A Retrospective Case-Control Study Evaluating Medications Associated with Inpatient Falls in a Single Veterans Affairs Medical Center.

Abstract

Background Falls, specifically in the older population, can lead to adverse health consequences including fractures, head injuries, and increased length of hospital stay. In addition, falls greatly increase total medical costs. Although risk factors have been identified and studied, inpatient falls still occur at a high rate. Objectives The primary objective of this study was to identify the medications associated with inpatient falls when compared to a matched control group of patients who did not fall at a Veterans Affairs Medical Center (VAMC). Methods This single-center, case-control, retrospective study reviewed patients admitted to a VAMC from August 2018 to August 2023. Patients were included if they were 65 years of age or older and admitted for at least 48 hours. Patients admitted to the intensive care unit or hospice unit were excluded. Fall patients were matched 1:1 to the control group for age, gender, length of stay, and service type at time of fall. The primary outcome was identifying medications associated with falls. Results Antipsychotics (P = 0.009), non-sedating antidepressants (P = 0.011), and finasteride (P = 0.034) were found to have a higher association with falls compared to the control group. Comorbidities with higher association with falls were history of falls (P = 0.001) and urinary incontinence (P = 0.013). Conclusion Administration of antipsychotics and nonsedating antidepressants increased risk of inpatient falls in this study. Further research is needed with larger and more diverse patient populations to validate these results.