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Risk factors associated with falls and related injuries of patients

hospitalized in a medical center in Taiwan.

Min-Ling Lin Min-Ling Lin 11 、、 2 2 I-Ju ChenI-Ju Chen 22

Nursing Department, Mackay Memorial Hospital, Taipei, Taiwan, ROC1

School of Nursing, National Yang Ming University2

國立陽明大學護理學院School of Nursing National Yang-Ming University2

Introduction~1Introduction~1 37.3 million people fall and get injury with treatment each year all

over the world.

The elderly falling ratio in Taiwan increased from 18.7% (1999) to

20.5% (2005), and The elderly felt more than 2 times increased

from 2.6% to 3.6%.

In the elderly who attend to ER, about 5% elderly are due to falling

over 42% of the elderly are able to go home.

30% have to be hospitalized for over 30 days.

13% of the elderly who live in nursing facility can’t restore

health status.

國立陽明大學護理學院School of Nursing National Yang-Ming University

Introduction~2Introduction~2

According to the previous study and past experience, most

falls are both predicable and preventable.

Average, 5 to 7 new falling prevention measures can make re-

falling ratio and injuries caused by falls less than 50%.

Changing the residential environment, restoring the

independence of elderly, good exercise programs are also can

be effective in preventing elderly falls.


Introduction~3 Patients in ER for falling are focused medical

treatment after the injury, but if the correct

assessments of fall factors, management,

rehabilitative exercise training, residential

environment, fall prevention plans, are taken, for the

prevention of elderly falls again, it is helpful .


Objectives

This study is to describe and analyze

the characteristics and the relevant

factors of falls patients’ hospitalized in

a medical center in Taiwan.


Methods-1Methods-1

This was a cross-sectional study conducted from

January 1, 2008 to the end of 2009. The study participants were recruited from medical

centers in Taipei, Taiwan. All the elder patients come to ER because of falling

and reviewed by all medical history. Totally, there are 2160 participants in this study.


Methods-2Methods-2

Data analysisDescriptive analyses were performed by

calculating frequencies, percentages, means, and standard deviations.

Independent t-test and Chi-square tests were used to examine differences in characteristics between of hospitalized in falls.

Logistic regression analysis was used to identify factors associated the effect of hospitalized on the falls.

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Result-1Result-1

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Variables n %age Mean±SD 77.00 ±7.44

≦70 y’s 549 23.4%71~80 y’s 1028 43.8%81~90 y’s 674 28.7%

≧91 y’s 98 4.2%

Gender male 832 35.4 %

female 1517 64.6%

Repeat of falls Yes 347 14.8%

No 2002 85.2%

N=2160


Result-2Result-2

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Variables n %The injury severity triage level 1

49 2.1%

triage level 2 1299 55.3% triage level 3 995 42.4%

triage level 4 6 0.3%

Falls events occurred Location home

1138 48.4%

facility 7 0.3%

Public places 801 34.1%

Other place 3 0.1%

unknown 400 17.0%

N=2160


Result-3Result-3

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Variables n %Falls events occurred place Bath room 206 8.8%

Bedroom 154 6.6%Living room 756 32.2%Balcony 2 0.1%

Kitchen 14 0.6%

Other(public places) 815 34.1%

Unknown 402 17.1%

Visit of ER Day shift 1110 47.3 %

Night shift 960 40.9 %

Graveyard shift 279 11.9 %

N=2160


Result-4Result-4

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Variables n %The causes of falls events Floor slippery 248 10.6%

Get up 61 2.6%Drug 3 0.1%Drink 22 0.9%

Transport 36 1.5%

Disease or weakness 21 0.9%

Going up or down stairs 91 3.9%

Obstacle 29 1.2%

Outside force 10 0.4%

Unknown 1828 77.8%

N=2160


Result-5Result-5

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Variables n %Accompanied by family Yes 1332 56.7%

No 837 35.6%

Unknown 180 7.7%

Hospitalization Yes 529 24.5%

No 1631 75.5%

Operation Yes 347 14.8%

No 2002 85.2%

Comorbility Yes 1459 62.1%

No 890 38%

N=2160


Result-6Result-6

Age is positive correlation with “Times of

fall”(p<0.05). The more age is, the more times of

fall.

The patients who are with Comorbility, fall happens

at living room, without accompany, triage level 2, or

age from 75 to 84 have higher rate of

hospitalization(p<.000).

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The logistic regression results are:Age 75-84 years (OR = 0.46, 95% CI: 0.34-0.64)Age ≧85 years(OR = 0.73, 95% CI: 0.53-0.99)Triage level 2 of injury severity(OR = 0.46, 95% CI: 0.23-

0.92)Falls at the time of getting up(OR = 5.23, 95% CI:1.32-

20.70)Falls accidents occur at

living room(OR = 5.25, 95% CI:2.15-12.86)kitchen(OR =7.29, 95% CI:1.70-31.22)public places(OR =6.88, 95% CI:1.97-23.96)

were associated with an increased risk for hospitalization. 14

Result-7Result-7


Discussion-1Discussion-1 The high risk group of the following categories :

“higher age”, “female gender” and “happen at living room” are the same findings as other study.

The people fall at “public places”(34.1%) and “day time”(47.3%) happen with high percentage may be caused by: The old people in Taiwan have more activities in day time

such as morning exercise at park, buy grocery in a traditional market. The low physical indicator of patient and unfriendly environment will cause higher percentage.

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Discussion-2Discussion-2

“Accompanied by families” with lower percentage is

different from other study. This is related the culture

of Taiwan family. There are many generations living

together in a family. The aging population and

decreasing of new born, Taiwan family is facing old

people taking care of old people. Therefore, even

with family, the fall is still happening.

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Conclusion-1Conclusion-1

More falls occur in the living room, kitchen, and

public places. That’s why we should improve our

condition of environment safety.

Education for fall prevention, taking get-up of the

bed for an example, it should be slower to

prevent from falls happening.

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Conclusion-2Conclusion-2

The rate of falls occur in public places as high as

34.7%; the government should develop

guidance and environmental safety related

measures in public places, in order to achieve

the goal ‘’effective prevention of falls’’.

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Thanks for your attention!Thanks for your attention!

e-mail : [email protected]

Health & Medicine

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