CC BY-NC-ND 4.0 · International Journal of Practical Otolaryngology 2018; 01(01): e16-e22
DOI: 10.1055/s-0038-1675405
Original Article
Georg Thieme Verlag KG Stuttgart · New York

In-Hospital Falls at the Department of Otorhinolaryngology

Toshiya Kimura
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
,
Makoto Miura
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
,
Kumiko Gyo
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
,
Koichiro Yamada
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
,
Keigo Honda
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
,
Yasuyuki Hayashi
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
2   Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan
,
Yuki Tanigami
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
,
Mai Nakahira
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
,
Hiroki Ikeda
1   Department of Otorhinolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Prefecture, Japan
3   Ikeda ENT Clinic, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

28 May 2018

13 August 2018

Publication Date:
31 October 2018 (online)

Abstract

A fall accident is an event that is associated with many disadvantages. In our hospital, 5,259 fall cases have been reported over the past 7 years according to our incident reports, and account for 16.5% of all incident reports. We conducted a detailed examination of 120 of these fall cases at the Department of Otolaryngology. Most of all, “before and after excretion” is a common fall-outbreak-motive reason for falls in all departments. In the field of otolaryngology, “use of drugs” and “walking disorder” are frequently encountered reasons for a fall. Calculation of age-specific fall rates revealed two peaks: around 0 years old and after 80 years old. It is suggested that a fall is associated with a reduced ability for maintaining the standing position. A correlation has been reported between the fall rate and the average length of hospitalization. Both the length of hospitalization of 12.3 days and fall rate of 1.97 among the cases seen at the Department of Otolaryngology are lower than all courses that are in other fields, on average. In the patients seen at the Department of Otolaryngology, the fall rate rises significantly as the length of hospitalization increases. In the Department of Otolaryngology, the fall rate of the malignancy group is high (2.91), irrespective of the treatment regimens. Each of the three items—“14 hospitalization days or more,” “65 years old or older,” and “malignancy”—contributes to falls in patients seen at the Department of Otolaryngology, and multivariate analysis revealed a particularly strong contribution of the previous two items. In elderly patients with expected long-term hospitalization, it is necessary to proactively attempt risk reduction; we first make all patients aware of the risk of long-term hospitalization at the first examination, and divide length of stay into multiple times. We review the assessment score after reexamining the “disease severity” and “performance status” as risk factors for falls, and want to realize more efficient measures for preventing falls in the future.

 
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