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Fall-related Injuries (fall-related + injury)
Selected AbstractsThe role of depressive symptoms in recovery from injuries to the extremities in older persons.INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2003A prospective study Abstract Background Previous research suggested that depressive symptoms play a role in recovery after hip fracture. However none of these studies were prospective and included only patients with hip fractures. Objective To examine the effect of depressive symptoms on the recovery of (instrumental) activities of daily living after fall-related injuries to the extremities in older persons. Design Prospective cohort study. Methods Data were collected from 168 older persons at baseline, prior to their injuries (hip fractures, other fractures or contortions and dislocations), and 8 weeks, 5 months and 12 months after their accident. Hierarchical multiple regression analysis was used to study the impact of depressive symptoms (as assessed with the Hospital Anxiety and Depression Scale; HADS) on disability (as assessed with the Groningen Activity Restriction Scale; GARS) after the injury while adjusting for several covariates. Results Depressive symptoms at baseline were not predictive for disability after the injury when covariates were taken into account. However, depressive symptoms 8 weeks after the fall were significantly related to disability at 8 weeks, 5 months and even 12 months after the injury. In addition, disability levels before the injury were highly predictive for recovery later on. Severity of injury was particularly predictive for disability at 8 weeks while age (which may generally represent the amount of physiological reserve) predicted disability at 5 and 12 months after the injury. Cognitive functioning 8 weeks post-injury was, in contrast to previous research, not predictive for recovery when covariates were taken into account. Conclusions Pre-injury levels of disability and post-injury depressive symptoms are associated with recovery and may warrant concern and special attention in clinical practice. Copyright © 2002 John Wiley & Sons, Ltd. [source] The use of fall prevention guidelines in German hospitals , a multilevel analysisJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2010Kathrin Raeder MA RN Abstract Aims, Falls and fall-related injuries are major problems in hospitals. The aim of this study was to examine the impact of fall prevention guidelines on falls and fall-related injuries in hospitals. Method, A cross-sectional study was conducted in German hospitals. Some 28 hospitals participated with a total of 5046 patients. Eleven of these hospitals had already implemented a fall prevention guideline, 10 were in the process of developing such a guideline and seven hospitals were not using any fall prevention guideline at all. A standardized questionnaire was used on the individual patient level to obtain details regarding the socio-demographic background, falls, fall-related injuries and other problems relevant to nursing. A further questionnaire referred to the use of fall prevention guidelines in the individual hospitals. Data specific to falls were analysed both on hospital level and on ward and patient level by means of a multilevel logistic model. Results, The univariate analyses suggest that patients in hospitals that are using guidelines are more likely to fall [odds ratios (OR) = 1.19, confidential interval (CI) = 0.65,2.18] than in hospitals that do not use any guideline (reference category) or are still in the developing stage (OR = 0.82, KI = 0.77,0.87). If, in a multivariate analysis, the ward level and individual patient variables (age, disorientation, confusion, incontinence) are included, the following results are obtained: the probability of falls in hospitals not using guidelines (reference category) is higher than in hospitals developing a guideline (OR = 0.86, KI = 0.58,1.28) or using a guideline (OR = 0.71, KI = 0.44,1.14). The differences are even more distinct regarding the injuries resulting from a fall that require medical treatment. The probability of these injuries is significantly lower in hospitals using guidelines (OR = 0.27, KI = 0.09,0.85) than in hospitals developing a guideline (OR = 0.61, KI = 0.24,1.54) or not using any guidelines at all (reference category). Conclusion, The present results of the multilevel analysis show that falls and fall-related injuries can be reduced by the implementation of fall prevention guidelines. [source] Predictors of serious injury among hospitalized patients evaluated for falls,,JOURNAL OF HOSPITAL MEDICINE, Issue 2 2010Sara M. Bradley MD Abstract BACKGROUND: Inpatient falls are common and result in significant patient morbidity. OBJECTIVE: To identify predictors of serious injury being found on imaging studies of inpatients evaluated after a fall. DESIGN: Retrospective study. SETTING: An 1171-bed urban academic medical center. PATIENTS: All inpatients who fell on thirteen medical and surgical units from January 1 to December 31, 2006. MEASUREMENTS: Patient characteristics, circumstances surrounding falls, fall-related injuries, and length of stay were collected through review of incident reports and computerized medical records. Primary outcome of fall-related injury was determined by evidence of injury on imaging studies within two weeks of the fall. Univariate and multivariate logistic regression were used to calculate adjusted odds ratios (ORs) for injury after an inpatient fall. RESULTS: A total of 513 patients had 636 falls during the study time period. Fall incidence rate was 1.97 falls per 1,000 patient days. 95 patients (19%) fell multiple times (range, 2-6 events); 74% of the falls occurred in patients who were previously assessed as being "at risk" by the nursing staff. Multivariate analysis, adjusting for age and sex, found evidence of trauma after a fall (OR = 24.6, P < 0.001) and ambulatory status (OR = 7.3, P < 0.01) to be independent predictors of injury being found on imaging studies. CONCLUSIONS: Inpatient falls are common despite high-risk patients being identified. After adjusting for age and sex, evidence of trauma and ambulatory status were independent predictors of an injury being found on imaging studies after an inpatient fall. Journal of Hospital Medicine 2010;5:63,68. © 2010 Society of Hospital Medicine. [source] Community-based programmes to prevent falls in children: A systematic reviewJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9-10 2005Rod McClure Objective: We systematically reviewed the literature to examine the evidence for the effectiveness of community-based interventions to reduce fall-related injury in children aged 0,16 years. Methods: We performed a comprehensive search of the literature using the following study selection criteria: community-based intervention study; target population was children aged 0,16 years; outcome measure was fall-related injury rates; and either a community control or historical control was used in the study design. Quality assessment and data abstraction were guided by a standardized procedure and performed independently by two authors. Results: Only six studies fitting the inclusion criteria were identified in our search and only two of these used a trial design with a contemporary community control. Neither of the high quality evaluation studies showed an effect from the intervention and while authors of the remaining studies reported effective falls prevention programmes, the pre- and post-intervention design, uncontrolled for background secular trends, makes causal inferences from these studies difficult. Conclusion: There is a paucity of research studies from which evidence regarding the effectiveness of community-based intervention programmes for the prevention of fall-related injury in children could be based. [source] | ||||||||||