Development of an algorithm for assessing fall risk in a Japanese inpatient population

AbstractFalling is a representative incident in hospitalization and can cause serious complications. In this study, we constructed an algorithm that nurses can use to easily recognize essential fall risk factors and appropriately perform an assessment. A total of 56,911 inpatients (non-fall, 56,673; fall; 238) hospitalized between October 2017 and September 2018 were used for the training dataset. Correlation coefficients, multivariable logistic regression analysis, and decision tree analysis were performed using 36 fall risk factors identified from inpatients. An algorithm was generated combining nine essential fall risk factors (delirium, fall history, use of a walking aid, stagger, impaired judgment/comprehension, muscle weakness of the lower limbs, night urination, use of sleeping drug, and presence of infusion route/tube). Moreover, fall risk level was conveniently classified into four groups (extra-high, high, moderate, and low) according to the priority of fall risk. Finally, we confirmed the reliability of the algorithm using a validation dataset that comprised 57,929 inpatients (non-fall, 57,695; fall, 234) hospitalized between October 2018 and September 2019. Using the newly created algorithm, clinical staff including nurses may be able to appropriately evaluate fall risk level and provide preventive interventions for individual inpatients.

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Missed opportunities for prevention of hip fracture in older patients

Vojnosanitetski pregled ◽

10.2298/vsp1205420d ◽

2012 ◽

Vol 69 (5) ◽

pp. 420-424 ◽

Cited By ~ 5

Author(s):

Emilija Dubljanin-Raspopovic ◽

Ljiljana Denic-Markovic ◽

Goran Tulic ◽

Mirko Grajic ◽

Sanja Tomanovic ◽

...

Keyword(s):

Risk Factors ◽

Clinical Practice ◽

Hip Fracture ◽

Fracture Risk ◽

Fall Risk ◽

Risk Level ◽

Bone Density Measurement ◽

Prevention Strategies ◽

Fall Risk Factors ◽

Bone Mineral Density Testing

Background/Aim. Osteoporotic fractures are a major cause of morbidity in the population. Therefore, fracture prevention strategies should be a major concern, and one of the priorities in the primary health care system. The aim of the study was to assess fracture and fall risk factors, and fracture risk level in patients with acute hip fracture, and to evaluate if there had been adequate osteoporosis treatment prior to fracture in this group of patients. Methods. Fracture and fall risk factors were assessed in 342 patients, ? 65 years old, hospitalized due to acute hip fracture at the Clinic for Orthopedic Surgery and Traumatology, Clinical Centre of Serbia in a 12-month period. Fall risk factors were assessed with the Fracture Risk Assessment (FRAX?) algorithm, and patients were classified in respect to fracture risk level. Results. Hip fracture occurred in the majority of the patients in the high risk group (74.2%), where no additional bone mineral density testing was needed. Less than 10% of the patients had a diagnosis of osteoporosis before injury, while less than 2% were treated. Cognitive impairment (95.3%), visual impairment (58.2%), lower index of daily activities (51.8%), and depression (47.1%) were the most frequently observed fall risk factors. Conclusion. The results of our investigation reveal insufficient identification of clinical fracture risk factors in the primary care setting, inadequate treatment of osteoporosis and, consequently, ineffective prevention of hip fractures in the geriatric population. The introduction of FRAX? into clinical practice enables more effective acknowledgment of patients with elevated fracture risk, even if bone density measurement is not available. The results of this study have a special significance for everyday clinical practice, because they impose a need for reviewing the existing approaches to osteoporosis prevention, and precise definiment of hip prevention strategies.

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The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

10.35262/jiag.v16i1.5-10 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

H Tuna ◽

Ö Bozan ◽

B Gürpınar ◽

N İlçin

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Risk ◽

Fear Of Falling ◽

Dynamic Balance ◽

Upper Body ◽

Functional Fitness ◽

Fall Risk Factors ◽

Rest Home ◽

History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

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Sex Differences in Modifiable Fall Risk Factors

The Journal for Nurse Practitioners ◽

10.1016/j.nurpra.2021.06.016 ◽

2021 ◽

Author(s):

Yuta Kubo ◽

Keisuke Fujii ◽

Takahiro Hayashi ◽

Naoki Tomiyama ◽

Akira Ochi ◽

...

