Review of perioperative falls

Area of Science:

• Gerontology
• Public Health
• Surgical Outcomes

Background:

• Falls represent a significant public health concern.
• Perioperative falls are increasingly recognized for their impact on risk prediction and quality assessment in healthcare.

Purpose of the Study:

• To conduct a literature review on the occurrence, injuries, and risk factors associated with preoperative and postoperative falls.
• To synthesize current knowledge and identify gaps in the research on perioperative falls.

Main Methods:

• A systematized literature search of PubMed was conducted for articles published between 1947 and November 2015.
• Twenty-four articles meeting inclusion criteria were analyzed, with a focus on studies involving patients over 65 undergoing orthopedic surgery.
• Study quality was assessed, with four articles rated as 'good' quality and moderate interrater reliability (κ = 0.77).

Main Results:

• Preoperative falls occurred in 24-48% of patients in the 3-12 months before surgery, with 70% experiencing injuries.
• Postoperative fall rates ranged from 0.8 to 16.3 per 1000 person-days, with 10-70% of fallers sustaining injuries, and 5-20% experiencing severe injuries.
• Prospective studies indicated higher fall and injury rates than retrospective studies, suggesting potential underdetection in retrospective research.

Conclusions:

• Perioperative falls are more common than general community falls, persisting up to 12 months post-surgery.
• Risk factors for perioperative falls are not well-understood, necessitating further investigation.
• Future research should employ prospective designs, validated definitions, and broader populations, with a specific focus on risk factors and post-hospitalization follow-up.