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Risk of Falls after Hospital Discharge
Author(s) -
Mahoney Jane,
Sager Mark,
Dunham Nancy Cross,
Johnson Jill
Publication year - 1994
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1994.tb01750.x
Subject(s) - medicine , injury prevention , poison control , suicide prevention , human factors and ergonomics , occupational safety and health , patient discharge , emergency medicine , medical emergency , hospital discharge , medline , gerontology , intensive care medicine , pathology , political science , law
Objectives To determine the incidence of falls within the first month after hospitalization and risk factors associated with falling during this period. Design Cohort study with 1‐month follow‐up after hospital discharge. Setting 370‐bed community hospital. Patients Consecutive sample of 214 patients, aged 70 years and over, hospitalized for medical illness more than 48 hours and discharged to the community. Exclusion criteria: terminal illness, neurologic diagnosis, discharge to skilled nursing facility. Measurements Information was obtained at hospital admission, discharge, and 1 month after discharge. Initial assessment included demographic data, vision, mood, pre‐admission function, and use of assistive device. Discharge assessment included length of hospital stay, use of assistive device, need for professional help after discharge, medications, cognition, and functional status. Patients were assessed 1 month after discharge for history of confusion and falls. Main outcome measure was falls in the first month after discharge. Main Results Twenty‐nine patients (13.6%) fell during the month after discharge. Major risk factors for falls included, at discharge, decline in mobility ( P = 0.005), use of assistive device ( P = 0.002), and cognitive impairment ( P = 0.05), and after hospital discharge, self‐report of confusion ( P = 0.002). Patients who were functionally dependent and needed professional help after discharge had the highest rate of falls (20.2%). In contrast, only 8.4% of independent patients not requiring professional help fell ( P = 0.01). Conclusions There is a high incidence of falls after hospital discharge, particularly among patients who are functionally dependent. Further study is needed to determine to what extent acute illness and hospitalization may influence falls risk.