Accidental Falls Research Articles

Factors Of Accidental Falls Among In Elderly Living Alone In Phetchaburi Province Thailand

This research was to study the factors of accidental falls among elderly living alone. The researcher conducted a mixed methods research (Mixed Methods Research) to study factors affecting the incidence of falls and falls in elderly people who live alone. The research results found that Factors that result in falls and falls in elderly people who live alone. Phetchaburi Province has a total of 5 main factors and 24 sub-factors, consisting of main physical factors. Sub-factors were eye disease (p = 0.001, β =1.063), osteoarthritis (p = 0.001, β = 0.955), urinary system intelligence (p = 0.001, β =1.588), frequently going to the bathroom at night (p = 0.001, β =1.236) Congenital disease (p = 0.001, β = 1.638) Regular hospital visits (p = 0.001, β = 1.494) Main behavioral factors Sub-factors include taking medicine to treat chronic diseases (p = 0.001, β = 2.959), using alcoholic beverages (p = 0.001, β = 4.014), not exercising (p = 0.001, β = 5.350), wearing comfortable shoes. Inappropriate (p = 0.001, β = 2.723) Inappropriate clothing (p = 0.001, β = 3.574) Main environmental factors Sub-factors: regularly using stairs (p = 0.001, β = 3.354), two-story house (p = 0.001, β = 4.571), split-level house (p =0.001, β = 2.296), light switch not nearby. mattress (p = 0.001, β =2.363) main economic and social factors The sub-factor was frequently attending social events (p = 0.001, β = 6.633), missing home visits from the health service unit (p = 0.001, β = 3.916). The main factor was caregiver. The sub-factor is living with offspring (p = 0.001, β = 6.019 ) and having to live alone (p =0.001, β = 1.002 ).

Clinical features of fallers and non-fallers: finding best-performing combinations of physical performance measurements to discriminate physical impairments between fallers and non-fallers among older adults with and without osteoporosis

SummaryIs osteoporosis related to worst outcomes after fall accidents? After a fall accident, there were no differences in walking and balance between individuals with/without osteoporosis. Gains in fat tissue, higher pain, and difficulty to walk were related to previous falls, regardless of osteoporosis.PurposeImpairments are expected after an accidental fall in the older age; whoever, it is still unclear if patients suffering from osteoporosis are in higher risks of fall accidents and if such accidents would cause worst outcomes compared with older adults without osteoporosis. The objective of this study was to discriminate fallers and non-fallers via a combination of physical performance measurements of older adults (65 + years) with and without osteoporosis.MethodsOlder adults (n = 116) were screened for a previous fall accident and tested during (i) quiet stance; (ii) single- and dual-task walking; (iii) 8-Foot Up-and-Go; (iv) Mini BESTest; (v) 2-min step-in-place and (vi) 30-s chair stand. Evaluation of average daily pain intensity and total body fat% were obtained.ResultsForty-four subjects (38%) reported a previous fall accident. There was, however, no association between osteoporosis and previous fall. Fallers had a higher daily pain intensity, higher body fat%, slower walking speed during a cognitive dual-task test and worse performance at the 8-Foot Up-and-Go test and the Mini BESTest compared to non-fallers.ConclusionsAlthough the presence of osteoporosis might not increase the risk of fall accidents, healthcare professionals should expect that accidental falls in older adults are associated with higher body fat%, higher daily pain intensity and problems performing daily activities such as walking.

A 10-Year Study of the Trend of Accidental Falls in the Elderly in a Japanese Hospital.

