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Factors Associated with Acute Injurious Falls in Elderly Hospitalized Patients: A Multicenter Descriptive Study.

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    Older adults experiencing serious falls in hospitals are more likely to have dementia and higher anticholinergic cognitive burden (ACB) scores. Specific medications, including antihistamines and antipsychotics, are associated with these falls, informing quality improvement efforts.

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    Area of Science:

    • Geriatric Medicine
    • Patient Safety
    • Health Services Research

    Background:

    • Hospital-acquired conditions (CMS-HAC) link Medicare payments to healthcare quality.
    • Inpatient falls with serious outcomes represent a significant area for improvement.
    • Medications affecting cognition in older adults are potential contributors to falls.

    Purpose of the Study:

    • To investigate the impact of commonly prescribed medication classes on CMS-HAC falls and trauma.
    • To analyze a large inpatient database from US hospitals (2019-2021).

    Main Methods:

    • Analysis of data from 835 hospitals (2019-2021) for patients aged 65+ with CMS-HAC falls and trauma.
    • Utilized logistic regression and stepwise Poisson regression to identify associated variables.
    • Identified the top 20 prescribed drug classes in patients experiencing falls.

    Main Results:

    • Among over 11 million encounters, 5,978 met the CMS-HAC serious fall definition.
    • Older patients (>79 years), those with prior falls, dementia, and higher anticholinergic cognitive burden (ACB) scores were more likely to experience serious falls.
    • First-generation antihistamines, second-generation antihistamines, and atypical antipsychotics were significantly associated with CMS-HAC falls.

    Conclusions:

    • Falls meeting the CMS-HAC definition are linked to a history of falling, dementia, and higher ACB scores.
    • Findings can guide quality improvement initiatives to reduce injurious falls in healthcare settings.