Incidence and determinants of falls among tertiary care hospital inpatients in Western India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20262732Keywords:
Inpatient falls, Fall incidence, Risk factors, Patient vulnerability, Visual impairmentAbstract
Background: Inpatient falls are a common and preventable cause of morbidity, prolonged hospital stay, and increased healthcare costs worldwide. However, data on incidence and context-specific risk factors in Indian hospital settings remain limited. Aim was to estimate the incidence of falls among inpatients in a tertiary care hospital in Western India and identify associated risk factors.
Methods: A cross-sectional survey and matched case-control study was conducted in a 560-bedded tertiary care hospital in Western India over 24 months. Among adult inpatients, 97 fall cases were identified and matched (1:2) with controls by gender, admission date, and length of stay. Fall incidence per 1000 person-days and adjusted odds ratios (aOR) were calculated using multivariate logistic regression.
Results: Among 4,179 inpatients, 97 falls occurred over 31,732 person-days (fall rate 2.32%; incidence 3.1 per 1000 person-days). Falls were most common in patients aged >60 years. Independent risk factors included hospital stay >7 days (aOR 5.56), composite vulnerability (aOR 8.82), prior fall within 6 months (aOR 7.21), visual impairment (aOR 75.2), and multiple comorbidities (aOR 5.31). Medication class was not significant on multivariate analysis. Use of sequential compression devices was associated with reduced fall risk (aOR 0.001).
Conclusions: Inpatient falls were associated primarily with patient vulnerability, sensory impairment, clinical complexity, and prolonged hospitalization. We recommend routine surveillance of inpatients to assess composite vulnerability, visual impairment, and other fall-related risk factors, with particular emphasis on patients aged over 60 years, alongside prioritised monitoring based on identified risk indicators.
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