Risk factors associated with falls among Chinese hospital inpatients in Taiwan

Abstract

Falls among hospital inpatients were not uncommon and were associated with physical, functional and psychological morbidity for patients and excess cost, bed occupancy, complaints and litigation for hospitals. Risk factors for falls of hospital inpatients have been reported, but rarely in a case–control design. To our best knowledge, there was no case–control study for risk of fall among hospital inpatients in Taiwan, one of the most rapidly aging countries. The main purpose of this study was to determine risk factors for falls among hospital inpatients in Taiwan. A prospective multi-center case–control study was started in 2002. During the study period, all incident falls reported by ward nurses were carefully reviewed by research staff on the next day, and a matched control subject was generated according to the age, sex, diagnosis, and pre-event length of stay. Risk factors of falls, including physical conditions, pharmaceutical agents, and environmental factors were compared between fallers and controls. In total, 202 incident falls (202 fallers, none of them fell twice, mean age: 68.2 ± 16.9 years, 73.8% males) were reported and the overall incidence of falls during the study period was 4.4 per 1000 bed days. Leg weakness (odds ratio (OR): 1.88, 95% confidence interval (CI): 1.16–3.05), reported insomnia at admission (OR: 2.28; 95% CI: 1.06–4.89), postural hypotension (OR: 5.57; 95% CI: 1.54–21.46), previous history of fall within 1 year before admissions (OR: 5.05, CI: 2.60–9.78), recent use of hypnotics (within 24 h) (OR: 1.86, 95% CI: 1.10–3.14) were all significant risk factors (for all comparisons p < 0.05), but family member's company may reduce in-hospital falls (OR: 0.51; 95% CI: 0.33–0.78). In conclusion, the incidence of falls among hospital inpatients was lower than that reported from other countries. Further study is needed to organize a comprehensive fall prevention program according to the risk factors identified in this study to reduce in-hospital falls in Taiwan.