Elderly people are prone to falls. We established the Falls Prevention Working Group (FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This study compared the trend of in-hospital falls in the elderly in two time periods (2008/9 and 2018/9) and determined the effects of FPWG-implemented measures. Using medical records, we counted the monthly number of falls suffered by patients during hospitalization in April 2008-March 2009 and April 2018-March 2019. We also categorized the falls according to the severity of fall-related complications.A total of 3609 hospital falls were recorded during the 2008-2019 period (2008/9: n=433, 2018/9: n=324). Falls were more common in patients aged 70-79 in 2008/9 but were noted in those aged ≥80 in 2018/9. The mean number of falls/month (27.3±6.4, range: 12-45) was stable throughout the year. The incidence of falls in 2018/9 (1.90/1000 per persons per day) was significantly lower than in 2008/9 (2.30/1000, p=0.006). Level ≥3b accidents, reflecting serious accidents with complications, were encountered in 12 of 433 accidents in 2008/9 compared with significantly fewer accidents (2 of the same severity among 324 accidents) in 2018/9 (p=0.030).Our results showed a decrease in in-hospital falls in 2018/9 and that the sufferers were older relative to 10 years earlier. A multidisciplinary team should recommend measures to prevent falls and an environment "resilient" to falls, and encourage patients to be aware of possible falls.

Accidental Falls Related to Physical and Environmental Risk Factors Among Older Hill Tribe Adults in Northern Thailand

Objective: Falls remain a cause of disability in the elderly. The present study was carried out to estimate the prevalence of falls among the hill tribe elderly population in Northern Thailand and identify its associated factors.Material and Methods: A cross-sectional study was conducted in participants from 61 hill tribe villages in Chiang Rai province, Thailand aged more than 60 years. A simple random method was used to select the participants. A questionnaire was developed and validated for data collection. Timed-up and go test (TUGT) was used to assess the dynamic balance and risk of falls in the participants. Logistic regression was used to evaluate the associations between the study variables (p-value<0.05).Results: One hundred eighty-two participants were recruited into the study with a mean age of 69.54 years (S.D.=7.02). 59.9 % were women. It was found that 17.6% of elderly who fell in the previous 6 months and 28.0% of elderly who risks of falls as assessed by the TUGT. The multiple logistic regression model showed that tribe (adjusted odds ratio (aOR)=4.40, 95 confidence interval (CI)%=1.88 to 22.02), dizziness (aOR=3.40, 95 CI%=1.70 to 16.70), history of fall in the last 6 months (aOR=2.42, 95 CI%=1.06 to 8.64), location of falls (aOR=1.37, 95 CI%=1.02 to 18.22), and the 15-item geriatric depression scale (GDS-15) (aOR=12.91, 95 CI%=1.07 to 84.85) were the associated risk factors for having a serious fall for hill tribe elderly.Conclusion: This study provides important determining factors associated with elderly falls, which can assist in developing and implementing an appropriate fall prevention program through environmental adjustments for the elderly.

Analysis of Data on Accidental Falls from the Hospital Incident Reporting in a General Hospital

Purpose: The purpose of this study was to analyze data on fall incidents based on a general hospital’s incident reporting system.Methods: This study conducted secondary data analysis to gather statistics on fall reports, general characteristics of patients, results of falls, and improvement strategies for fall prevention using the 2017-2019 fall incidents from the incident report system.Results: There were 693 cases reported over three years. Among the fall incidents, three hundred twenty (46.2%) were adverse events, three hundred seventy-three (53.8%) were near misses, and none were related to sentinel events. Five hundred ninety-five (85.9%) were male, with an average age of 74.08±8.99. The falling incidents happened mostly in patients' rooms (410, 59.1%). At the time of the fall, the patients were conscious and alert (607, 87.6%). As a result of the fall, three hundred sixty (51.9%) caused no harm, permanent damage, side effects, or death.Conclusion: The study findings suggest that the fall characteristics of older patients should be considered to establish a fall-prevention strategy tailored to the institution.

