• Title/Summary/Keyword: Risk factors for falls

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Factors associated with the injury severity of falls from a similar height and features of the injury site in Korea: a retrospective study

  • Dae Hyun Kim;Jae-Hyug Woo;Yang Bin Jeon;Jin-Seong Cho;Jae Ho Jang;Jea Yeon Choi;Woo Sung Choi
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.187-195
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    • 2023
  • Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

Analysis of Nursing Diagnoses Applied to Emergency Room Patients - Using the NANDA Nursing Diagnosis Classification - (응급실 입원환자에게 적용된 간호진단분석 - NANDA 간호진단 분류 이용 -)

  • Kim, Young A;Choi, Soon Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.1
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    • pp.16-24
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    • 2015
  • Purpose: This study was done to identify essential nursing diagnoses using NANDA and their related factors and defining characteristics of patients who were cared in an emergency room. Methods: The research checklist developed by the researcher consisted of 44 nursing diagnoses with defining characteristics and related factors and was applied to 235 patients who were admitted to an emergency room from November 1 to December 31, 2012. Results: Forty-one of forty-four nursing diagnoses were identified. The most frequent nursing diagnoses were acute pain, risk for falls, and activity intolerance. The most frequent defining characteristic for the nursing diagnosis of 'acute pain' was verbal report of pain. The agreement rate with NANDA (2009)'s defining characteristics was 66.7%. Conclusion: Results indicate that identification of essential nursing diagnoses and their defining characteristics and related/risk factors is important for emergency patient nursing care to facilitate use of NANDA taxonomy in the emergency nursing practice and documentation systems.

Examination of useful items for the assessment of fall risk in the Korean community-dwelling elderly (한국 노인의 낙상위험평가 설문항목의 유효성 검토)

  • Shin, Sohee
    • Journal of the Korea Convergence Society
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    • v.9 no.6
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    • pp.271-277
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    • 2018
  • The aim of this study was to select useful items for assessing fall risk in community-dwelling elderly. This study assumed five fall risk factors: Symptoms of falling, physical function, disease and physical symptoms, environment, and behavior and character based on previous studies. The questionnaire consisted of 44 items according to the contents validation, crossover analysis and factor analysis. The Korean version of the Fall Risk Assessment Scale (FRA-K) will be used as a useful tool to improve the fall problems perceived to be serious social problems and to provide important information for prevention of falls.

Factors Influencing the Fear of Falling According to Gender in Frail Elderly (지역사회 재가 허약노인의 낙상두려움 관련요인 성별 비교)

  • Choi, Kyungwon;Park, Un-A;Lee, In-Sook
    • 한국노년학
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    • v.31 no.3
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    • pp.539-551
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    • 2011
  • Purpose: This study was to investigate the factors influencing the fear of falling in frail elderly according to gender. Methods: The participants were the elderly over 65 years who were registered for case management for frail elderly of 253 public health centers. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 18.0. Results: Prevalence of fear of falling and the influential factors were different according to gender. 75.3% of the male elderly, 85.4% of the female elderly had the fear of falling. The predictors for men's fear of falling were static balance ability, experiences of previous falls, whereas for women static balance ability, TImed up and go, depression, experiences of previous falls, educational status were significant. Conclusion: Fear of falling and the influential factors of the frail elderly according to gender should be assessed regularly to find the high risk group. On the basis of that, prevention program for fear of falling and fall need to be developed and provided, which should be gender sensitive.

Physical Function and Psychological Status in the Elderly those who Experienced a Fall or not (재가 노인의 낙상 경험 유무에 따른 신체적 기능과 정서 상태)

  • Chang, Chong-Mi;Kang, Hyun-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.7 no.1
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    • pp.48-57
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    • 2004
  • Introduction : The purposes of this study was to examine physical function and psychological status in the elderly caused by a fall. Method : The study was designed as a descriptive survey. Its subjects consisted of the 299 elderly over 65 years. Collected data were analyzed by the SPSS 10.0 program package. Results : The result of this study are as follows : 1) The score for ADL was significantly lower in the fall group. 2) Grip strength was significantly lower in the fall group. 3) Lapse of the motion sitting and standing was significantly longer in the fall group. 4) One-leg-standing time with the eyes open and closed was significantly shorter in the fall group. 5) Return time of 3m walk was significantly longer in the fall group. 6) The score for dizziness was significantly higher in the fall group. 7) The score for fear for a fall and depression were significantly higher in the fall group. 8) The score for falls efficacy was significantly lower in the fall group. Conclusion: ADL, muscle strength, balance, dizziness, fear for a fall, falls efficacy and depression turned out to be closely related to the fall of the elderly. Therefore, it would be required to develop and applicate the fall prevention program regarding these above risk factors.

