Objective: To analyze the influence of chronic diseases on falls among middle-aged and older Chinese. Methods: Baseline data of 13 670 middle-aged and older adults recruited from China Health and Retirement Longitudinal Study (CHARLS) in 2011 were used and followed up to 2018, among those were 7 443 (54.45%) middle-aged people aged 45-59 and 6 227 (45.55%) older adults aged 60 and above. The Cox proportional hazards model was used to analyze the effects of different types, the number of chronic diseases and the interaction between chronic illness and other factors on the fall risk of middle-aged and older people. Results: After adjusting for confounding factors, respiratory diseases increased the risk of falls by 21% (HR=1.21, 95%CI:1.02-1.45), and arthritis increased the risk of falls by 27% (HR=1.27,95%CI: 1.12-1.43) in the group aged 45-59, kidney disease increased the risk of falls by 26% (HR=1.26, 95%CI: 1.03-1.53) in the group aged 60 and above. A linear dose-response relationship between the number of chronic diseases and fall risk (χ2=133.61, P<0.001) was found in all the age groups. The interaction between having chronic diseases and the factors of females (HR=1.64, 95%CI: 1.43-1.89), impaired activities of daily living (ADL) (HR=1.66, 95%CI: 1.39-1.99), and having a fall history (HR=2.58, 95%CI: 2.24-2.97) increased the risk of falls. Conclusions: There is a positive linear relationship between the number of chronic diseases and the fall risk among Chinese aged 45 and above. The female middle-aged and elderly patients with chronic diseases and the middle-aged and elderly patients with impaired ADL or a history of falls are the high-risk groups for falls that need to be focused on intervention. The window of fall injury prevention should be moved forward to the middle-aged stage in time.
Accidental Falls ; Activities of Daily Living ; Aged ; China/epidemiology* ; Chronic Disease ; Cohort Studies ; Female ; Humans ; Longitudinal Studies ; Middle Aged ; Risk Factors

risk factors (noise, vibration, abnormal temperature, etc.) and shift work.]]>
Accidental Falls ; Employment ; Fatigue ; Logistic Models ; Risk Factors ; Salaries and Fringe Benefits ; Vibration

PURPOSE: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. METHODS: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. RESULTS: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. CONCLUSION: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.
Accidental Falls ; Diagnosis ; Diagnostic Tests, Routine* ; Electronic Health Records ; Forests ; Humans ; Inpatients* ; Judgment ; Pediatrics ; Risk Assessment* ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures*

OBJECTIVE: To investigate the risk factors for fall in the elderly population residing in rural areas of Korea and provide useful data for their prevention. METHODS: As part of farmers’ health promotion project, a retrospective study was conducted with a total of 350 elderly people recruited from March 2016 to December 2016. These subjects were divided into two groups: 254 non-fallers and 96 fallers. A person who fell to the floor at least once in the past year was defined as a faller. Participants were asked to visit the hospital once. The demographic characteristics, social environment, and educational levels were surveyed using a questionnaire. Physical examination was performed in the following order: cognitive function, lower leg strength and torque, body composition, and knee image test. RESULTS: Statistically significant factors for falls in univariate analysis were female gender, age, living alone, educational level less than middle school, skeletal muscle mass, Mini-Mental State Exam, knee osteoarthritis, hip torque, hip power mean, knee torque, and knee power mean. Multivariate analysis was performed to identify variables most relevant to falls among statistically significant factors in univariate logistic analysis. It was confirmed that female gender and age of 70–79 years were statistically significant factors related to falls. CONCLUSION: Female gender and elderly status (70–79 years) are important risk factors for falls in rural areas underscoring the need for special attention when considering risk factors for falls among the elderly living in rural areas.
Accidental Falls ; Aged ; Body Composition ; Cognition ; Female ; Health Promotion ; Hip ; Humans ; Knee ; Korea ; Leg ; Multivariate Analysis ; Muscle, Skeletal ; Osteoarthritis, Knee ; Physical Examination ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sociological Factors ; Torque