Influência das ações dos profissionais de saúde na adaptação de pessoas idosas em domicílio após internamento por quedas: revisão integrativa

Abstract Objective To identify how healthcare professionals' actions for fall prevention in elderly individuals in both the hospital and home settings influence adaptation and continuity of home-based care. Method An integrative review conducted with a search in the Virtual Health Library (VHL), the Scientific Electronic Library Online (SciELO), the United States National Library of Medicine (PubMed), EBSCO, SCOPUS, and Web of Science. The search used the following Medical Subject Headings (MeSH) terms: "Aged," "Accidental Falls," "Patient Discharge," "Discharge, Patient," "Discharges, Patient," "Patient Discharges," "Discharge Planning," "Discharge Plannings," "Planning, Discharge," and "Plannings, Discharge." Original articles from the past five years were selected, with no language restrictions, and that addressed the research question. Article search and selection were conducted independently and blind by two reviewers between November and December 2022. Results The final sample included eight studies. Six were conducted in Australia, seven were in the English language, and the year 2019 had the highest number of publications. Fall prevention actions were primarily implemented by physiotherapists and occupational therapists through health education and digital videos for guidance related to home modifications. These actions had a positive impact on the motivation, engagement, and awareness of the elderly population and their caregivers. Conclusion The actions of healthcare professionals facilitated greater engagement for the continuity of care and the control of fall risks.

Comprehensive Risk Assessment Analysis of Accidental Falls in Shipyards Using the Gaussian Fuzzy AHP Model

Comprehensive Risk Assessment Analysis of Accidental Falls in Shipyards Using the Gaussian Fuzzy AHP Model

Traumatic dental injuries in adults attending a London-based trauma clinic in the UK: a seven-year survey

Introduction This survey reports the incidence of traumatic dental injuries in an adult population attending an adult dental trauma clinic in a London teaching hospital.Materials and methods Retrospective data were collected from patients attending an adult dental trauma clinic between 2012 and 2018.Results In total, 1,769 patients attended, with more men seen (1,030; 58.2%) compared to women (739; 41.8%) and this was statistically significant (p <0.05). The most common aetiological factor was an accidental fall (728; 41.15%), followed by assaults (413; 23.35%), bicycle accidents (253; 14.3%), sports injuries (132; 7.46%) and road traffic accidents (84; 4.75%). Lateral luxation (833) was the most common traumatic injury and this was followed by avulsions (362; 17%). Enamel-dentine fractures were the most common type of fracture injury (1,273; 64%).Discussion This retrospective survey attempts to report on the incidence of traumatic dental injuries in a London-based cohort of patients attending a specialised dental trauma clinic. In line with other reports, there were more men than women affected, which is probably attributed to behavioural activities.Conclusion(s) Accidental falls are the most common cause of a traumatic dental injury, lateral luxation was the most common type of displacement injury and enamel-dentine fractures were the most common type of fracture injury.

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Introduction: The Episodes of falls in the elderly are considered a public health problem. Physiological, behavioral and environmental changes, such as architectural barriers, are the main factors of risk for the occurrence of episodes of falls within elderly. The objective of this study is to evaluate the risk of falls in polymedicated elderly people, aged 75 years or over, in a civil parish area of a Community Care Unit of the Central Alentejo Health Center Group. Methodology: A cross-sectional, descriptive study with a quantitative approach was carried out involving 53 elderly people, to whom fall risk assessment instruments were applied, namely the Morse Scale and an observation grid. Results: Of the population studied (N = 53), 33 elderly people had already suffered episodes of falls, the main reason being the imbalance. All seniors are polymedicated, taking at least 4 different medications per day. As for current health problems, the most prevalent are vision problems, high blood pressure, rheumatic diseases and hearing problems. In relation to the physical environment at home, there was the presence of numerous risk factors/architectural barriers that can potentiate the occurrence of falls as well as a lack of knowledge regarding them. Conclusion: It is concluded that it is necessary to establish health-promoting community intervention strategies that contribute to the training and awareness of the elderly in the adoption of measures to prevent falls. Keywords: Accidental Falls; Aged; Polypharmacy; Public Health.

