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http://dx.doi.org/10.7739/jkafn.2019.26.1.1

Triggers and Outcomes of Falls in Hematology Patients: Analysis of Electronic Health Records  

Jung, Min Kyung (Seoul St. Mary's Hospital)
Lee, Sun-Mi (College of Nursing, The Catholic University of Korea)
Publication Information
Journal of Korean Academy of Fundamentals of Nursing / v.26, no.1, 2019 , pp. 1-11 More about this Journal
Abstract
Purpose: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. Methods: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. Results: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p<.001), and healthcare costs of 17,052,784 Won (p<.001). Conclusion: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.
Keywords
Accidental falls; Risk factors; Hematology; Length of stay; Health care costs;
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1 Rueda-Lara M, Lopez-Patton MR. Psychiatric and psychosocial challenges in patients undergoing haematopoietic stem cell transplants. International Review of Psychiatry. 2014;26(1):74-86. https://doi.org/10.3109/09540261.2013.866075   DOI
2 Miwa Y, Yamagishi Y, Konuma T, Sato T, Narita H, Kobayashi K, et al. Risk factors and characteristics of falls among hospitalized adult patients with hematologic diseases. Journal of Geriatric Oncology. 2017;8(5):363-367. https://doi.org/10.1016/j.jgo.2017.07.003   DOI
3 Kim CG, Suh MJ. An Analysis of fall incidence rate and its related factors of fall in inpatients. Journal of Korean Socity of Quality Assurance in Health Care. 2002;9(2):210-228.
4 Filler K, Kelly DL, Lyon D. Fall risk in adult inpatients with leukemia undergoing induction chemotherapy. Clinical Journal of Oncology Nursing. 2011;15(4):369-370. https://doi.org/10.1188/11.cjon.369-370   DOI
5 Ueki S, Ikegame K, Kozawa M, Miyamoto J, Mori R, Ogawa H. Risk analysis of falls in patients undergoing allogeneic hematopoietic stem cell transplantation. Clinical Journal of Oncology Nursing. 2014;18(4):396-399. https://doi.org/10.1188/14.cjon.396-399   DOI
6 Abreu HC, Reiners AA, Azevedo RC, Silva AM, Abreu D, Oliveira A. Incidence and predicting factors of falls of older inpatients. Revista de Saude Publica. 2015;49:37. https://doi.org/10.1590/s0034-8910.2015049005549
7 Capone LJ, Albert NM, Bena JF, Tang AS. Predictors of a fall event in hospitalized patients with cancer. Oncology Nursing Forum. 2012;39(5):E407-E415. https://doi.org/10.1188/12.onf.e407-e415
8 Chang VC, Do MT. Risk factors for falls among seniors: Implications of gender. American Journal of Epidemiology. 2015;181(7):521-531. https://doi.org/10.1093/aje/kwu268   DOI
9 Vela CM, Grate LM, McBride A, Devine S, Andritsos LA. A retrospective review of fall risk factors in the bone marrow transplant inpatient service. Journal of Oncology Pharmacy Practice. 2017;24(4):272-280. https://doi.org/10.1177/1078155217697485   DOI
10 Lee JY, Jin Y, Piao J, Lee SM. Development and evaluation of an automated fall risk assessment system. International Journal for Quality in Health Care. 2016;28(2):175-182. https://doi.org/10.1093/intqhc/mzv122   DOI
11 Donabedian, A. Methods for deriving criteria for assessing the quality of medical care. Medical Care Review. 1980;37(7):653-698.
