对医院和患者相关因素对在家跌倒风险的影响知之甚少。目的:本研究比较住院时间、医疗状况、跌倒史和家庭保健对急症住院出院后家庭跌倒率的影响。方法:这是一项回顾性队列研究,比较老年人(≥65岁)在急症住院治疗出院后发生的家庭伤害跌倒的期间发生率。数据收集自2016年1月1日至2018年12月31日期间的国家医疗保健利用行政记录。我们使用对数线性泊松回归对出院后损伤跌倒发生率作为出院天数和患者水平协变量的函数进行建模。结果:共有736,230名老年人被纳入研究队列。出院后家中跌倒的绝对风险为7%。出院后第1周跌倒发生率最高,为0.05例/ 100人天,比出院后90天的发病率高74.29倍。跌倒风险随年龄增加而增加,在≥85岁年龄组中风险最高。与住院1天相比,住院2天的跌倒风险增加,但住院5至30天的跌倒风险降低。出院后接受家庭保健和有跌倒史与风险增加有关。结论:老年人在急症护理住院出院后的头7天发生家中跌倒的风险最高。这些发现描述了与患者相关的风险因素,急性护理医院可以利用这些因素来制定针对老年患者的出院指南,旨在减少早期护理过渡到家庭期间的家庭跌倒风险。
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来源期刊
Journal of Trauma Nursing
Journal of Trauma Nursing CRITICAL CARE MEDICINENURSING&-NURSING
CiteScore
1.20
自引率
10.00%
发文量
106
期刊介绍: ​Journal of Trauma Nursing (JTN) is the official journal of the Society of Trauma Nurses. The Society of Trauma Nurses believes that trauma is a disease impacting patients through the continuum of care. The mission of STN is to ensure optimal trauma care through education, collaboration, leadership and membership engagement. As the official publication of the Society of Trauma Nurses, the Journal of Trauma Nursing supports the STN’s strategic goals of effective communication, education and patient advocacy with original, peer-reviewed, research and evidence-based articles and information that reflect the highest standard of collaborative care for trauma patients.​ The Journal of Trauma Nursing, through a commitment to editorial excellence, implements STN’s vision to improve practice and patient outcomes and to become the premiere global nursing organization across the trauma continuum.
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