Comorbid Conditions, Other Factors Increase Risk of In-Hospital Falls

Investigators from Hospital for Special Surgery have identified several factors associated with an increased risk of in-hospital falls after total hip or knee replacement surgery, including comorbid conditions and undergoing a joint replacement revision surgery.

For their research, HSS researchers used the Nationwide Inpatient Sample, sponsored by the Agency for Healthcare Research and Quality. The investigators analyzed data between 1998-2007 to identify patients who had undergone a total hip or knee replacement. Using statistical modeling, they then compared characteristics of patients who had suffered in-hospital falls to those who had not suffered a fall.

 

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Their findings showed patients were more likely to fall if they were male, older, belonged to a minority race or were undergoing a revision joint replacement surgery. Patients were also at heightened risk if they had certain comorbid conditions, including congestive heart failure, a clotting or bleeding disorder, liver disease, neurologic disease, electrolyte/fluid abnormalities and recent weight loss. Pulmonary circulatory disease posed the greatest risk.

Additionally, obesity, hypothyroidism, uncomplicated diabetes and cancer were not associated with an increased risk of falling. Postoperative complications were also associated with higher fall rates, although it remains unclear if they were the reason or the consequence for this event.

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