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Fall Risk ◽

Fall Risk Factors

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Effects of physical exercise on fall risk factors in elderly at home in intervention trial

Environmental Health and Preventive Medicine ◽

10.1007/bf02898014 ◽

2006 ◽

Vol 11 (5) ◽

pp. 250-255 ◽

Cited By ~ 5

Author(s):

Ryosaku Kobayashi ◽

Hiroto Nakadaira ◽

Kazuo Ishigami ◽

Keiko Muto ◽

Shizuki Anesaki ◽

...

Keyword(s):

Risk Factors ◽

Physical Exercise ◽

Fall Risk ◽

Intervention Trial ◽

Fall Risk Factors ◽

At Home

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Nursing care related to fall prevention among hospitalized elderly people: an integrative review

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2020-0904 ◽

2021 ◽

Vol 74 (suppl 2) ◽

Author(s):

Adnairdes Cabral de Sena ◽

Angela Maria Alvarez ◽

Simony Fabíola Lopes Nunes ◽

Nadia Pinheiro da Costa

Keyword(s):

Risk Factors ◽

Elderly People ◽

Nursing Care ◽

Fall Prevention ◽

Fall Risk ◽

Risk Prevention ◽

Hospitalized Elderly ◽

Clinical Nursing ◽

Fall Risk Factors ◽

Care Behavior

ABSTRACT Objective: to identify scientific productions on nursing care related to fall risk prevention among hospitalized elderly people. Methods: an integrative literature review from 2015 to 2019 in the PubMed/MEDLINE, Scopus, Web of Science, LILACS, BDENF, SciELO and CINAHL databases, in Portuguese, English and Spanish. The keywords were elderly, hospitalization, accidents due to falls, nursing care. Results: thirty-three publications were analyzed. The synthesis of the studies resulted in the categories: Clinical nursing assessments to prevent falls among hospitalized elderly people; Fall risk factors for elderly people; Fall risk prevention strategies for elderly people. Final considerations: it was found that the scientific knowledge produced on nursing care related to fall risk prevention for hospitalized elderly people evidences the clinical assessment, risk factors and strategies such as nursing care, contributing to foster self-care behavior and promotion security for elderly people.

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Fall risk factors as predictors of osteoporotic fractures in people with diabetes mellitus

Medical Council ◽

10.21518/2079-701x-2019-4-104-107 ◽

2019 ◽

pp. 104-107

Author(s):

E. S. Mazurenko

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Fall Risk ◽

Osteoporotic Fractures ◽

Fall Risk Factors

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Assessment of risk of falls and internal risk factors in elderly patients who need heart pacemarkers

Slauga. Mokslas ir praktika ◽

10.47458/slauga.2021.2.16 ◽

2021 ◽

Vol 2 (9 (297)) ◽

pp. 1-8

Author(s):

Guoda Burneikaitė ◽

Lina Spirgienė

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Fall Risk ◽

Pacemaker Implantation ◽

Leg Pain ◽

Old Patients ◽

Fall Risk Factor ◽

Fall Risk Factors ◽

Experienced Fatigue ◽

Risk Of Falls

Abstract. The aim is to assess the frequency of falls and intrinsic fall risk factors in patients requiring pacemakers. Methodology. The research was conducted from November 2020 to February 2021. Participated patients were hospitalized at the LUHS hospital Kauno Klinikos Department of Cardiology and required heart pacemaker implantation. Total 82 patients participated in the study. The questionnaire was composed by the authors of the research. The study was obtained by the Bioethics Permit of the Medical Academy of LUHS (No. BEC-SL (B) -42). Results. Almost half of the patients fell (45.1%) at least once a year. Elderly patients (65 years and older) are more likely to experience falls than patients under 65 years of age p=0,006. Elderly patients are more often exposed to various internal risk factors of falls: urination at night (82,9 %), weakness (82,9 %), dizziness (76,8 %). Perceived decreased leg muscle strength was found in both women and men (69.6% and 52.8%, respectively, p = 0.002). Patients older than 65 years and therefore <65 years experienced leg pain (54,9% and 7,2%, respectively, p = 0.002), urination at night (68,4% and 14,6%, respectively, p = 0.009), and experienced fatigue (63,0% and 13,6%, p = 0.028). Conclusions. Almost half of the patients who were in need of heart pacemaker implantation experienced falls. ≥ 65 years old patients experienced falls more than once a year. It has been found that these patients often experience weakness, fatigue, and dizziness. A common intrinsic fall risk factor is urination at night. ≥ 65 years old patients have more internal falls risk factors than patients under 65 years old.

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