A 10-Year Study of the Trend of Accidental Falls in the Elderly in a Japanese Hospital.

T. Takekawa, Kei Obuchi, Shu Watanabe, Naoki Yamada, M. Abo
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Abstract

Elderly people are prone to falls. We established the Falls Prevention Working Group (FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This study compared the trend of in-hospital falls in the elderly in two time periods (2008/9 and 2018/9) and determined the effects of FPWG-implemented measures. Using medical records, we counted the monthly number of falls suffered by patients during hospitalization in April 2008-March 2009 and April 2018-March 2019. We also categorized the falls according to the severity of fall-related complications.A total of 3609 hospital falls were recorded during the 2008-2019 period (2008/9: n = 433, 2018/9: n = 324). Falls were more common in patients aged 70-79 in 2008/9 but were noted in those aged ≥ 80 in 2018/9. The mean number of falls/month (27.3 ± 6.4, range: 12-45) was stable throughout the year. The incidence of falls in 2018/9 (1.90/1000 per persons per day) was significantly lower than in 2008/9 (2.30/1000, p = 0.006). Level ≥ 3b accidents, reflecting serious accidents with complications, were encountered in 12 of 433 accidents in 2008/9 compared with significantly fewer accidents (2 of the same severity among 324 accidents) in 2018/9 (p = 0.030).Our results showed a decrease in in-hospital falls in 2018/9 and that the sufferers were older relative to 10 years earlier. A multidisciplinary team should recommend measures to prevent falls and an environment "resilient" to falls, and encourage patients to be aware of possible falls.
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日本医院老年人意外跌倒趋势的十年研究
老年人容易跌倒。我院于2015年成立了预防跌倒工作组(FPWG),以减少住院期间的跌倒次数。本研究比较了两个时间段(2008/9年和2018/9年)老年人院内跌倒的趋势,并确定了FPWG实施的措施的效果。通过病历,我们统计了 2008 年 4 月至 2009 年 3 月和 2018 年 4 月至 2019 年 3 月患者住院期间的每月跌倒次数。我们还根据跌倒相关并发症的严重程度对跌倒进行了分类。2008-2019年期间,共记录了3609起住院跌倒事件(2008/9年:n = 433,2018/9年:n = 324)。2008/9年,70-79岁的患者更常见跌倒,但2018/9年,年龄≥80岁的患者也有跌倒。平均每月跌倒次数(27.3 ± 6.4,范围:12-45)全年保持稳定。2018/9年度的跌倒发生率(1.90/1000人/日)明显低于2008/9年度(2.30/1000,P = 0.006)。2008/9年度的433起事故中有12起发生了≥3b级事故,反映了严重的事故并发症,而2018/9年度的事故明显减少(324起事故中有2起同样严重)(p = 0.030)。我们的研究结果表明,2018/9年度院内跌倒率有所下降,与10年前相比,患者年龄更大。多学科团队应推荐预防跌倒的措施和对跌倒有 "弹性 "的环境,并鼓励患者注意可能发生的跌倒。
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