STUDY DESIGN: Retrospective database analysis. PURPOSE: To identify risk factors that predict mortality following acute spine fractures in geriatric patients of Singapore. OVERVIEW OF LITERATURE: Acute geriatric spinal fractures contribute significantly to local healthcare costs and hospital admissions. However, geriatric mortality following acute spine fractures is scarcely assessed in the Asian population. METHODS: Electronic records of 3,010 patients who presented to our hospital’s emergency department and who were subsequently admitted during 2004–2015 with alleged history of traumatic spine fractures were retrospectively reviewed, and 613 patients (mean age, 85.7±4.5 years; range, 80–101 years; men, 108; women, 505) were shortlisted. Mortality rates were reviewed up to 1 year after admission and multivariate analyses were performed to identify independent risk factors correlating with mortality. RESULTS: Women were more susceptible to spine fractures (82.4%), with falls (77.8%) being the most common mechanism of injury. Mortality rates were 6.0%, 8.2%, and 10.4% at 3, 6, and 12 months, respectively. The most common causes of death at all 3 time points were pneumonia and ischemic heart disease. Based on the multivariate analysis at 1-year follow-up, elderly women had a lower mortality rate compared to men (p<0.001); mortality rates increased by 6.3% (p=0.024) for every 1-year increase in the patient’s age; and patients with an American Spinal Injury Association (ASIA) score of A–C had a much higher mortality rate compared to those with an ASIA score of D–E (p<0.001). CONCLUSIONS: An older age at presentation, male sex, and an ASIA score of A–C were identified as independent factors predicting increased mortality among geriatric patients who sustained acute spine fractures. The study findings highlight at-risk groups for acute spine fractures, thereby providing an opportunity to develop strategies to increase the life expectancy of these patients.
Accidental Falls ; Aged ; Asia ; Asian Continental Ancestry Group ; Cause of Death ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Health Care Costs ; Humans ; Life Expectancy ; Male ; Mortality ; Multivariate Analysis ; Myocardial Ischemia ; Pneumonia ; Retrospective Studies ; Risk Factors ; Singapore ; Spinal Cord Injuries ; Spinal Fractures ; Spinal Injuries ; Spine

BACKGROUND: Falls are the most frequent adverse events reported in hospitals. The aim of this study was to investigate the incidence rate and characteristics of falls in patients who used comprehensive nursing care service in National Health Insurance Service Ilsan Hospital. METHODS: Incidence rate of falls was investigated in patients using comprehensive nursing care service, from July 2013 to Jun 2017 and compared with those not using this service. The characteristics and risk factors for falls, and fall-related injuries were obtained. RESULTS: Among the 62,445 patients who used the comprehensive nursing care service for 4 years, total of 672 falls were reported. The incidence rate of falls per 1,000 patients-day was 1.15. The percentage of fall-related injuries was 26.9% and that of major injury was 2.2%. Although the incidence rate of all falls was slightly higher in patients using comprehensive nursing care service than those not using this service, falls-related injuries were not correlated with the implementation of this service. CONCLUSION: The falls could be more frequently detected and reported in comprehensive nursing care service, but there was no difference in fall-related injuries.
Accidental Falls ; Humans ; Incidence ; National Health Programs ; Nursing Care ; Nursing ; Risk Factors

