Understanding and managing the risk of "head impact" from in-hospital falls: A cross-sectional analysis of data from 166 public hospitals.

Abstract

Falls are a leading cause of preventable harm in the hospitalized elderly, and head impacts (HIs) can be a precursor to serious injury. The aim of this study was to examine if the risk of fall-related HI can be explained by incident characteristics. All reported falls across public hospital facilities in the state of Queensland, Australia, over a 2-year period were analyzed using univariate and multiple logistic regression. In all, 650 instances of HI were reported across 24 218 falls. Falls due to fainting were associated with elevated HI odds (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.30, 3.08). Similarly, falls while walking (OR = 1.48, 95% CI = 1.20, 1.81) and falls during certain time periods, namely, from 11:00 pm to midnight (OR = 1.79, 95% CI = 1.24, 2.59) and between 5:00 am and 6:00 am (OR = 1.50, 95% CI = 1.01, 2.22) were linked to increased HI odds. Falls among males were associated with lowered odds of HI (adjusted odds ratio [AOR] = 0.78, 95% CI = 0.64, 0.74). Results confirm links between characteristics of inpatient falls and the likelihood of HI, and these data can assist risk managers to better target fall prevention strategies. Assisted mobility in high-risk patients and improved environmental lighting are advanced as foci for future research.