A Comprehensive Analysis of Risk Factors Associated With Inpatient Falls

Abstract

Objectives The primary objective of this study was to identify the relationship between rates of falls among hospitalized patients and the use of inpatient medications associated with falls. Methods This is a retrospective study on patients older than 60 years, hospitalized between January 1, 2021, and December 31, 2021. Ventilated patients and patients with a length of stay or fall less than 48 hours after admission were excluded. Falls were determined by assessing documented post fall assessments in the medical record. Patients who fell were matched 3:1 with control patients based on demographic data (age, sex, length of stay up to the fall time, and Elixhauser Comorbidity score). For controls, a pseudo time to fall was assigned based on matching. Medication information was gathered from barcode administration data. Statistical analysis was conducted using R and RStudio. Results A total of 6363 fall patients and 19,089 controls met the inclusion and exclusion criteria. Seven drug classes were identified as statistically significant (P < 0.001) in increasing an inpatient’s rate of falling: angiotensin-converting enzyme inhibitors (unadjusted odds ratio [OR], 1.22), antipsychotics (OR, 1.93), benzodiazepines (OR, 1.57), serotonin modulators (OR, 1.2), selective serotonin-reuptake inhibitors (OR, 1.26), tricyclics and norepinephrine reuptake inhibitors (OR, 1.45), and miscellaneous antidepressants (OR, 1.54). Conclusions Hospitalized patients older than 60 years are more likely to fall while taking angiotensin-converting enzyme inhibitors, antipsychotics, benzodiazepines, serotonin modulators, selective serotonin-reuptake inhibitors, tricyclics, norepinephrine reuptake inhibitors, or miscellaneous antidepressants. Patients on opiates and diuretics had a significant decrease in rate of falls.