Falls and fractures in the acute care setting: A retrospective cohort study

Falls with fracture in hospitalised patients remain a common occurrence with significant morbidity and mortality. Our objectives were to determine the characteristics of patients who suffer falls with fractures in hospital, and to examine whether outcomes in this cohort differ from those of patients who fall without sustaining a fracture.

Coding data pertaining to a 6-year period (2012-2017) were interrogated. Patients coded as having suffered a fall in hospital during this period were identified and divided into those who did and those who did not suffer fractures due to their fall. Patient demographics and comorbidities were compared between groups and outcome measures examined with descriptive statistics and binary logistic regression.

From 236,720 inpatient admissions, 721 falls were recorded, 128 of which were associated with a fracture. Delirium (30% in those who suffered a fracture vs. 21% in those who did not, p < 0.040), dementia (23% vs. 13%, p < 0.004), female sex (53% vs. 44%, p < 0.020) and older age (76.8 vs. 72.8 years, p < 0.010) were associated with falls with fractures in hospital. Falls with fractures were associated with a longer length of inpatient stay by 9.2 days (95% CI 5.5-12.9, p < 0.001) and were an independent predictor of inpatient mortality.

Greater understanding of characteristics of patients at risk of falls with fractures, as well as knowledge of the considerable associated morbidity and mortality, will help to prognosticate when these events occur and, potentially, to put preventative measures in place.