95 Associated Factors and Outcomes of Falls in Acute Elderly Inpatients

Abstract

Introduction: It is thought that more than 1:3 individuals ≥65 years old fall at least once per year. With an increasing number of elderly inpatients in an ageing Australian population, falls prevention is now part of patient safety. We aimed to characterise associated factors of inpatient falls and patient outcomes in an acute medical ward in a regional hospital. Methodology: Inpatient falls for a 12-month duration (January-December 2018) were identified through a mandatory incident reporting system. Identifiable cases were included in the study with medical records reviewed retrospectively to ascertain active medical issues. Individuals with recurrent falls in the same admission were only counted once. Statistical analyses were performed in cases which completed an Ontario Modified Stratify (Sydney Scoring) Falls Risk Screen (OMS) during admission. AnOMS score of ≥9 was indicative of high falls risk (HFR). Active issues were categorised based on major diagnostic categories. Results: A total of 77 falls occurred during the 12-month period. Fifty three events fulfilled criteria for further analyses. This comprised of 24 (45.3%) males and 29 (54.7%) females once recurrent fallers were accounted. The mean cohort age was 80.2 years (SD 13.6) with a mean OMS score of 14.3 (SD 8.6) whereby 63.0% were deemed HFR. The top six categories of active issues experienced in this group were history of fall(s) contributing to admission (47.2%), cognitive impairment/ delirium/ dementia (43.4%), infection (43.4%), significant orthopaedic/ rheumatological disorders (39.6%), ischaemic heart disease/ heart failure/ valvulopathy (34%) and hypertension (34%). Medical admission outcomes for inpatient fallers were as follows; 58.5% discharged, 22.6% transferred to subacute care, 3.8% interhospital transfer and 15.1% death. Conclusion: Recommended cut-off scores for the OMS are likely suboptimal inmultimorbid elderly acute medical inpatients. Based on the limited sample size, elderly inpatients who experienced in-hospital falls are at higher risk of mortality.