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Introduction Old age and society ageing are pressing problems in many countries, and a subject of many studies and publications. People over 80 years old, who are at a particular risk of significant geriatric problems, including falls, are the fastest growing age group. Falls are a leading cause of unintended injuries and associated disability, morbidity, and mortality. They also represent a significant medical, social, and economic problem. Analyses conducted to this date concerned the risk of falling and the rate of falls among elderly people in the environment of their residence. Only scarce studies focus on falls of patients during hospitalisation. Aim of the study The aim of this study was an assessment of the risk and the frequency of falls in geriatric patients during hospitalisation. Material and methods At its first stage, the study covered 256 patients hospitalised at the Internal Medicine and Geriatrics Clinic at the University Hospital in Kraków. At the second stage, the study focused on 60 people who experienced a fall during hospitalisation. The study was conducted between April 2018 and April 2019, and was preceded by a pilot study. The data was collected by analysing documents and conducting a diagnostic survey using standardised research tools: the Tinetti test, the Mini–Mental State Examination (MMSE), the Activity of Daily Living ; (ADL) Scale, the Instrumental Activities of Daily Living Scale (IADL), the Yesavage Geriatric Depression Scale (GDS), the MNA Scale, and a proprietary questionnaire. Statistical analyses were performed using the software application IBM SPSS Statistics 26.0 with the Exact Tests module. The quantitative variables were presented as arithmetic means, standard deviations, minimums, maximums, and medians. The qualitative variables were analysed by calculating the number and the percentage of occurrences for each value. The qualitative variables in groups were compared with the Chi-square test. The relationship strength was determined with the Phi coefficient and Cramér's V. For ordinal variables, relevant coefficients were used: Kendall's tau-b for tables with the same number of columns and rows, and Kendall’s tau-c for tables with the different number of columns and rows. In cases when a dependent variable was measured on a quantitative scale and an independent variable was determined on a qualitative scale, the non-parametric Kruskal-Wallis analysis was used. When conditions for using parametric tests were not met, correlations between ordinal or quantitative variables were determined with the Spearman’s rho coefficient. The level of significance of α=0.05 (p < 0.05) was used in the analyses. Results The risk of a fall during hospitalisation was h ; igh in 21.9% and moderate in 39.8% of the study participants. A statistically significant relationship was found between the risk of falling and factors such as functional independence (p = 0.0001), cognitive functioning (p = 0.049), and taking more than five types of medicines a day (p = 0.020). No relationship was found between the risk of falling and social and demographical data (age, sex, education level, place of residence), symptoms of depression, and a nutritional status. In own studies, the fall occurred in 23.4% of the patients during hospitalisation. Falls usually occurred between Day 1 and Day 7 of hospitalisation, at night or in the morning, in a patient room near the patient’s bed and in a bathroom, during walking or undertaking individual activities. In the opinion of the study participants, external causes of falls included a failure to observe recommendations of the medical personnel, no barriers installed on the bed, and a lack of necessary auxiliary equipment. The main internal causes of the fall included gait dysfunctions, dizziness, and a loss of balance. For 66.7% of the participants, the fall had undesirable consequences, such as skin abrasions, bruises, haematomas, or pain. A subjective fear of falling down again accompanied every third person that experienced a fall during their stay at the hospital. Conclusions Due to th ; e observed increase in the number of people hospitalised at the elderly age, each patient over 65 years old admitted to a hospital should undergo a comprehensive geriatric assessment. An early diagnosis of people at a risk of falling, modification of risk factors for falls, and education of patients, their families, and medical personnel represent effective tools for prevention of falls.
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Feb 20, 2024
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Feb 20, 2024
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http://dl.cm-uj.krakow.pl:8080/publication/5045
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| Edition name | Date |
|---|---|
| ZB-139545 | Feb 20, 2024 |
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