Study finds no link between elderly patient activity and hospital falls

Elderly patients who suffered in-hospital falls were found to be no more active than patients who did not fall, according to a study from the University of Texas.

Investigators for the retrospective case-control study, published in the Archives of Physical Medicine and Rehabilitation, analyzed the mobility patterns of elderly patients aged 65 years or older who were fitted with small electronic devices that counted their steps.

"We matched 10 patients who had fallen with 25 who had not fallen based on age, gender, reason for admission, illness severity and mobility status before admission," Steven Fisher, PT, PhD, stated in a University of Texas press release. "All of these people had worn step activity monitors during their stay in the hospital and when we analyzed the data from these devices, we found no statistical difference in the amount of walking between the groups."

The study's results, Fisher suggested in the release, indicate that reducing elderly patients' mobility could not only risk hospital deconditioning, but also do little to prevent falls.

Nurses documented fall incidents throughout each patient's hospital stay, using a standardized patient safety event report. Information collected for all participants included the number of steps per 24-hour interval, time spent walking and total number of activity episodes.

Those patients who fell, according to the study abstract, took an average of 480.3 steps - with a standard deviation of ± 432.2 steps. The researchers reported these patients also spent 53.8 ± 36.9 minutes walking and engaged in 25.8 ± 16.9 episodes of activity. Patients who did not fall took 680.1 ± 876.0 steps, spent 50.1 ± 58.6 minutes walking and were engaged in 21.6 ± 23.8 episodes of activity. Using logistic regression, the team reported no associations between fall outcome and mean daily steps.

According to the release, the team did find that cognition was an important factor in fall rates, as patients suffering from delirium were more likely to fall. Hospital environment also was noted as a potential contributing factor, as all of the falls in the study took place at night, with 60% of falls related to bathroom visits.

Reference:

Fisher SR, Galloway RV, Kuo YF, et al. Pilot study examining the association between ambulatory activity and falls among hospitalized older adults. Arch Phys Med Rehabil. 2011. doi:10.1016/j.apmr.2011.06.022.

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