Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct 7;16(1):173.
doi: 10.1186/s12877-016-0346-7.

Fall risk as a function of time after admission to sub-acute geriatric hospital units

Kilian Rapp  1   2 , Johannes Ravindren  3 , Clemens Becker  4 , Ulrich Lindemann  4 , Andrea Jaensch  5 , Jochen Klenk  4   5
Affiliations

Fall risk as a function of time after admission to sub-acute geriatric hospital units

Kilian Rapp et al. BMC Geriatr. .

Abstract

Background: There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk.

Methods: This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014. Falls, personal characteristics and functional status at admission were extracted from the hospital information system. The rehabilitation stay was divided in 3-day time-intervals. The fall rate was calculated for each time-interval in all patients combined and in subgroups of patients. To analyse the influence of covariates on fall risk over time multivariate negative binomial regression models were applied for each of 5 time-intervals.

Results: The overall fall rate was 10.2 falls/1,000 person-days with highest fall risks during the first week and decreasing risks within the following weeks. A particularly pronounced risk pattern with high fall risks during the first days and decreasing risks thereafter was observed in men, disoriented people, and people with a low functional status or impaired cognition. In disoriented patients, for example, the fall rate decreased from 24.6 falls/1,000 person-days in day 2-4 to about 13 falls/1,000 person-days 2 weeks later. The incidence rate ratio of baseline characteristics changed also over time.

Conclusions: Fall risk differs considerably over time during sub-acute hospitalisation. The strongest association between time and fall risk was observed in functionally limited patients with high risks during the first days after admission and declining risks thereafter. This should be considered in the planning and application of fall prevention measures.

Keywords: Accidental Falls; Confusion; Femoral Fractures; Rehabilitation Centers; Stroke.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Fall rate as a function of time (a) after admission to the rehabilitation clinic, (b) stratified by gender, (c) by diagnosis, (d) by orientation, (e) by Barthel index, (f) by cognitive function (DemTect)
Fig. 2
Fig. 2
Distribution of falls between day and night stratified by time after admission to the rehabilitation clinic
See this image and copyright information in PMC

References

    1. Rapp K, Lamb SE, Klenk J, Kleiner A, Heinrich S, König H-H, et al. Fractures after nursing home admission: incidence and potential consequences. Osteoporos Int. 2009;20(10):1775–1783. doi: 10.1007/s00198-009-0852-y. - DOI - PubMed
    1. Rapp K, Becker C, Lamb SE, Icks A, Klenk J. Hip fractures in institutionalized elderly people: incidence rates and excess mortality. J Bone Miner Res Off J Am Soc Bone Miner Res. 2008;23(11):1825–1831. doi: 10.1359/jbmr.080702. - DOI - PubMed
    1. Rapp K, Cameron ID, Becker C, Kleiner A, Eckardt M, König H-H, et al. Femoral fracture rates after discharge from the hospital to the community. J Bone Miner Res Off J Am Soc Bone Miner Res. 2013;28(4):821–827. doi: 10.1002/jbmr.1809. - DOI - PubMed
    1. von Renteln-Kruse W, Krause T. Incidence of in-hospital falls in geriatric patients before and after the introduction of an interdisciplinary team-based fall-prevention intervention. J Am Geriatr Soc. 2007;55(12):2068–2074. doi: 10.1111/j.1532-5415.2007.01424.x. - DOI - PubMed
    1. Schwendimann R, Bühler H, De Geest S, Milisen K. Characteristics of hospital inpatient falls across clinical departments. Gerontology. 2008;54(6):342–348. doi: 10.1159/000129954. - DOI - PubMed