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Medications and Patient Characteristics Associated with Falling in the Hospital
Filetype[PDF - 229.46 KB]


Details:
  • Pubmed ID:
    25782559
  • Pubmed Central ID:
    PMC4573384
  • Funding:
    K24 AI067794/AI/NIAID NIH HHS/United States
    KL2 RR024994/RR/NCRR NIH HHS/United States
    KL2 TR000450/TR/NCATS NIH HHS/United States
    U01 CI000333/CI/NCPDCID CDC HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    Objectives

    To evaluate specific medications and patient characteristics as risk factors for falling in the hospital.

    Methods

    Case-control study comparing demographic, health, mobility, and medication data for 228 patients who fell between 6/29/2007 and 11/14/2007 at a large tertiary care hospital and 690 randomly-selected control patients. Logistic regression was used to identify fall risk factors.

    Results

    Independent risk factors for falling included: history of falls (OR, 2.7; 95% CI, 1.8 – 4.2); needing an assistive device (OR, 3.2; 95% CI, 1.5 – 6.8) or person assistance (OR, 2.1; 95% CI, 1.3 – 3.3) to ambulate; being underweight (OR, 2.4; 95% CI, 1.2 – 4.7) or obese (OR, 1.6; 95% CI, 1.0 – 2.5); confusion (OR, 2.4; 95% CI, 1.5 – 4.0); dizziness (OR, 2.1; 95% CI, 1.1 – 4.3); incontinence (OR, 1.5; 95% CI, 1.0 – 2.3); and an order for a hydantoin (OR, 3.3; 95% CI, 1.3 – 8.0) or benzodiazepine anticonvulsant (OR, 2.2; 95% CI, 1.5 – 3.3), haloperidol (OR, 2.8; 95% CI, 1.2 – 6.8), tricyclic antidepressant (OR, 2.4; 95% CI, 1.2 – 4.9) or insulin (OR, 1.5; 95% CI, 1.0 – 2.1). Female gender (OR, 0.8; 95% CI, 0.6–1.0), proton pump inhibitors (OR, 0.6; 95% CI, 0.4 – 0.9), and muscle relaxants (OR, 0.4; 95% CI, 0.3 – 0.7) were associated with lower risk of falling.

    Conclusions

    This study identified medications and patient characteristics associated with increased risk for falling in the hospital. High-risk medications identified in this study may serve as targets for medication review or adjustment, which have been recommended as a component of multifaceted fall prevention programs.