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Introduction: Confusion in hospitalized patients is a frequent problem that can have the consequences such as: physical restraint, falls and mortality. Early recognition is the best tool to reduce it. Objectives: Describe the confusion in hospitalized patients and verify its relationship with the variables physical restraint, falls and mortality. Material and Methods: Observational study of quantitative nature, cross-sectional, descriptive-correlational developed at an Internal Medicine ward of a Hospital Center in the Portuguese Northern Region. The data collection instrument was performed by the author. Data were collected between June and August 2021, from every patient admitted to an internal medicine ward. Spearman's correlation coefficient was used to verify the relationship between the variables. Results: The final analysis included 194 patients of which 70.7% presented with confusion and 47.8% were between 80 and 89 years of age. Physical restraint occurred in 22.3% of the participants, all with identified confusion, and two falls were reported (1.3%). Regard-ing mortality, 39.5% died in the following three months. The significant positive correla-tion between confusion, physical restraint and mortality is highlighted. Conclusion: The presence of confusion is very common in the Internal Medicine ward mainly in patients over 70 years of age. The presence of confusion is related to the appli-cation of physical restraint. This study highlights the significant relationship between confusion and mortality. Keywords: Accidental Falls; Confusion; Institutionalization; Mortality; Physical Restraint.

Preparing for the Worst or Hoping for the Best? The State of Fall Training in Prosthesis Users

ABSTRACT Introduction The risk of accidental falls is greater in people with lower-limb loss than in their able-bodied peers. Most popular strategies to mitigate injuries from such falls include technical solutions that prevent falls or protect vulnerable body segments from destructive forces. Fall training is another effective intervention, but little evidence on its use in prosthesis users has been published. This research had the goal to investigate to what extent fall training is provided to the target population and what factors may be obstacles to its wider adoption. Methods An online questionnaire was developed and administered nationwide, targeting people with lower-limb loss. Descriptive statistics were used to describe the availability of fall training, and a logistic regression was performed to investigate variables that predict whether an individual receives fall training or not. Results A total of 180 responses was recorded, 166 of which were included in the analysis. More than two-thirds of respondents had not received fall training. Those who had physical therapy as part of their rehabilitation regimen were 3.7 times more likely to also have had fall training. Discussion Our data suggest that the potential benefits of providing fall training to people with lower-limb loss are not being fully realized. Interdisciplinary collaboration between prosthetists and therapists can help expand access to fall training interventions to better prepare patients for the likely event of an accidental fall.

Differences in Trauma Injury Patterns and Severity Between Intentional and Accidental Falls From a Height: A Japanese Nationwide Trauma Database Study.

BackgroundFall from a height is a common cause of trauma requiring emergency care; in many cases, the trauma team needs to urgently develop the initial treatment strategy. The mechanism of injury (intentional or accidental) is an important factor in predicting trauma patterns and severity. We aimed to describe how the severity of injuries in each body region contributes to overall trauma severity and skeletal trauma patterns in intentional and accidental falls.MethodsData accumulated between January 1, 2004 and May 31, 2019 were obtained from a nationwide trauma database. Patients aged ≥18 years and injured by falls from a height were included. The median Abbreviated Injury Scale (AIS) score for the Injury Severity Score (ISS) for each body region (region 1: head, face, and neck; region 2: thorax; region 3: abdomen; region 4: lower extremity and pelvis; and region 5: upper extremity) was investigated. Skeletal injury patterns were classified into four groups: group I (intentional/severe), group II (accidental/severe), group III (intentional/not severe), and group IV (accidental/not severe). Severe trauma was defined as a trauma with an ISS of 16 or more. The groups were compared using the chi-square test and Mann-Whitney U test.ResultsAmong the 342,263 patients enrolled in the database, 28,409 met the inclusion criteria: 6,812 in group I, 11,754 in group II, 2,384 in group III, and 7,459 in group IV. The intentional fall group showed an increase in the AIS score for region 4 as the ISS increased, whereas the accidental fall group showed an increase in the AIS score for region 1. Both groups showed an increase in the AIS score for region 2 as the ISS increased. The intentional fall group had a higher proportion of fractures in the lower extremities and pelvis than the accidental fall group.ConclusionsThere were differences in trauma patterns and trauma severity levels between patients who experienced intentional and accidental falls from a height. Our findings provide a comprehensive understanding of this topic. Further studies are required to assess the usefulness of our findings for the development of initial treatment strategies at the ED.

