Falls in hospital: a case-control study.
Gudrun Cathrine Lindgren de Groot, Ahmad Al-Fattal, Irene Sandven
PMID 31294860WHAT IT FOUND
Hospital patients with poor or very poor balance were far more likely to fall.
Older age, male sex and sedating or mental-health drugs were also linked. Check balance and review these drugs early.
Key findings
01In Model A, poor balance had an OR of 21.50 (95% CI 10.26 to 45.04) and very poor balance an OR of 19.62 (95% CI 9.55 to 40.27) for falling.
02In Model B, each 10-year age increase had an OR of 1.51 (95% CI 1.34 to 1.69), reported by the authors as a 50% increase in the probability of falling.
03In Model A, anxiolytic/hypnotic drugs had an OR of 1.80 (95% CI 1.22 to 2.67), antiepileptic drugs an OR of 1.13 (95% CI 1.11 to 4.06), and antipsychotic drugs an OR of 2.01 (95% CI 1.15 to 3.51); in Model B, antipsychotic drugs had an OR of 3.27 (95% CI 1.94 to 5.51) and antidepressant drugs an OR of 3.85 (95% CI 1.09 to 13.63).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study used old medical records, so fall status and risk factors could be incomplete or inaccurate. It was done in one hospital, so it may not apply to other settings. It could not establish whether the risk factors were present before the fall. Vision, dizziness and cognitive status were not measured, so other fall risks may have been missed. Personal assistance and walking aids were not investigated. The final models did not include renal function, chronic diseases or opioids, so they do not show every possible association.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not conclude that assessing balance or reviewing medications prevents falls. This was a retrospective case-control study of associations, not a trial of interventions, and it could not establish the timing between risk factors and falls.