Incidence and risk factors of hospital falls on long-term care wards in Japan
Article first published online: 6 JAN 2011
© 2011 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 18, Issue 3, pages 572–577, June 2012
How to Cite
Tanaka, B., Sakuma, M., Ohtani, M., Toshiro, J., Matsumura, T. and Morimoto, T. (2012), Incidence and risk factors of hospital falls on long-term care wards in Japan. Journal of Evaluation in Clinical Practice, 18: 572–577. doi: 10.1111/j.1365-2753.2010.01629.x
- Issue published online: 8 MAY 2012
- Article first published online: 6 JAN 2011
- Accepted for publication: 2 November 2010
- long-term care;
- patient safety;
- risk factor
Rationale, aims and objective Falls among hospitalized patients are an important patient safety issue. In particular, the incidence of falls and risk of related injuries among the elderly are particularly high. Because the epidemiology of falls is not well scrutinized in Japanese long-term care wards, we evaluated the incidence and risk factors of falls in this setting.
Methods A prospective cohort study was conducted on long-term care wards with 160 beds in a general hospital in Japan. All patients admitted to the wards over 25 months were enrolled and followed until discharge. The baseline characteristics and incidences of falls were measured.
Results We enrolled 2973 patients with a mean age of 74 years, and median length of stay was 36 days. During the study period, 657 falls occurred in 411 (14%) patients. The incidence of falls was 3.8 per 1000 patient-days, and by 15 and 30 days after admission to the ward, 7.3% and 11.4% of patients, respectively, had fallen. Independent risk factors related to falls during hospitalization were advanced age [≥70 years, hazard ratio (HR) 1.5, 95% confidence interval (CI) 1.2–2.0], history of falls (HR 1.2, 95% CI 1.0–1.5), frequent urination (HR 1.4, 95% CI 1.0–1.8) and requirement for toileting assistance (HR 1.4, 95% CI 1.1–1.8). Among patients who fell during the study period, 23% sustained an injury.
Conclusions Many patients on long-term care wards in Japan were elderly and experienced falls during their hospital stay, with consequent injuries. Taking into account the risk factors identified, we need to devise effective strategies to prevent falls and related injuries.