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Delirium markers in older fallers: a case-control study.

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Hospitalized older patients who experienced falls were more likely to show signs of inattention and altered consciousness prior to the fall. These brief assessments can aid in predicting patient falls.

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Area of Science:

  • Geriatrics
  • Patient Safety
  • Neurology

Background:

  • Hospitalized older patients are at risk for falls and delirium, posing significant consequences.
  • Delirium markers, such as inattention and altered consciousness, were investigated for their association with falls.

Purpose of the Study:

  • To determine if assessments of inattention and altered consciousness are associated with falls in hospitalized older patients.

Main Methods:

  • A retrospective case-control study was conducted using quality databases from a Veterans Affairs referral center (2010-2012).
  • Older fallers were identified and matched with non-fallers (3:1 ratio) based on age and ward type.
  • Risk factors including altered consciousness, cognitive performance, attention, sensory deficits, and dehydration were compared between groups.

Main Results:

  • Inattention (Months of the Year Backward test) was more prevalent in fallers (67.2%) compared to non-fallers (50.8%), with an odds ratio (OR) of 2.0.
  • Altered consciousness was also more common in fallers (28.4%) than non-fallers (12.4%), with an OR of 2.8.

Conclusions:

  • Alterations in consciousness and inattention, identified before a fall, were significantly more common in patients who fell.
  • Incorporating brief assessments of consciousness and attention into fall prediction protocols is recommended.