Falls in A Tertiary Care Hospital – Association with Delirium: A Replication Study

Background Delirium has been previously implicated as a risk factor for patient falls. This is a replication study of a 2009 investigation examining the prevalence of diagnosed and undiagnosed delirium in patients who fell during their hospital stay. Objective To determine the prevalence of delirium at our institution and to examine the relationship of falls with delirium, advanced age and hospital procedures. Method The authors performed a retrospective chart review of 99 patients who fell during their inpatient stay using the data collection tool developed for the 2009 study. Similar information was gathered on patient demographics, fall date, fall location, hospital service type, discharge disposition, diagnosis of delirium, synonyms used to describe delirium, metabolic derangements, and surgeries and/or procedures performed. Data was collected on the day of admission, day of the fall and two days prior to the fall. Results Falls in the general hospital were associated with delirium (73% of subjects had evidence or a diagnosis of delirium at the time of their fall), advanced age (64.5% were older than 70 years of age), and specific procedures and surgeries. Conclusion As identified in the previous study, improving delirium recognition and treatment may reduce the number of patient falls and promote more favorable outcomes such as reduced length of stay, fewer discharges to intermediate care facilities and prevention of fall injuries. A comprehensive fall risk assessment that includes a delirium detection tool would improve the sensitivity and specificity of these instruments to detect those at greatest risk.