12 Hong HJ, Kim N, Jin Y, Piao J, Lee SM. Trigger factors and outcomes of falls among Korean hospitalized patients: analysis of electronic medical records. Clinical Nursing Research. 2015;24(1):51-72. https://doi.org/10.1177/1054773814524225   DOI
13 Choi EJ, Lee YS, Yang EJ, Kim JH, Kim YH, Park HA. Characteristics and risk factors for falls in tertiary hospital inpatients. Journal of Korean Academy of Nursing. 2017;47(3):420-430. https://doi.org/10.4040/jkan.2017.47.3.420   DOI
14 Kim YS, Choi-Kwon S. Fall risk factors and fall risk assessment of inpatients. Korean Journal of Adult Nursing. 2013;25(1):74-82. https://doi.org/10.7475/kjan.2013.25.1.74   DOI
15 Kim EK, Lee JC, Eom MR. Falls risk factors of inpatients. Journal of Korean Academy of Nursing. 2008;38(5):676-684. https://doi.org/10.4040/jkan.2008.38.5.676   DOI
16 Park SH, Kim EK. Systematic review and meta-analysis for usefulness of fall risk assessment tools in adult inpatients. Korean Journal of Health Promotion. 2016;16(3):180-191. https://doi.org/10.15384/kjhp.2016.16.3.180   DOI
17 Lunde AV, Barrett-Connor E, Morton DJ. Serum albumin and bone mineral density in healthy older men and women: The Rancho Bernardo Study. Osteoporosis International. 1998;8(6):547-551. https://doi.org/10.1007/s001980050097   DOI
18 Kang YO, Song R. Validation of fall risk assessment scales among hospitalized patients in south Korea using retrospective data analysis. Korean Journal of Adult Nursing. 2015;27(1):29-38. https://doi.org/10.7475/kjan.2015.27.1.29   DOI
19 Lee DG, Rho YI, Moon KR. Assessment of nutritional status in hospitalized pediatric patients. Korean Jounal of Pediatric gastroenterology and Nutrition. 2001;4(1):83-91.   DOI
20 Vivanti A, Ward N, Haines T Nutritional status and associations with falls, balance, mobility and functionality during hospital admission. The Journal of Nutrition Health and Aging, 2011;15(5):388-391. https://doi.org/10.1007/s12603-010-0302-8   DOI
21 Lee YW, Nam SI. Medications as risk factor for falls. Research in Vestibular Science. 2016;15(4):101-106. https://doi.org/10.21790/rvs.2016.15.4.101   DOI
22 Chiu MH, Lee HD, Hwang HF, Wang SC, Lin MR. Medication use and fall-risk assessment for falls in an acute care hospital. Geriatrics Gerontology International. 2015;15(7):856-863. https://doi.org/10.1111/ggi.12359   DOI
23 Lee YJ, Gu MO. Circumstances, Risk factors, and the predictors of falls among patients in the small and medium-sized hospitals. Journal of Korean Clinical Nursing Research. 2015;21(2):252-265. https://doi.org/10.22650/JKCNR.2015.21.2.252   DOI
24 Jung JY, Suh CH. Glucocorticoid-induced osteoporosis. The Korean Journal of Medicine. 2017;92(2):142-149. https://doi.org/10.3904/kjm.2017.92.2.142   DOI
25 Kim SJ, Lee YM. Falls risk factors of elderly inpatients. Journal of the Korean Data Analysis Society. 2014;16(4):2191-2203.
26 Choe MA. Steroid induced muscle atrophy. Perspectives in Nursing Science. 2005;2(1):19-36.
27 Hirose M, Nakabayashi N, Fukuda S, Yamaguchi S, Igawa M, Egami K, et al. Additional medical costs due to hospitalacquired falls. Journal of Patient Safety. 2015 Forthcoming. https://doi.org/10.1097/pts.0000000000000200
28 Evans D, Hodgkinson B, Lambert L, Wood J. Falls risk factors in the hospital setting: a systematic review. International Journal of Nursing Practice. 2001;7(1):38-45. https://doi.org/10.1046/j.1440-172x.2001.00269.x   DOI
29 Choi EH, Ko MS, Yoo CS, Kim MK. Characteristics of fall events and fall risk factors among inpatients in general hospitals in Korea. Journal of Korean Clinical Nursing Research. 2017;23(3):350-360. https://doi.org/10.22650/JKCNR.2017.23.3.350   DOI
30 Coussement J, De Paepe L, Schwendimann R, Denhaerynck K, Dejaeger E, Milisen K. Interventions for preventing falls in acute- and chronic-care hospitals: A systematic review and meta-analysis. Journal of the American Geriatrics Society. 2008;56(1):29-36. https://doi.org/10.1111/j.1532-5415.2007.01508.x   DOI