In-Hospital Sequelae of Injurious Falls in 24 Medical/Surgical Units in Four Hospitals in the United States

摘要

Background: Up to 50% of patient falls in the hospital result in injury. This study was conducted to determine whetherinjurious falls were associated with increased hospital length of stay (LOS), discharge to a place other than home, and inhospitalmortality.Methods: A secondary data analysis from a prospective case-control study was conducted in 24 medical/surgical unitsin four hospitals in the United States. Patients who fell and sustained an injury were matched with at least one controlpatient who was on the same unit, at the same time, for a similar number of days on the unit at the time of the fall. Datawere collected by viewing patients’ electronic health records, as well as the hospitals’ incident reporting systems. Logisticregression and Cox regression analyses were conducted.Results: The 1,033 patients (mean age, 63.7 years; 510 males [49.4%]) who sustained an injurious fall were matched with1,206 controls (mean age, 61.6 years; 486 males [40.3%]). Fallers were significantly more likely than controls to stay longerthan 10 days in the hospital (odds ratio [OR], 1.59; 95% confidence interval [CI] = 1.46–1.74) and to be discharged to aplace other than home (OR, 1.52; 95% CI = 1.21–1.91).Conclusion: Compared to controls, hospital patients who sustained an injurious fall had longer LOS and were morelikely discharged to a place other than home. These associations remained when controlling for patient-level confounders,suggesting that the fall altered trajectory was sustained toward these outcomes. Injurious falls were not significantly associatedwith increased risk of mortality.