Salon 2 14 kasim 15.30 17.00 mınlıng lın

1. 1
Risk factors associated with falls
and related injuries of patients
hospitalized in a medical center in
Taiwan.
MMiinn--LLiinngg LLiinn 11 、22 II--JJuu CChheenn 22
Nursing Department, Mackay Memorial Hospital, Taipei,
Taiwan, ROC1
School of Nursing, National Yang Ming University2

2. IInnttrroodduuccttiioonn~~11
 37.3 million people fall and get injury with treatment each year all
over the world.
 The elderly falling ratio in Taiwan increased from 18.7% (1999) to
20.5% (2005), and The elderly felt more than 2 times increased
from 2.6% to 3.6%.
 In the elderly who attend to ER, about 5% elderly are due to falling
over 42% of the elderly are able to go home.
30% have to be hospitalized for over 30 days.
13% of the elderly who live in nursing facility can’t restore
health status.
國立陽明大學護理學院
School of Nursing National Yang-Ming University 2

3. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
IInnttrroodduuccttiioonn~~22
 According to the previous study and past experience, most
falls are both predicable and preventable.
 Average, 5 to 7 new falling prevention measures can make re-falling
ratio and injuries caused by falls less than 50%.
 Changing the residential environment, restoring the
independence of elderly, good exercise programs are also can
be effective in preventing elderly falls.

4. Introduction~3
 Patients in ER for falling are focused medical
treatment after the injury, but if the correct
assessments of fall factors, management,
rehabilitative exercise training, residential
environment, fall prevention plans, are taken, for the
prevention of elderly falls again, it is helpful .
國立陽明大學護理學院
School of Nursing National Yang-Ming University 4

5. Objectives
This study is to describe and analyze
the characteristics and the relevant
factors of falls patients’ hospitalized in
a medical center in Taiwan.
國立陽明大學護理學院
School of Nursing National Yang-Ming University 5

6. MMeetthhooddss--11
 This was a cross-sectional study conducted from
January 1, 2008 to the end of 2009.
 The study participants were recruited from medical
centers in Taipei, Taiwan.
 All the elder patients come to ER because of falling
and reviewed by all medical history.
 Totally, there are 2160 participants in this study.
國立陽明大學護理學院
School of Nursing National Yang-Ming University 6

7. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
MMeetthhooddss--22
 Data analysis
Descriptive analyses were performed by
calculating frequencies, percentages, means, and
standard deviations.
Independent t-test and Chi-square tests were used
to examine differences in characteristics between
of hospitalized in falls.
Logistic regression analysis was used to identify
factors associated the effect of hospitalized on the
falls.
7

8. N=2160
國立陽明大學護理學院
School of Nursing National Yang-Ming University
RReessuulltt--11
8
Variables n %
age Mean±SD 77.00 ±7.44
≦70 y’s 549 23.4%
71~80 y’s 1028 43.8%
81~90 y’s 674 28.7%
≧91 y’s 98 4.2%
Gender male 832 35.4 %
female 1517 64.6%
Repeat of falls Yes 347 14.8%
No 2002 85.2%

9. N=2160
國立陽明大學護理學院
School of Nursing National Yang-Ming University
RReessuulltt--22
9
Variables n %
The injury
severity triage level 1
49 2.1%
triage level 2 1299 55.3%
triage level 3 995 42.4%
triage level 4 6 0.3%
Falls events
occurred Location home 1138 48.4%
facility 7 0.3%
Public places 801 34.1%
Other place 3 0.1%
unknown 400 17.0%

10. N=2160
國立陽明大學護理學院
School of Nursing National Yang-Ming University
RReessuulltt--33
10
Variables n %
Falls events
occurred place Bath room 206 8.8%
Bedroom 154 6.6%
Living room 756 32.2%
Balcony 2 0.1%
Kitchen 14 0.6%
Other(public places) 815 34.1%
Unknown 402 17.1%
Visit of ER Day shift 1110 47.3 %
Night shift 960 40.9 %
Graveyard shift 279 11.9 %

11. N=2160
國立陽明大學護理學院
School of Nursing National Yang-Ming University
RReessuulltt--44
11
Variables n %
The causes of falls
events Floor slippery 248 10.6%
Get up 61 2.6%
Drug 3 0.1%
Drink 22 0.9%
Transport 36 1.5%
Disease or weakness 21 0.9%
Going up or down stairs 91 3.9%
Obstacle 29 1.2%
Outside force 10 0.4%
Unknown 1828 77.8%

12. N=2160
國立陽明大學護理學院
School of Nursing National Yang-Ming University
RReessuulltt--55
12
Variables n %
Accompanied by family Yes 1332 56.7%
No 837 35.6%
Unknown 180 7.7%
Hospitalization Yes 529 24.5%
No 1631 75.5%
Operation Yes 347 14.8%
No 2002 85.2%
Comorbility Yes 1459 62.1%
No 890 38%

13. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
RReessuulltt--66
 Age is positive correlation with “Times of
fall”(p<0.05). The more age is, the more times of
fall.
 The patients who are with Comorbility, fall happens
at living room, without accompany, triage level 2, or
age from 75 to 84 have higher rate of
hospitalization(p<.000).
13

14. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
RReessuulltt--77
 The logistic regression results are:
Age 75-84 years (OR = 0.46, 95% CI: 0.34-0.64)
Age ≧85 years(OR = 0.73, 95% CI: 0.53-0.99)
Triage level 2 of injury severity(OR = 0.46, 95% CI: 0.23-
0.92)
Falls at the time of getting up(OR = 5.23, 95% CI:1.32-
20.70)
Falls accidents occur at
living room(OR = 5.25, 95% CI:2.15-12.86)
kitchen(OR =7.29, 95% CI:1.70-31.22)
public places(OR =6.88, 95% CI:1.97-23.96)
were associated with an increased risk for
14 hospitalization.

15. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
DDiissccuussssiioonn--11
 The high risk group of the following categories :
“higher age”, “female gender” and “happen at living
room” are the same findings as other study.
 The people fall at “public places”(34.1%) and “day
time”(47.3%) happen with high percentage may be
caused by:
The old people in Taiwan have more activities in day time
such as morning exercise at park, buy grocery in a
traditional market. The low physical indicator of patient
and unfriendly environment will cause higher percentage.
15

16. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
DDiissccuussssiioonn--22
 “Accompanied by families” with lower percentage is
different from other study. This is related the culture
of Taiwan family. There are many generations living
together in a family. The aging population and
decreasing of new born, Taiwan family is facing old
people taking care of old people. Therefore, even
with family, the fall is still happening.
16

17. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
CCoonncclluussiioonn--11
 More falls occur in the living room, kitchen, and
public places. That’s why we should improve our
condition of environment safety.
 Education for fall prevention, taking get-up of the
bed for an example, it should be slower to
prevent from falls happening.
17

18. 國立陽明大學護理學院
School of Nursing National Yang-Ming University
CCoonncclluussiioonn--22
 The rate of falls occur in public places as high as
34.7%; the government should develop
guidance and environmental safety related
measures in public places, in order to achieve
the goal ‘’effective prevention of falls’’.
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19. TThhaannkkss ffoorr yyoouurr aatttteennttiioonn!!
國立陽明大學護理學院
School of Nursing National Yang-Ming University
e-mail : min5741@gmail.com