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Cited by 714Balance, Gait, and Falls PreventionPharmaceutical Practices and Patient OutcomesPatient Safety and Medication Errors

Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review

Oliver, D.·2004·Age and Ageing
DOI 10.1093/ageing/afh017
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Abstract

OBJECTIVE: To identify all published papers on risk factors and risk assessment tools for falls in hospital inpatients. To identify clinical risk assessment tools or individual clinical risk factors predictive of falls, with the ultimate aim of informing the design of effective fall prevention strategies. DESIGN: Systematic literature review (Cochrane methodology). Independent assessment of quality against agreed criteria. Calculation of odds ratios and 95% confidence intervals for risk factors and of sensitivity, specificity, negative and positive predictive value for risk assessment tools (with odds ratios and confidence intervals), where published data sufficient. RESULTS: 28 papers on risk factors were identified, with 15 excluded from further analysis. Despite the identification of 47 papers purporting to describe falls risk assessment tools, only six papers were identified where risk assessment tools had been subjected to prospective validation, and only two where validation had been performed in two or more patient cohorts. CONCLUSIONS: A small number of significant falls risk factors emerged consistently, despite the heterogeneity of settings namely gait instability, agitated confusion, urinary incontinence/frequency, falls history and prescription of 'culprit' drugs (especially sedative/hypnotics). Simple risk assessment tools constructed of similar variables have been shown to predict falls with sensitivity and specificity in excess of 70%, although validation in a variety of settings and in routine clinical use is lacking. Effective falls interventions in this population may require the use of better-validated risk assessment tools, or alternatively, attention to common reversible falls risk factors in all patients.

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Crossref · 10.1093/ageing/afh017

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88 of 88 references verified0 citation errors · 0 not checkable

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  • Getting out of the bed unsupervised may lead to falls, which are a major problem in hospitals and contribute to substantial healthcare burden.

    “Getting out of the bed unsupervised may lead to falls being a major problem in hospitals and contribute to substantial healthcare burden, e. g., a significant injury or an increased length of stay (( Oliver et al. 2004), (Oliver et al. 2010)).”

    From Advanced Sensing and Human Activity Recognition in Early Intervention and Rehabilitation of Elderly People (2020) · cites this paper as Oliver et al. 2004

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Authors
Oliver, D.
Affiliations
University of Reading (GB)
Corresponding author
Oliver, D.
Venue
Age and Ageing
Publisher
Oxford University Press (OUP)
Published
2004-03-01
Volume
33
Issue
2
Pages
122-130
ISSN
  • 0002-0729 (ISSN-L)
  • 1468-2834
DOI
10.1093/ageing/afh017
OpenAlex
W2124142667
Cited by
714
References
88
Citations by year
2026: 15 · 2025: 21 · 2024: 24 · 2023: 20 · 2022: 34 · 2021: 23 · 2020: 44 · 2019: 32 · 2018: 42 · 2017: 40 · 2016: 30 · 2015: 47 · 2014: 36 · 2013: 46 · 2012: 43
FWCI
3.41
Type
journal article
Language
en
Open access
closed
Locations
  • Age and Ageing (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
fall risk factors, fall prevention, gait instability, urinary incontinence, fall history, sedative-hypnotic drugs, tool validation, sensitivity and specificity
MeSH terms
Accidental Falls, Hospitals, Humans, Inpatients, Risk Factors, Risk Management, Risk Assessment

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