Preventing Postoperative Falls in the Older Adult

Abstract

A M t r r l c p p n the US, adults 65 years and older represent the fastest rowing segment of the population. There are projecions that this population will double in size to almost 70 illion in the next 3 decades. About one-third of all urgical procedures and about half of emergency surgical rocedures are performed on older adults. The surgical ates are nearly twice as high in this age group as they are n younger adults. Although older adults constitute bout 14% of the US population, they use close to half f the hospital expenditures and 44% of total hospital ay care. A fall has been defined as an event that results in the atient coming to rest inadvertently on the ground or ther surface lower than the body. For older adults, the isk of falling increases rapidly with advancing age, espeially for frail older adults. The hospital fall rate has een reported between 2 and 7 falls per 1,000 patient ays. Hospital fall rates are highly variable according o the type of patient and hospital setting. Hitcho and olleagues, in a prospective descriptive study of inpaient falls in an urban academic hospital, reported inpaient falls from medicine, neurology, orthopaedics, surery, and other services. They found a fall rate for edicine and neurology services at 6.12 per 1,000 paient bed days and a rate of 2.18 per 1,000 patient bed ays for the surgery service. Interestingly, the orthopaeic service was found to have a low fall rate risk of 0.80 er 1,000 patient bed days. There is limited evidence on factors contributing to npatient falls or the effectiveness of hospital fall prevenion programs in hospitalized older adults after operaions. In this article, we will review the literature on