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Cited by 546Balance, Gait, and Falls PreventionPatient Safety and Medication ErrorsHospital Admissions and Outcomes

Characteristics and circumstances of falls in a hospital setting: A prospective analysis

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Hitcho, Eileen B., Krauss, Melissa J., Birge, Stanley, Dunagan, William Claiborne, Fischer, Irene, Johnson, Shirley, Nast, Patricia A., Costantinou, Eileen +1 more·2004·Journal of General Internal Medicine
DOI 10.1111/j.1525-1497.2004.30387.xPMC PMC1492485
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Abstract

Objective To describe the epidemiology of hospital inpatient falls, including characteristics of patients who fall, circumstances of falls, and fall-related injuries.Design Prospective descriptive study of inpatient falls. Data on patient characteristics, fall circumstances, and injury were collected through interviews with patients and/or nurses and review of adverse event reports and medical records. Fall rates and nurse staffing levels were compared by service.Setting A 1,300-bed urban academic hospital over 13 weeks.Patients All inpatient falls reported for medicine, cardiology, neurology, orthopedics, surgery, oncology, and women and infants services during the study period were included. Falls in the psychiatry service and falls during physical therapy sessions were excluded.Measurements and main results A total of 183 patients fell during the study period. The average age of patients who fell was 63.4 years (range 17 to 96). Many falls were unassisted (79%) and occurred in the patient's room (85%), during the evening/overnight (59%), and during ambulation (19%). Half of the falls (50%) were elimination related, which was more common in patients over 65 years old (83% vs 48%; P <.001). Elimination-related falls increased the risk of fall-related injury (adjusted odds ratio, 2.4; 95% confidence interval 1.1 to 5.3). The medicine and neurology services had the highest fall rates (both were 6.12 falls per 1,000 patient-days), and the highest patient to nurse ratios (6.5 and 5.3, respectively).Conclusions Falls in the hospital affect young as well as older patients, are often unassisted, and involve elimination-related activities. Further studies are necessary to prevent hospital falls and reduce fall injury rates.

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  • Prolonged hospitalization increases risk for adverse outcomes including accelerated functional decline, delirium, pressure ulcers, nosocomial infections and falls.

    “First, prolonged hospitalization increases risk for adverse outcomes including accelerated functional decline, delirium, pressure ulcers, nosocomial infections and falls [8–12].”

    From Risk factors, costs and complications of delayed hospital discharge from internal medicine wards at a Canadian academic medical centre: retrospective cohort study (2019) · cites this paper as [11]

    The Abstract reports that falls among hospital inpatients are common, supporting the falls portion of the cited statement. The paper does not establish that a longer hospital stay increases fall risk; its prospective study describes the circumstances and rates of inpatient falls, not risk by length of stay. The other listed outcomes are not attributed specifically to this paper within the citation range. (LLM, conf=0.84)

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Authors
Hitcho, E. B., Krauss, M. J., Birge, S., Dunagan, W. C., Fischer, I., Johnson, S., Nast, P. A., Costantinou, E., & Fraser, V. J.
Affiliations
  • Washington University in St. Louis (US)
  • BJC HealthCare (US)
  • Barnes-Jewish Hospital (US)
Corresponding author
  • Krauss, Melissa J.
  • Fraser, Victoria J.
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2004-07
Volume
19
Issue
7
Pages
732-739
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1111/j.1525-1497.2004.30387.x
PMC
PMC1492485
OpenAlex
W2050520474
Cited by
546
References
37
Citations by year
2026: 15 · 2025: 23 · 2024: 19 · 2023: 22 · 2022: 23 · 2021: 21 · 2020: 33 · 2019: 31 · 2018: 23 · 2017: 44 · 2016: 31 · 2015: 24 · 2014: 29 · 2013: 29 · 2012: 37
FWCI
27.52
Type
journal article
Language
en
Open access
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
Keywords
inpatient falls, fall-related injuries, fall epidemiology, nurse-to-patient ratio, nurse staffing, fall prevention, fall circumstances, elderly patients
MeSH terms
Accidental Falls, Workforce, Adolescent, Adult, Aged, Aged, 80 and over, Demography, Female, Hospitalization, Hospitals, Teaching, Humans, Male, Middle Aged, Missouri, Nursing Service, Hospital, Prospective Studies, Retrospective Studies, Risk Factors, Incidence, Age Distribution, Sex Distribution

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