The use of pediatric fall risk assessment tool in gastrointestinal endoscopic procedures: A prospective study

Abstract

Background and Aims: The aim of this study is to evaluate the fall risk with Humpty Dumpty Fall Scale and determine related risk factors in pediatric patients undergoing gastrointestinal endoscopy. Materials and Methods: A prospective descriptive study was conducted in a large tertiary pediatric hospital. Patients' demographics, type of endoscopy, duration of endoscopic procedures, type of procedural sedation, doses of administered drugs during anesthesia, and post-procedure Humpty Dumpty Fall Scale scores were collected. Post-hoc and logistic regression analyses were performed to identify within-group differences and independent predictors of patient outcomes. Results: One hundred ninety-two pediatric patients (54.2% female) with a mean (standard deviation) age of 11.16 (5.32) years were admitted for a diagnostic gastrointestinal endoscopy. During procedures, the most commonly administered sedatives were midazolam (98.9%), propofol (96.9%), fentanyl (63.0%), and ketamine (34.9%). According to the Humpty Dumpty Fall Scale, 148 (77.1%) patients had a high risk for falls. No falls after endoscopic procedures was observed in the patients. When the predictive factors determining being at high-risk for falls were examined, the simultaneous application of esophagogastroduodenoscopy and colonoscopy under the same procedural sedation increases the risk of being high-risk 5.2 times compared to the performing esophagogastroduodenoscopy alone (p = 0.047). Conclusion: To the best of our knowledge, this is the first study evaluating the use of Humpty Dumpty Fall Scale to predict falls in pediatric patients undergoing gastrointestinal endoscopy with procedural sedation. Although 77.1% of the patients were found to be at high risk for falls, there was no fall event after the endoscopic procedures due to precautionary measures. Our results indicate that pediatric patients undergoing gastrointestinal endoscopy with sedation are at increased risk of falling and preventive measures should be taken.