Citation

Patman SM, Dennis D, Hill K. Aust. Crit. Care 2011; 24(3): 167-174.

Affiliation

School of Physiotherapy and Institute for Health and Rehabilitation Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia.

Copyright

(Copyright © 2011, Confederation of Australian Critical Care Nurses, Publisher Elsevier Publishing)

DOI

10.1016/j.aucc.2011.06.001

PMID

21783378

Abstract

BACKGROUND: Falling among adults in acute care is an important problem with falls rates in tertiary hospitals ranging from 2% to 5%. Factors that increase the risk of falling, such as advanced age, altered mental status, medications that act on the central nervous system and poor mobility, often characterise individuals who survive a prolonged intensive care unit (ICU) admission. PURPOSE: To measure the incidence of falls and describe the characteristics of fallers among intensive care survivors. METHODS: A comprehensive retrospective chart review was undertaken of 190 adults who were intubated and ventilated for ≥168h and survived their acute care stay. Using a standardised form, several variables were extracted including falls during hospitalisation and risk factors such as age, severity of illness, and length of stay in intensive care and hospital. FINDINGS: Thirty-two (17%, 95% confidence interval 11.5-22.2%) patients fell at least once on the in-patient wards following their ICU stay. Compared with non-fallers, fallers were younger (53.2±17.9 vs. 44.1±18.3 years; p=0.009) and had a shorter duration of inotropic support in ICU (84±112 vs. 56±100h; p=0.040). The majority of fallers were aged less than 65 years (84%). Both fallers and non-fallers had similar APACHE II scores (20±8 vs. 21±7; p=0.673), length of stay in intensive care (14.2±8.7 vs. 14.0±9.7 days; p=0.667) and hospital length of stay (43.9±33.1 vs. 41.0±38.8 days; p=0.533). CONCLUSION: Falling during hospitalisation is common in intensive care survivors. Compared with non-fallers, fallers were younger and required inotropes for a shorter duration. Those who survive a prolonged admission to an ICU may benefit from specific assessment of balance and falls risk by the multidisciplinary team.

Language: en