Tohoku J. Exp. Med., 2017 November, 243(3)

Exploring Risk Factors of Patient Falls: A Retrospective Hospital Record Study in Japan

MAMI ISHIKURO,¹ SERGIO RAMÓN GUTIÉRREZ UBEDA,² TAKU OBARA,^1,3 TOSHIHIDE SAGA,^3,4 NAOFUMI TANAKA,⁵ CHIYO OIKAWA^4,6 and KEISEI FUJIMORI^4,7

¹Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization (ToMMo), Tohoku University, Sendai, Miyagi, Japan
²Center of Investigation and Study of Health, National Autonomous University of Nicaragua, Managua, Nicaragua
³Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan
⁴Medical Safety Management Office, Tohoku University Hospital, Sendai, Miyagi, Japan
⁵Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
⁶Department of Nursing, Tohoku University Hospital, Sendai, Miyagi, Japan
⁷Department of Breast and Endocrine Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan

Patient falls are common adverse medical events in hospitals. The objectives of this study were to clarify the factors of patient falls at hospitalization or transfer to another ward, which could be assumed that patients experience new environment. Patients who were hospitalized or transferred to another ward at a hospital in Japan, between January 14 and February 14, 2014 were included. We used a risk assessment sheet and applied stepwise regression analysis to identify factors of patient falls. We also investigated changes in patient conditions on the risk assessment sheet by the chi-square test. A total of 1,362 patients (53.2% female; mean age, 57.1 ± 18.0 years) were eligible for analysis, and 38 (2.8%) fell during the study period. The fallers were significantly older than the non-fallers (63.8 ± 18.0 vs. 56.9 ± 18.7 years, P = 0.03), but no significant difference was seen in sex (55.3% vs. 53.1% female). “History of falls”, “Tubes inserted”, “Need assistance/supervision for toileting” and “Excretion more than two times per night” were significantly related to patient falls (adjusted odds ratios [95% confidence interval]: 2.41 [1.05-5.53], 3.64 [1.57-8.43], 4.52 [2.00-10.23] and 3.92 [1.38-11.09]). Among 30 fallers, “Overestimation or non-understanding of own physical abilities” was significantly more frequent after falls (30.0%) than before falls (6.7%, P = 0.02). The factors found in this study might be useful for identifying patients at higher risk of falls.

keywords —— falls; hospital; inpatients; risk assessment; safety

© 2017 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2017, 243, 195-203

Correspondence: Keisei Fujimori, Ph.D., Medical Safety Management Office, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.

e-mail: fujimori-k@med.tohoku.ac.jp