Falls in the General Hospital: Association With Delirium, Advanced Age, and Specific Surgical Procedures

• DOI: 10.1176/appi.psy.50.3.218
• Publication Date: 2009-06-30T18:37:00Z
• Authors: Barbara E. Lakatos; Virginia Capasso; Monique T. Mitchell; Susan M. Kilroy; Mary Lussier-Cushing; Laura Sumner; Jennifer Repper-D...; Erin P. Kelleher; Leslie A. Delisle; Constance Cruz; Theodore A. Stern
• Keywords: Aged, 80 and over; Male; Age Factors; Delirium; Middle Aged; Hospitals, General; 3. Good health; Diagnosis, Differential; 03 medical and health sciences; Cross-Sectional Studies; Injury Severity Score; Postoperative Complications; Massachusetts; Risk Factors; Secondary Prevention; Humans; Wounds and Injuries; Accidental Falls; Female; 0305 other medical science; Aged; Retrospective Studies

Falls and delirium in general-hospital inpatients are related to increases in morbidity, mortality, and healthcare costs. Patients fall despite safeguards and programs to reduce falling.The authors sought to determine the prevalence of diagnosed and undiagnosed delirium in patients who fell during their hospital stay.The authors performed a retrospective electronic chart review of 252 patients who fell during their hospital stay. Falls were categorized by their severity (i.e., minor, moderate, and major). Demographic information, patient outcomes, and diagnostic criteria for delirium (per DSM-IV) were collected on the day of admission, the day of the fall, and the 2 days preceding the patient's fall.Falls in the general hospital were associated with delirium (both diagnosed and undiagnosed), advanced age, and specific surgical procedures.Improving the recognition of undiagnosed delirium may lead to sustainable and successful fall prevention programs. Detection of impairments in mental status can assist staff to create individualized patient care plans. Knowledge about which patients are at risk for injury from delirium and falls can lead to improvements in patient safety, functioning, and quality of life.