Levels and trends of significant injury-caused deaths in the Chinese population, 2010-2019

Objective: To analyze the level and changing trend of significant injury-caused deaths in the Chinese population from 2010 to 2019 and provide evidence for related intervention. Methods: Data on notable injury-caused deaths in areas under National Disease Surveillance Programs were collected from 2010 to 2019. Crude and standardized mortality rates of four significant injuries were calculated to describe the status of injury-caused deaths. The trend of changes in standardized mortality rates was analyzed using the Joinpoint regression model. Results: The overall trend of standardized mortality rate on an injury during 2010-2019 was consistently decreasing (AAPC=-3.5%, P<0.001) while the general direction of accidental fall standardized mortality rate was increasing (AAPC=1.0%, P=0.104). The standardized mortality rate for significant injuries fluctuated with age, increasing for those aged 50-79 years (AAPC=3.9% for the 50- group, AAPC=5.6% for the 60- group, and AAPC=4.6% for the 70- group, all P<0.001). The standardized mortality rates for all major injuries were higher in males than those in females, with road traffic accidents and drowning declining faster in males than that in females (AAPC=-5.3% in the male road traffic accident group, AAPC=-3.8% in the female road traffic accident group, AAPC=-4.0% in the male drowning group, AAPC=-3.5% in the female drowning group, all P<0.001), and suicide and sequelae declining faster in females than that in males (AAPC=-6.4% in female, AAPC=-4.7% in male, all P<0.001). The standardized mortality rate for significant injuries was higher in rural than that in urban areas and decreased faster than that in urban areas. The central region had the highest standardized mortality rate for suicide and sequelae. The western part had the highest standardized mortality rates for road traffic accidents, accidental falls, and drowning, with the fastest decline in road traffic accidents and drowning (AAPC=-5.3% in the road traffic accident group and AAPC=-5.3% in the drowning group, both P<0.001). Conclusions: The mortality rate from significant injuries in the Chinese population showed a continuous downward trend from 2010 to 2019, with a rebound in the standardized mortality rate from accidental falls in recent years among the elderly, males, rural residents, and central and western regions being the focus of future prevention and control.

Accidental Fall Death in McLean County: Examining Variables in Community-Dwelling Older Adults.

Fall risk assessment is a complex phenomenon involving several risk factors, including an individual's balance and mobility status, chronic health conditions, visual impairment, hearing deficits, environmental hazards (e.g., loose rugs, clutter), and being homebound or semi-homebound. Comprehensive fall risk assessment is the cornerstone of fall prevention in older adults throughout the community. The current study was based on secondary data and sought to examine variables associated with death due to accidental fall in a rural, midwestern county in Illinois, and to heighten awareness for consistent screening and risk assessment in older adults residing in the community. Results illustrated that among community-dwelling older adults with accidental falls, blunt injury or subdural hematoma had significantly fewer days until death than a fracture. [Journal of Gerontological Nursing, 48(6), 26-32.].

Incidence of accidental falls and development of a fall risk prediction model among elderly patients with diabetes mellitus: A prospective cohort study.

To investigate the incidence of accidental falls and develop a fall risk prediction tool in elderly patients with diabetes mellitus. The risk of fall in elderly patients with diabetes is higher than that in the general elderly, there is fewer fall assessment tools for elderly patients with diabetes. A prospective cohort study. Between June and September 2019, a total of 1007 elderly patients with diabetes were enrolled from a tertiary specialist diabetes hospital in Tianjin and were prospectively followed up for 6months to determine outcomes of accidental falls through telephone. Demographic and diseases related factors were collected at baseline. Incidence of falls was investigated, and a nomogram was developed based on logistic regression model. SPSS 21.0 and R 3.6.3 were used to analyse the data. The article was reported in accordance with STROBE guidelines. Among 1007 elderly patients, 950 finished the follow-up. A total of 133 falls occurred in 93 patients during the follow-up period, with a fall rate of 9.79%. Diabetic peripheral neuropathy, walking aids, depression, fall history, fatigue and sex were independent predictors of accidental fall in diabetes elderly patients. The sensitivity and specificity of the predictive model were 73.12% and 52.63%, respectively, and a fall risk prediction nomogram was developed based on the regression model. A nomogram including 6 easily available prediction factors (diabetic peripheral neuropathy, walking aids, depression, fall history within 1year, fatigue, sex) was developed, and it can be used in safety management among Chinese elderly patients diagnosed with diabetes. Nomogram can be used to identify diabetic elderly patients at high risk of accidental falls.

