http://cre.sagepub.com/content/early/2013/07/23/0269215513496801.abstract
Abstract
Objective: To develop a practical taxonomy of falls and to determine whether these different fall groups have different outcomes.
Design: Descriptive study examining patient characteristics at the time of each fall and iterative development of falls taxonomy.
Setting: An inpatient stroke rehabilitation ward.
Methods: All falls
over 21 months were reviewed retrospectively. Case notes were reviewed
and each patient’s level of functioning
at the time of fall, together with admission
profile and discharge outcomes, were collected. Outcomes for fallers (as
opposed
to falls) were compared using the predominant
fall type.
Results: There were
241 falls in 122 patients and most falls occurred around the bed (196
(81%) falls). Toileting-related falls occurred
in 54 patients (22.4%). The taxonomy proposes
seven main fall types. One fall type (‘I’m giving it a go’) appeared
quite different
and was associated with better functioning at
time of fall and better outcomes. Other fall types were related to high
dependency
needs, visuospatial difficulties or delirium.
Medication-related falls were uncommon in this cohort.
Conclusions: The falls
taxonomy developed showed four main types of falls with different, but
overlapping, patient characteristics at
time of fall with different outcomes. Different
fall-prevention strategies may be required for each group.
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