Incidence and Risk Factors for Subsequent Adverse Events among Outpatients after an In-Hospital Fall.

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Eitaro Kodani, Yukiko Takeda, Misako Iida, Yukiko Takagi, Tami Okumura, Eriko Miyao, Masami Akeda
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Abstract

Background: Information is limited on the incidence and risk factors for further serious conditions after an in-hospital fall. Using data from the incident-accident reports, we assessed the incidence and risk factors for subsequent adverse events (SAEs) among outpatients after in-hospital falls.

Methods: Incident-accident reports from April 2017 to March 2024 at Nippon Medical School Tama Nagayama Hospital were reviewed to identify outpatient falls. Data on patient characteristics and fall-related details were collected. Multivariable logistic regression analysis was performed to identify risk factors for SAEs.

Results: We analyzed data from 118 outpatients with in-hospital falls (mean age: 76.4±11.7 years; male: 56.8%): 39 (33.1%) experienced SAEs, including 5 fractures (4.2%), 13 functional disorders (11.0%), 17 surgical procedures (14.4%), and 17 admissions (14.4%). Multivariable analysis showed that males had a significantly higher odds ratio (OR) for SAEs than females, even after adjusting for age (OR, 2.80; 95% CI, 1.21-6.48; P=0.016). For each SAE, the floor of the fall, number of previous falls, and site of the fall were significantly associated with a subsequent fracture, functional disorder, and surgical procedure after an in-hospital fall, respectively.

Conclusions: The incidence rate of SAEs among outpatients with in-hospital falls was 33.1%. Male sex was the only significant risk factor for SAEs, and factors contributing to individual SAE types were distinct. To prevent further adverse outcomes after in-hospital falls, medical staff should pay more attention to patients with these risk factors.

住院患者跌倒后门诊患者不良事件的发生率及危险因素
背景:关于院内跌倒后进一步严重疾病的发生率和危险因素的信息有限。使用事故-事故报告中的数据,我们评估了住院患者跌倒后门诊患者后续不良事件(SAEs)的发生率和危险因素。方法:回顾2017年4月至2024年3月日本医学院多摩长山医院的事故报告,以确定门诊跌倒。收集患者特征和跌倒相关细节的数据。进行多变量logistic回归分析以确定SAEs的危险因素。结果:我们分析了118例住院跌倒门诊患者的资料(平均年龄:76.4±11.7岁;男性:56.8%):39例(33.1%)发生SAEs,包括5例骨折(4.2%),13例功能障碍(11.0%),17例手术(14.4%)和17例入院(14.4%)。多变量分析显示,即使在调整年龄后,男性发生SAEs的优势比(OR)也显著高于女性(OR, 2.80; 95% CI, 1.21-6.48; P=0.016)。对于每个SAE,跌倒的楼层、先前跌倒的次数和跌倒的位置分别与随后的骨折、功能障碍和住院跌倒后的手术程序显著相关。结论:住院跌倒患者发生急性脑损伤的发生率为33.1%。男性性别是SAE的唯一显著危险因素,导致SAE类型的因素各不相同。为防止住院跌倒后发生进一步的不良后果,医务人员应更加重视具有这些危险因素的患者。
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来源期刊
Journal of Nippon Medical School
Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-
CiteScore
1.80
自引率
10.00%
发文量
118
期刊介绍: The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.
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