Objective: Identify factors that predict fall-related injury in hospitalized adults. Design: Retrospective cohort study. Setting: 435-bed university hospital. Participants: Inpatients with reported falls in 2010. Results: Medical records were available for 286/293 (98%) of reported falls in 251 patients. 25% (63/286) of falls were associated with injury, 4% (11/286) with serious injury. Compared to all fallers, patients with injury did not differ by gender or age. In univariate analysis, patients who reported hitting their head, had pre-fall confusion, or who received narcotics within 24 hours before falling were more likely to suffer injury (estimated odds ratios 6.04, 2.00 and 5.1, respectfully). In multivariate analysis, receiving a narcotic prior to falling was the strongest predictor of injury (estimated odds ratio 5.59; 95% confidence intervals 2.14 — 14.65, p <0.001). Conclusions: In this single-institution study, 25% of patients who fell suffered injury and 4% serious injury. Neither age nor gender predicted fall-related injury. Recent narcotic administration was the strongest predictor of injury. Strategies to prevent fall-related injury in the hospital should target patients receiving narcotics. When evaluating inpatients who have fallen, providers should be especially vigilant about injury in patients who have pre-fall confusion, hit their head, or have received recent narcotics.
The International Journal of Risk & Safety in Medicine
Int J Risk Saf Med 2013;25(4):229-34.