Falls in hospitalized geriatric psychiatry patients: high incidence, but only a few fractures

Int Psychogeriatr. 2018 Jan;30(1):161-165. doi: 10.1017/S1041610217001831. Epub 2017 Sep 18.

Abstract

Fall rates from 3.2 to 17.1 falls per 1,000 hospital days in geriatric psychiatry facilities have been reported to date. Up to 5% of the falls result in severe injuries, but data concerning medical consequences are scare. This brief report presents a retrospective analysis of one year fall protocols from a geriatric psychiatry department focusing on consequences of falls. Fall-induced injuries were rated in four categories: no injuries, mild injuries (contusions, hematomas, abrasions), moderate injuries (lacerations, dislocations), and severe injuries (fractures, cerebral hemorrhages). In total, 510 falls were registered during the study period, indicating a fall rate of 17.7 falls per 1,000 hospital days. Overall, 375 falls (73.5%) resulted in no injuries, 67 (13.1%) resulted in mild injuries, 59 (11.6%) resulted in moderate injuries, and only 9 (1.8%) falls led to severe injuries (fractures and cerebral hemorrhages). These results indicate a quite high fall rate in our sample of hospitalized geriatric psychiatry patients with only a relatively small number of severe injuries resulting from the falls. These results raise the question about the use of physical restraints and the use of bedrails in geriatric patients to prevent falls as the medical implications of falls may be less problematic than previously thought.

Keywords: fall-induced injury; fall-rate; geriatric psychiatry; hospital care; older people.

MeSH terms

  • Accidental Falls / prevention & control
  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Female
  • Geriatric Psychiatry
  • Germany / epidemiology
  • Hospitals, Psychiatric / statistics & numerical data*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / prevention & control