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Risk Factors for Fall in Elderly Patients:Follow-Up Study after Hospital Discharge

Open Journal of Internal Medicine 2018年第4期8卷 220-231页

作者： Pedro Caetano Joao Freitas Carla Brandao tiago teofilo Ines Campos Jorge Laíns Manuel Veríssimo Rehabilitation Medicine Centre—Rovisco Pais TochaPortugal Department of Reumatology Centro Hospitalar e Universitário de Coimbra(CHUC)CoimbraPortugal Department of Plastic Surgery and Burns Unit Centro Hospitalar e Universitário de Coimbra(CHUC)CoimbraPortugal Department of Physical Medicine and Rehabilitation Hospital Central do FunchalFunchalPortugal

Introduction: Increased occurrences of falls after discharge are reported, especially in elderly people. Falls are a major cause of disability and identification of risk factors associated with falls is required to plan preventive actions. This study aims to determine the occurrence of falls in the three months after discharge and risk factors in elderly patients. Materials and Methods: 100 patients over 65 admitted to an Internal Medicine Ward participated. Questionnaires were given during hospitalization and three months after discharge. Follow-up information was unavailable for 31 patients (25 deceased, 6 unreachable). Results: Of those analyzed 52% were males with 80 ± 8.1 years (mean ± SD). Polymedication (p = 0.002), use of psychoactive drugs (p = 0.007), analgesics (p = 0.034) and walking devices (p = 0.006) were associated with a higher incidence of falls 6 months before hospitalization. Post-discharge follow-up was obtained for 69 patients: 18 reported falling during the follow-up. There was a higher risk of fall in patients with a history of falls in the 6 months before admission (p = 0.015 RR = 2.76). Patients who had one or more falls after discharge had a significantly shorter length of hospital stay compared to those who didn’t fall (p = 0.012). In multivariate logistic regression, we found that patients who were hospitalized more than 7 days had a lower risk of falling in the post-discharge period (OR = 0.195, p = 0.017) independently of the history of falls 6 months prior to admission. Conclusions: Further studies are required to validate the risk factors identified after discharge and to evaluate preventive measures. Elderly patients discharged from an Internal Medicine Ward should be screened to determine the risk of falls, specifically previous history of falls and medication. These patients should integrate a fall prevention program.

关键词： Risk Factors Falls Hospital Discharge Elderly

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