Background Falls among hospitalised elderly patients are a major public health concern since they can cause loss of independence, injury and sometimes patient death.
Purpose To examine risk factors, especially drugs, potentially related to falls in elderly patients and to define possible actions.
Materials and methods A retrospective (May 1 2010–March 31 2013) study was performed at ISMETT, a 90-bed hospital. Patient characteristics (age/gender/body mass index, BMI), clinical conditions (diagnosis/comorbidity), ward (Intensive Care Unit, Step-Down Unit, Cardiothoracic Surgery Unit and Abdominal Surgery Unit), length of stay, number of medicines taken within three days before falling and severity of injuries were recorded. Medicines responsible for falls were recorded and analysed according to STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions) criteria. Data were collected from incident report forms and electronic medical records. Results were expressed in percentages.
Results In the study period 49 cases were reported: 32 (65%) were male, 17 (35%) were female, 26 (53%) were older than 65 years, 20 (41%) were overweight, 27 (55%) were admitted for heart disease. The main comorbidities were cardiovascular disease (74%), anxiety/depression (26.5%), arthropathies (26.5%). The highest number of falls was recorded in the Cardiothoracic Surgery Unit (63%) and occurred within ten days of admission (51%). Sixty-seven percent had been given more than ten drugs three days before falling. Severity of injuries was: minor (83%), moderate (15%) and severe (2%). According to STOPP criteria, 40% (10/26) of the elderly who fell were taking opioids, 32% (8/26) vasodilators, 20% (5/26) neuroleptics, 16% (4/26) benzodiazepines and 4% (1/26) first-generation antihistamines. Forty-six percent (12/26) took at least one of the STOPP criteria drugs, while 31% (8/26) took two or more drugs.
Conclusions The incidence of falls is related to a higher percentage of male patients, older than 65 years, who were overweight and had heart failure. According to STOPP criteria, 77% (20/26) of the patients were taking drugs related to a higher risk of falling. Although it is difficult to draw definitive conclusions on influential drugs, it is important to monitor patient treatment. The pharmacist can highlight potential risks for patients and suggest dosing changes or medicines associated with a lower risk of falling.
No conflict of interest.
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