Document Detail


Falls Among Patients Who Had Elective Orthopedic Surgery: A Decade of Experience From a Musculoskeletal Specialty Hospital.
MedLine Citation:
PMID:  23321996     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To evaluate falls among elective orthopedic in-patients at a musculoskeletal hospital. BACKGROUND: Falls are the most commonly reported hospital incidents. Approximately 30% of in-hospital falls result in minor injury; up to 8% of falls result in moderate to severe injury. Given the projected rise in elective orthopedic procedures, it is important to better understand fall patterns in this population. METHODS: Retrospective cohort (2000-2009). RESULTS: There were 868 falls among orthopedic patients >18 years. Fall rate was 0.9% of admissions; 2.0 falls/1000 in-patient days. Average age was 68 years; 57.7% were women. Knee replacements (38.2%), spine procedures, (18.5%) and hip replacements, (14.7%) were the procedures most commonly associated with falls. 386 falls (45.8%) involved bathroom usage. 110 first falls (13.1%) resulted in injuries. 28 falls (3.3%) resulted in serious events, including 5 returns to operating room, 3 transfers to higher level of care, 14 prosthesis dislocations, 6 fractures, 2 intra-cranial bleeds and 1 hemorrhage. Patients with serious injuries were more likely to fall earlier, (post-operative day 2.7 vs. 4.1, (mean difference 1.4 days, 95% CI 0.51 to 2.3; P-value 0.003) and to have had hip replacement: (OR 3.7; 95% CI 1.7-8.2). Serious injuries were not associated with BMI, age, gender, hospital location, day or fall history. CONCLUSION: Falls are avoidable events, which are poorly described among orthopedic patients having elective procedures. This large series identifies hip replacement patients as being at almost four-fold risk of having a serious adverse event after falling. However, as this is a retrospective study, larger prospective trials are needed to confirm results, and to inform prevention strategies.J Orthop Sports Phys Ther. Epub 14 January 2013. doi:10.2519/jospt.2013.4349.
Authors:
Lisa A Mandl; Stephen Lyman; Patricia Quinlan; Tina Bailey; Jacklyn Katz; Steven K Magid
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-14
Journal Detail:
Title:  The Journal of orthopaedic and sports physical therapy     Volume:  -     ISSN:  1938-1344     ISO Abbreviation:  J Orthop Sports Phys Ther     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908150     Medline TA:  J Orthop Sports Phys Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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