PURPOSE: The purpose of this study is to identify risk factors of accidental falls by age in the Korean elderly. METHODS: The study subjects included 10,242 community-dwelling elders aged 65 or over. The data were analyzed by logistic regression analysis. RESULTS: The risk factors of accidental falls in the younger old group (aged 65~74) include fear of falling (OR=16.28, 95% CI: 12.03~22.03), depression (OR=1.24, 95% CI: 1.06~1.44), and hearing impairment (OR=1.20, 95% CI: 1.01~1.43). The risk factors of accidental falls in the older old group (aged 75~84) include fear of falling (OR=11.54, 95% CI: 7.04~18.93), muscle strength (OR=1.36, 95% CI: 1.15~1.60), number of chronic disease (OR=1.65, 95% CI: 1.09~2.50), and presence of spouse (OR=1.27, 95% CI: 1.06~1.51). The risk factors of accidental falls in the oldest old group (aged 85 years old or older) include fear of falling (OR=8.05, 95% CI: 1.85~34.98) and exercise (OR=2.91, 95% CI: 1.36~6.24). Fear of falling is defined as a common factor in the all age groups. CONCLUSION: Different strategies should be developed for age groups to prevent elderly falls with understanding of contributing factors of falls in each group.
Accidental Falls ; Aged ; Aged, 80 and over ; Chronic Disease ; Depression ; Hearing Loss ; Humans ; Logistic Models ; Muscle Strength ; Risk Factors ; Spouses

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.
Accidental Falls ; Adult ; Antipsychotic Agents ; Case-Control Studies ; Education ; Electronic Health Records ; Health Care Costs ; Hematology ; Humans ; Hypoalbuminemia ; Length of Stay ; Leukopenia ; Linear Models ; Logistic Models ; Narcotics ; Nursing ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Self Care ; Steroids

PURPOSE: The purpose of this study was to develop a valid Adult Fall Assessment Scale Korean version (FAS-K) for inpatients in general hospitals in Korea. METHODS: This a 14 item FAS-K was developed based on a review of national and international research and expert opinions in related field. Interrater reliability of FAS-K was analyzed using the ICC (Intraclass Correlation Coefficients). To examine the validity of FAS-K, a CVI (Content Validity Index), the Pearson correlation coefficients between FAS-K and two widely used scales, the Morse Fall Scale (MFS) and the Johns Hopkins Hospital Fall Risk Assessment Tool (JHFRAT), and the Mann-Whitney test were used. RESULTS: The ICC was .958. The CVI ranged from .70 to 1.00. The FAS-K was significantly associated with the MFS (r=.74, p<.001) and with the JHFRAT (r=.87, p<.001), verifying the concurrent validity of FAS-K. As for the construct validity of FAS-K, significant differences between the fall and non-fall groups were found not only in the MFS (Z=−3.23, p=.001) but also in the FAS-K (Z=−3.10, p=.002). CONCLUSION: The findings indicate that the FAS-K is a reliable fall risk assessment tool with high validity.
Accidental Falls ; Adult ; Expert Testimony ; Hospitals, General ; Humans ; Inpatients ; Korea ; Risk Assessment ; Weights and Measures

PURPOSE: The aim of this study was to evaluate the efficiency of the Humpty Dumpty Falls Scale as one of the falls risk assessment tools, and also to evaluate risk factors as predictors of falls in pediatric patient populations. METHODS: In a retrospective, case-control design with data from the electronic medical records of 13 pediatric patients who fell and 1,941 who did not fall before matching and 429 who did not fall after matching by gender, age, diagnosis, and length of stay. RESULTS: All the variables showed no significant differences after matching. At the cutoff score of 13, sensitivity, specificity, negative and positive predictive values were 92.3%, 37.1%, 99.9%, and 0.01%, respectively. The area under the Receiver Operating Characteristics was 0.597. The results from the logistic regression showed that the pediatric inpatient population who had higher risk scores was significantly associated with falls. The odds ratios ranged from 1.31 to 4.71 with 90% confidence interval. CONCLUSION: The saturation impairments criterion as one of the diagnostic parameter was negatively associated with falls, but the relative risk score was higher than the other criteria. Therefore, it seems that the diagnostic parameter seems to be required to verify results through large sample studies.
Accidental Falls ; Case-Control Studies ; Child ; Diagnosis ; Electronic Health Records ; Humans ; Inpatients ; Length of Stay ; Logistic Models ; Odds Ratio ; Retrospective Studies ; Risk Assessment ; Risk Factors ; ROC Curve ; Sensitivity and Specificity