Falls Are the Leading Cause of Injuries among Farmers—Limitations of Practicing Judo in Preventing These Incidents

Benefits related to doing martial arts go beyond health-related and constitute very useful life skills. One of them is ability to fall safely. It is an important skill since falls are a common cause of injuries. The aim of the study is knowledge regarding the burden of falls in a population of farmers. This systematic review was prepared according to PRISMA guidelines. A literature search was conducted in PubMed, Science Direct, Scopus, Springer Link, Web of Science. A total of 21 articles met eligibility criteria. The common general observation was that fall (regardless of type) caused various body injuries in populations of agriculture workers. Fall was the leading cause of injuries in only one population, and the most frequently classified second or third causes among all other listed injuries. People employed in the agriculture sector constitute an occupational group with an increased risk of injury as a result of accidental fall, which may lead to disability or even death (in extreme situations). Safe fall training would be an important addition to traditional fall prophylaxis applied on farms. The authors indicate the limitations of judo as a base of such a program, such as with superficial analysis of this issue in scientific publications. There is a need for a critical and wary approach to recommendations that are limited to prophylaxis of the effects of accidental falls that are founded on judo or other combat sports and martial arts.

Hospitalization of unintentional fall injuries in Kuwait: a national database study

BackgroundAccidental falls are a major cause of morbidity placing pressure on hospital capacity and utilizing costly services. Evaluating the burden of falls is key for planning, implementation, and evaluation of prevention strategies. To date, no studies have been published on accidental falls at the population level in Kuwait. We studied the burden of accidental falls on public hospital inpatient capacity in Kuwait and identified the subgroups with the highest utilization of inpatient service days.MethodsFrom the national database of inpatient hospitalizations, we selected hospitalizations of patients admitted to Kuwait’s public hospitals for unintentional injury caused by an accidental fall from 1 January through 31 December 2016. We studied the number of inpatient service days (bed days), length of stay (LOS), and number of hospitalizations by age group, gender, and nationality. Mann–Whitney, Kruskal-Wallis, and Chi square tests were used for comparison. Logistic regression was used to quantify the risk of prolonged LOS and fractures among fall-related hospitalizations.ResultsAccidental falls were responsible for 2.9% of inpatient hospitalizations, 3.7% of inpatient service days (61,140 days) with an ALOS of 9.1 days in Kuwait’s public hospitals in 2016. Accidental falls were responsible for 4.6% of older adult service days, and an even higher 5.6% of older women service days. In the age group 13–64, fall-related service days for non-Kuwaitis (5.7%) were more than triple those for Kuwaitis (1.8%) with a substantial percentage among male non-Kuwaitis (8.1%). The risk factors for exceeding the national ALOS for fall-related hospitalizations were female gender (OR 1.36), age 65 and older (OR 9.72), age 13–64 (OR 5.20), being non-Kuwaiti (OR 1.39), sustaining a femur fracture (OR 11.67), and undergoing surgery (OR 2.63). Fall-related hospitalizations associated with a higher risk of fractures were females (OR 1.22), patients 65 years and older (OR 5.09), patients aged 13–64 (OR 3.65), and non-Kuwaitis (OR 1.28).ConclusionsAccidental falls impose a considerable burden on inpatient service utilization in Kuwait. This varies by age, gender, and nationality. To reduce this burden, prevention programs should target working-age non-Kuwaiti males and older females.

Emergency Department Outcome of Patients with Traumatic Brain Injury – A Retrospective Study from Pakistan.

