13 Characteristics, Circumstances, and Clinical Outcomes of Inpatient Falls in the Medical Department, Hospital Kuala Lumpur (HKL)

Abstract Introduction Falls among hospital inpatients are common, generally ranging from 2.3 to 7 falls per 1000 patient bed days1. Around 30% of falls as inpatient are injurious2. Falls are associated with a longer length of stay in hospital and greater utilization of healthcare facilities3. Objective The goal of this study is to describe patient characteristics, circumstances of fall and clinical outcomes after inpatient fall Methodology This is a retrospective, descriptive study of all patients admitted to the Medical Department in year 2017 who sustained an inpatient fall. The data was obtained from the database of the Falls Team HKL. Results 162 patients, with an average age of (61.82±15.50) years were included in this study. Of these, 103(63.58%) were male and 74(45.68%) were ≥65 years. 120(74.1%) were walking unaided prior to admission. 146(90.1%) patients were admitted with an acute medical illness and 13(8.0%) with an acute fall. Median time to first fall was 5(IQR 3-8) days after admission. 160(98.77%) falls occurred in the ward. 79(48.77%) falls occurred between 9:00pm to 6:59am. 75(46.3%) patients fell near their bed and 56(34.6%) fell in the toilet. 47(29.01%) had an injurious fall; 32(19.7%) had minor injury, 9(5.6%) had moderate injury and 6(3.7%) had severe injury. Patients with injurious falls were more likely to have “Direct Impact to Head” during fall [OR; 12.73 (95%CI 5.62 – 28.82)]. They were also more likely to have a Head CT after fall [(OR; 6.41 (95%CI 3.02 – 13.62)]. 18(11.1%) patients died during hospitalisation. Median time to death was 9(IQR 4-16.25) days after fall. 144(88.9%) patients were discharged alive at median 6(IQR 3.75 – 9.25) days after fall. Upon discharge, only 49(30.2%) patients were walking unaided. Conclusion Inpatient falls affects patients of all age groups, regardless of gender. Our data shows that Inpatient falls can cause increased morbidity due to falls related injuries; however, there is no difference in age, gender, length of stay or death as inpatient between patients with injurious and non-injurious falls.