Association of medication use with increased fall risk in inpatients: a single-center matched study

Background: Evaluation of drug-induced fall risk is often neglected in clinical practice. The purpose of this study was to analyze the effects of medication use on falls in hospitalized elderly patients. Methods: This was a retrospective case-control study. A total of 1,020 patients were evaluated who were 60 years and over and admitted between January 1st and December 31, 2021. Patients aged 60 years and over with reports of fall accidents in 2021 were included in the fall group. Cases were matched 1:4 on sex, age, medical department, and Morse Fall Scale (MFS) score to randomly selected control from patients with no falls. Demographics, MFS score, physical examination, and medication profile were collected from electronic medical records. Data were analyzed by chi-square test and multiple logistic regression analysis.Results: After adjustment for age, sex, medical department, MFS score and Charlson comorbidity index, hemoglobin level, sodium level, ambulatory aid, gait/transferring (impaired), mental status, polypharmacy (10 and more), use of anxiolytics, antipsychotics, opioids, and anticholinergics were significantly associated with falls. On multiple regression analysis, hemoglobin level, ambulatory aid (furniture), use of anxiolytics, and opioids were significantly associated with falls in every model. Conclusions: The type of medication, especially anxiolytics and opioids, was more significantly associated with increased risk of falls than polypharmacy. It is suggested to be aware of the effects of medication on falls and evaluate medication use on a regular basis.