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Fall Risk Home Environment and Fall Experiences among Community-Dwelling Older People (지역사회 재가노인의 낙상위험주거환경과 낙상경험)

  • Han, Jiyoon;Park, Eunok
    • Journal of agricultural medicine and community health
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    • v.47 no.1
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    • pp.27-39
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    • 2022
  • Objectives: The purpose of this research was to explore Fall Risk Home Environment(FRHE) and to investigate the association between FRHE and fall experience among community-dwelling older adults. Methods: The data were collected from 299 older adults using FRHE through observation and interview at home of the participants and were analyzed with SPSS 22.0 applying descriptive statistics, χ2-test, t-test, and logistic regression analysis. Results: The prevalence of fall experience during the past year was 51.5%. 'No handles beside the toilet or bathtub'(73.2%) was most common FRHE factor, 'thresholds in your room or kitchen'(68.9%), 'wearing socks, outer socks, or slipper when you move in the house'(59.5%), and threshold on the gate (apartment entrance)(55.5%) were followed. The findings of logistic regression of FRHE on fall experiences showed darkness of house had the highest Odds Ratio (OR 9.83 95% CI 3.75-25.71), followed by furniture obstructs your walking in the house(OR 7.07, CI 2.88-17.36), dark kitchen (OR 5.13, CI 2.38-11.03). The group having fall experiences presented significantly higher score of FRHE than the group of non experiences of fall. Conclusion: The community dwelling older adults exposures to various FRHE factors and FRHE might increase the risk of falls. Assessing and modifying the home environment could be a good strategy to prevent fall among older adults.

Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures

  • Byun, Joung Hun;Kim, Han Young
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.130-134
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    • 2013
  • Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

The Effects of Ankle Strengthening Training and Whole Body Vibration on the Balance of Older Adults Who Have Experienced a Fall

  • Choi, Jung Hyun;An, Ho Jung
    • Journal of International Academy of Physical Therapy Research
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    • v.6 no.2
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    • pp.884-890
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    • 2015
  • This study observed the effects of ankle strengthening exercise and whole body vibration on the balance ability of older adults, thereby intending to provide basic materials for intervention methods aimed at improving older adults' balance ability. The subjects were 20 older adults who had experienced a fall. They were equally divided into two groups. Ankle strengthening training was applied to one group and ankle strengthening training and whole body vibration were applied to the other group, a timed up and go (TUG) test and Tinetti performance oriented mobility assessment (POMA) were performed, and changes in the subjects' limits of stability were observed. The TUG and POMA results significantly differed between before and after the experiment in the angle strengthening training (AST) group and the angle strengthening training with whole body vibration (ASTWV) group. In addition, the interaction between timing and each group was statistically significant. The limits of stability significantly changed after the intervention in both groups. Differences in the posterior and right limits of stability were significant between the AST group and ASTWV group. Therefore, ankle strengthening exercise and whole body vibration improve older adults' balance maintenance and reduce falls or the risk factors for falls in older adults.

A Study on the Prediction of Fall Factors for the Elderly Living in the City (도시 생활 노인의 낙상요인 예측에 관한 연구)

  • Lee, Hyun-Ju;Lee, Tae-Yong;Tae, Ki-Sik
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.12 no.1
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    • pp.46-52
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    • 2018
  • The purpose of this study was to investigate the factors affecting falls in 107 elderly living in the city aged 65 or older by evaluating general characteristics, chronic disease status, medical variables related to falls, balance-related confidence, physical ability and depression. Also, the correlations between the significant differences in variables were identified, and the prediction power was determined by deriving the variables with high influence to induce the fall. In the faller group, urinary incontinence, foot pain, lower extremity weakness, number of chronic disease and medication use were significantly higher than those of the nonfaller group. Also, statistically significant differences were evaluated in ABC (Activities-specific Balance Confidence) score, BBS (Berg Balance Scale) score, SGDS (Short Geriatric Depression Scale), FRT (Functional Reach Test) value. The main correlated factor for fall was ABC score, the lower the ABC score, fall risk is increased which is a significant negative impact. When the evaluation is performed by combining those scales, the hit ratio to classify whether faller or nonfaller is increased to 70.01% which is quite higher value.

Analysis of occupational accidents for fisher's on gillnet fishing vessel using the written verdict (재결서를 이용한 자망어선 어선원의 어로작업 중 안전사고 분석)

  • Yoo-Won, LEE;Su-Hyung, KIM;Kyung-Jin, RYU
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.58 no.4
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    • pp.367-373
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    • 2022
  • We analyzed work safety risk factors, which are likely to occur during fishing in gillnet fishing vessels using the written verdict of the Korea Maritime Safety Tribunal from 2016 to 2020, and considered work safety management. Of the total of 37 fatal accidents, three cases in the East Sea, six cases in the South Sea, and 28 cases in the West Sea were very frequent. The accident rate per vessel by sea area (%) was 0.08% in East Sea, 0.12% in South Sea, and 0.40% in the West Sea. Based on the East Sea, the number of fatal accidents was 1.6 times higher in the South Sea and 5.4 times higher in the West Sea. Six cases (16.2%) occurred during departure and preparation for fishing in the fishing process, and all other 31 cases (83.8%) occurred during fishing operation. In the order of accident types, 21 cases (56.8%) of being struck by object, eight cases (21.6%) of contact with machinery and six cases (16.2%) of falls from height were found to be fatal accidents in gillnet fishery. Human factors, such as fishers' carelessness and negligent safety management by captain accounted for 27 cases (73.0%) of the main cause, and 35 cases (94.6%) of the secondary cause. In addition to human factors such as fisher's carelessness and negligent safety management by captain, mechanical factors, environmental factors and management factors must be improved together to reduce human casualties. These results are expected to be utilized as basic data for reducing safety accidents during the work of fishers.