Inpatient Mobility and the Relative Incidence of Falls With Injury Versus Hospital-Acquired Pressure Ulcers

Mobility is a key indicator of overall health and significantly influences outcomes among hospitalized patients. While the link between immobility and pressure ulcer development is well established, less is known about patients who are able to ambulate. Although mobility may reduce the risk of pressure ulcers, it may increase the likelihood of falls and related injuries. This study aimed to compare the incidence of falls with injury and hospital-acquired pressure ulcers in ambulatory patients.

This retrospective cohort study included adults aged 18 to 89 years admitted to a rural tertiary care center in Southern West Virginia from January 1, 2021, to December 31, 2023. Patients with a history of lower extremity amputation, cerebral vascular accident and/or transient ischemic attack or an admitting diagnosis that included pressure ulcers were excluded.

Out of 9693 patients who met the inclusion criteria, 100 (1.03%) experienced falls without injuries, 23 (0.24%) had falls with injuries, and 19 (0.20%) developed hospital-acquired pressure ulcers. Overall, 62.79% of all recorded falls were unassisted, 6.98% were assisted by nursing staff or physical therapists, and 30.23% were undocumented. Among those with pressure ulcers, 8 (42.11%) were ambulated by either nursing staff or physical therapists.

This study is consistent with the possibility that increased mobility may not be associated with a higher risk of falls when appropriate supervision and safety protocols are in place. These findings are hypothesis-generating and suggest further investigation is needed to better understand how to balance fall prevention with mobility practices in hospital settings.