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In-hospital falls more likely in patients undergoing hip or knee replacement

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More patients suffer in-hospital falls when recovering from hip and knee replacement surgery than from other procedures, according to a recent study published in the Journal of Arthroplasty. Congestive heart failure, clotting or bleeding disorders, liver disease, neurological disease, electrolyte and fluid abnormalities and recent weight loss were found to be comorbities that increased patient risk for falls, with pulmonary circulatory disease as the greatest risk.

“If a patient comes in for revision surgery or has certain comorbidities, we know they are at increased risk,” Stavros Memtsoudis, MD, PhD, lead author for the study and an anesthesiologist from the Hospital for Special Surgery, stated in a news release. “Thus patients with these characteristics could be tagged and awareness of staff to especially watch out for this population could be raised.

Researchers used the Nationwide Impatient Sample to analyze patient data between 1998 and 2007 to compare total hip and knee replacement patients who suffered from in-hospital falls to those who did not fall.

The rate of falls among all patients investigated in the study was 0.85%, representing 2.1 falls per 1,000 inpatient days. That rate is going up, the authors noted — increasing from 0.4% to 1.3% within a 10-year period. Memtsoudis attributed the increase to better reporting of falls and a patient population that is getting sicker, adding in the release he believes his team’s findings could be used to develop more effective in-hospital fall prevention programs.

Independent risk factors for falls included revision surgery, advanced age, male sex, minority race and the presence of comorbidities. Those patients who suffered an in-hospital fall were likely to have longer hospital stays and less likely to be discharged to their primary residence.

Reference:

• Memtsoudis SG, Dy CJ, Ma Y, et al. In-hospital patient falls after total joint arthroplasty. J Arthroplasty. 2011. [Published online ahead of print]. doi: 10.1016/j.arth.2011.10.010.

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