Abstract
BackgroundIn-hospital falls may result in serious clinical adverse consequences, but the effects of anesthesia in the occurrence of postoperative falls are still undetermined. Anesthesia may theoretically cause postoperative falls due to the residual pharmacologic and neuromuscular blocking effects of anesthetics. We retrospectively reviewed events of in-hospital falls occurred after anesthesia management to identify the incidence and risk factors of postanesthesia falls.MethodsWe reviewed the postanesthesia visit of patients received anesthesia in the Hualien Buddhist Tzu Chi General Hospital from January 2009 to December 2013. Falls happened within 24 h after anesthesia were recorded. The Poisson regression model was used for simultaneous analysis of the association between incidence proportion of postanesthesia falls and the potential risk factors.ResultsA total of 60,796 inpatients received anesthesia management over the past 5 years, and ten patients fell within 24 h after anesthesia. All cases happened in the general wards. Falls occurred more often at the bedside, presence of caregivers, and during the daytime. Patients underwent regional anesthesia, and old age significantly increased the risk of postanesthesia falls, while differences in gender and ASA physical status did not affect the occurrence of postanesthesia falls.ConclusionsThe overall incidence proportion of postanesthesia falls is 1.6 cases per 10,000 patients (95 % CI 0.006 to 0.026 %) over a 24-h observation period. Falls are more commonly happened during the less expected periods after operation and are increased in the elderly and patients received regional anesthesia. This study highlights that more comprehensive clinical practice guidelines for postoperative care should be exercised to prevent the in-hospital falls.
Highlights
In-hospital falls may result in serious clinical adverse consequences, but the effects of anesthesia in the occurrence of postoperative falls are still undetermined
Lam et al Perioperative Medicine (2016) 5:11 effect on the postoperative falls is hard to identify from these previous studies, and there is currently no study reported the incidence of postanesthesia falls
Patient characterization From January 1, 2009 to December 31, 2013, there were a total of 78,064 individuals who received anesthesia management during surgical or other invasive interventions in the Hualien Buddhist Tzu Chi General Hospital, Taiwan, and 60,796 (77.9 %) of these patients were hospitalized for at least 24 h after anesthesia
Summary
In-hospital falls may result in serious clinical adverse consequences, but the effects of anesthesia in the occurrence of postoperative falls are still undetermined. We retrospectively reviewed events of in-hospital falls occurred after anesthesia management to identify the incidence and risk factors of postanesthesia falls. In-hospital falls are serious events resulting in bone fracture, traumatic head injury, visceral organ contusion, and skin abrasion. These in-hospital adverse events increase the length of hospital stay and cause extraneous medical expense but may. We retrospectively reviewed the postanesthesia records (2009 to 2013) in our department and analyzed the characteristics of in-hospital falls after anesthesia management. Our long-term aim is to identify the risk factors contributing to falls during the postanesthesia period and to promote prevention programs in the surgical patients who carry high risk of in-hospital falls
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