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Risk Factors and Injury Associated With Falls in Elderly Hospitalized Patients in a Community Hospital

Chelly, Jacques E. MD, PhD, MBA*†; Conroy, Linda RN, MSN, MPM; Miller, Gregory AS§; Elliott, Marc N. PhD; Horne, Jennifer L. BA*; Hudson, Mark E. MD*

doi: 10.1097/PTS.0b013e3181841802
Original Articles

Objective: Hospitalized patient falls are a major cause of disability, functional impairment, and even death. The objective of this prospective study was to assess the frequency and contributing factors of falls in hospitalized patients.

Methods: Between December 2004 and November 2005, data related to falls in hospitalized patients were recorded: patient demographics, the patient's functionality, mental status, surrounding circumstances, and the level of injury. Outcome measures were overall rates of patient falls as a function of ward, shift, month, age, and incidence rate ratios (IRRs).

Results: Falls were recorded in 611 patients. The overall patient fall rate was 4.36 (95% confidence interval, 4.02 to 4.72) per 1000 patient-days. The fall rate was significantly above the mean for the neurosurgical (IRR = 2.32; P < 0.001) and short-stay wards (IRR = 1.69; P = 0.013). Patients aged 56 to 70 years or older than 70 years fell 1.45 and 1.78 times more frequently, respectively, versus patients aged 55 years or younger (P < 0.001). The odds that a fall resulted in injury were multiplied by 1.19 for each additional decade of age (P = 0.018), and the age-adjusted injury rate for the oncology ward (46.4%) was significantly higher than the overall average (P = 0.001).

Conclusions: Age and the patient condition before and during hospitalization resulted as the most important determinants of falls in hospitalized patients.

From the *Department of Anesthesiology, University of Pittsburgh Medical Center, and †Department of Orthopedic Surgery, ‡Shadyside Hospital, §UPMC Center for Quality Improvement & Innovation, ∥RAND Corporation, Santa Monica, California.

Correspondence: Jacques E. Chelly, MD, PhD, MBA, Shadyside Hospital, Department of Anesthesiology, Suite M104 (Posner Pain Center), 5230 Centre Ave, Pittsburgh, PA 15232 (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.