Introduction: Traumatic brain injury (TBI) is a leading cause of global morbidity and mortality in both adults and children. As with other severe injuries, the outcome of TBIs is also gravely related to the quality of emergency care. Effective emergency care significantly contributes to reduced morbidity and mortality. This study was ensued to evaluate the characteristics of TBIs in Pakistan and their outcomes in the emergency department (ED).&#x0D; Methods: This retrospective review included records of all TBI patients seen in the Neurosurgical ED of Jinnah Postgraduate Medical Centre, Karachi, Pakistan from 1st September 2019 till 7th December 2019.&#x0D; Results: During the study period, 5,546 patients with TBI were seen in the ED; an estimated 56.5 patients per day. There were 4,054 (73.1%) male and 1,492 (26.9%) female patients. Most of these (26%) were of age &lt;10 years. The most common culprit of TBI was road traffic accidents (RTAs) (n=2,163; 39%) followed by accidental fall (n=1,785; 32.2%). Head injury was mostly mild (n=4,034; 72.8%) and only 265 (4.7%) had a severe injury. Only 10% (n=549) patients were admitted for further treatment, 16% were managed in the ED then discharged, and 67% were immediately discharged from the ED after the first examination and necessary management. The ED mortality rate of TBIs was 2.2% (n=123/5,546) in our study. All of these cases had severe head injuries.&#x0D; Conclusion: Major culprits of TBI are RTAs and accidental falls. TBIs are mostly mild-to-moderate and the ED mortality rate is low.

Fall Risk Assessment Scales: A Systematic Literature Review.

Background: Falls are recognized globally as a major public health problem. Although the elderly are the most affected population, it should be noted that the pediatric population is also very susceptible to the risk of falling. The fall risk approach is the assessment tool. There are different types of tools used in both clinical and territorial settings. Material and methods: In the month of January 2021, a literature search was undertaken of MEDLINE, CINHAL and The Cochrane Database, adopting as limits: last 10 years, abstract available, and English and Italian language. The search terms used were “Accidental Falls” AND “Risk Assessment” and “Fall Risk Assessment Tool” or “Fall Risk Assessment Tools”. Results: From the 115 selected articles, 38 different fall risk assessment tools were identified, divided into two groups: the first with the main tools present in the literature, and the second represented by tools of some specific areas, of lesser use and with less supporting literature. Most of these articles are prospective cohort or cross-sectional studies. All articles focus on presenting, creating or validating fall risk assessment tools. Conclusion: Due to the multidimensional nature of falling risk, there is no “ideal” tool that can be used in any context or that performs a perfect risk assessment. For this reason, a simultaneous application of multiple tools is recommended, and a direct and in-depth analysis by the healthcare professional is essential.

A Case-Control Study of Accidental Falls During Surgical Hospitalizations.

Postoperative falls are preventable complications. The study aims were to describe the rate and circumstances surrounding postoperative falls and explore potential associations with patient and procedural characteristics with emphasis on the use of sedative medications. Medical records of hospitalized patients undergoing non-lower extremity surgery under general anesthesia from January 1, 2010, through April 30, 2018 were reviewed for falls within 72 postoperative hours. Perioperative use of sedatives, sleep aids, gabapentinoids, and opioids were abstracted. Each fall case was matched with two controls on age, sex, and procedure type. Descriptive statistics and multivariable analysis accounting for the matched design were performed. There were 343 falls among 200186 hospitalized surgical patients (incidence of 17.1 [95% CI: 15.4, 19.0] falls per 10000 procedures) with largest proportion of falls occurring on postoperative day 2 (n = 134, 39.1%). Most falls occurred in the general hospital wards (n = 304, 88.6%) and were unwitnessed (n = 186, 55.9%). The incidence of major injuries was 1.0 (95% CI: .1 - 3.6) per 100000 procedures. Home use of non-benzodiazepine hypnotics (odds ratio 2.68, 95% CI: 1.47, 4.88, P=.001) and blood transfusions were associated with increased fall risk. Hospital stay was longer in patients who fall (7 [4, 15] vs. 5 [3, 9] days, P < .001). The rate of postoperative falls in our institution was low and frequently unwitnessed. The use of non-benzodiazepine hypnotics is a modifiable risk factor associated with postoperative falls. Serious complications after falls were rare.