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Fall

To drop or descend under the force of gravity, as to a lower place through loss or lack of support.

de Souza et al., analyzed 1071 fall incidents in a hospital. The incidence of falls in inpatient units was 1.7 per 1000 patient days. Among the recorded falls, 95.3% occurred in patients who had been previously assessed as being at high or moderate risk of falls; 61.5% were using medications associated with increased risk of falls. Regarding age, 70.8% of the falls occurred in patients aged ≥60 years. Falls occurred mostly (72.6%) in inpatients units, and in 63.4% of the incidents the fall was witnessed by a family member/companion or a health team professionals. No injuries were recorded in 71.4% of the patients. Serious adverse events or sentinel events, such as fractures or head trauma occurred in 2.1% of the patients. Of these, 80% were in the group aged ≥60 years; 83% of the head traumas and 58% of the fractures occurred in patients who had been assessed as being at high risk of falls. Fractures were associated (p = 0.026) with age 70-79 years.

At the hospital where the study was performed, new fall prevention strategies must focus on patients admitted to inpatient units, aged ≥60 years, assessed as being at high risk of falls, and using medications associated with increased risk of falls 1)


A study of Eom included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80-84 years and in women aged 75-79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant.

This study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the Korean Neuro-Trauma Data Bank System (KNTDBS). Although the study has some limitations, the results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population 2).


Falls are common in older adults with psychiatric disorders, but the epidemiological findings have been inconsistent. A meta-analysis examined the prevalence of falls in older psychiatric patients and its moderating factors. PubMed, EMBASE, Web of Science and PsycINFO databases were independently searched by three investigators from their inception date to Nov 31, 2017. The random effects meta-analysis was used to synthesize the prevalence of falls, while meta-regression and subgroup analyses were conducted to explore the moderating factors. Sixteen of the 2061 potentially relevant papers met the entry criteria for the meta-analysis. The pooled lifetime prevalence of falls was 17.25% (95% confidence interval: 13.14%-21.35%). Neither univariate and nor multivariate meta-regression analyses revealed any moderating effects of the study region, duration, sample size, and quality on the prevalence of falls (P values > 0.05). Falls in older adults with psychiatric disorders are common 3)


Despite the growing epidemic of falls, the true incidence of peripheral nerve injury (PNIs) in this patient population remains largely unknown.


In total, 28 epidemiological studies on TBI from 16 European countries were identified in the literature. A great variation was found in case definitions and case ascertainment between studies. Falls and road traffic accidents (RTA) were the two most frequent causes of TBI, with falls being reported more frequently than RTA 4).

References

1)
de Souza AB, Maestri RN, Röhsig V, Lorenzini E, Alves BM, Oliveira D, Gatto DC. In-hospital falls in a large hospital in the south of Brazil: A 6-year retrospective study. Appl Nurs Res. 2019 Aug;48:81-87. doi: 10.1016/j.apnr.2019.05.017. Epub 2019 Jun 14. PubMed PMID: 31266614.
2)
Eom KS. Epidemiology and Outcomes of Traumatic Brain Injury in Elderly Population : A Multicenter Analysis Using Korean Neuro-Trauma Data Bank System 2010-2014. J Korean Neurosurg Soc. 2019 Mar;62(2):243-255. doi: 10.3340/jkns.2018.0017. Epub 2019 Feb 27. PubMed PMID: 30840980.
3)
Rao WW, Zeng LN, Zhang JW, Zong QQ, An FR, Ng CH, Ungvari GS, Yang FY, Zhang J, Peng KZ, Xiang YT. Worldwide prevalence of falls in older adults with psychiatric disorders: A meta-analysis of observational studies. Psychiatry Res. 2018 Dec 31;273:114-120. doi: 10.1016/j.psychres.2018.12.165. [Epub ahead of print] PubMed PMID: 30641340.
4)
Peeters W, van den Brande R, Polinder S, Brazinova A, Steyerberg EW, Lingsma HF, Maas AI. Epidemiology of traumatic brain injury in Europe. Acta Neurochir (Wien). 2015 Oct;157(10):1683-96. doi: 10.1007/s00701-015-2512-7. Epub 2015 Aug 14. PubMed PMID: 26269030.
fall.txt · Last modified: 2019/07/04 18:40 by administrador