Research Activities, June 2012: Patient Safety and Quality: Patients recovering in the hospital from total knee or hip replacement have increased risk of falls

Research Activities, June 2012: Patient Safety and Quality: Patients recovering in the hospital from total knee or hip replacement have increased risk of falls

Patients recovering in the hospital from total knee or hip replacement have increased risk of falls

The risk of in-hospital falls (IFs) for patients recovering from total hip or knee replacement (total hip or total knee arthroplasty—THA or TKA, respectively) is increased for patients of advanced age, male sex, and with more coexisting conditions, according to a new study. Earlier studies found that the occurrence of IFs for patients undergoing short-term hospitalization ranged from 2–17 percent. Up to half of patients who fell sustained a fall-related injury, with 1–10 percent of these injuries classified as serious (including fractures and head injuries).

This study found an overall IF incidence of 0.85 percent in a national estimate of 5.3 million patients undergoing THA or TKA over a 10-year period. The IF rate grew from 0.4 percent to 1.3 percent during that period. Patients who fell had a mean age of 68.2 years versus 66.6 years for those who didn't fall. Men were 7 percent more likely to fall than women, and patients treated at rural hospitals were 16 percent more likely to fall than those at urban hospitals. When coexisting conditions were evaluated as risk factors, patients with pulmonary circulatory disease had three times the risk of falling than those without the disease. Fall risk rose by at least 40 percent for abnormal clotting, neurologic disease, and electrolyte/fluid imbalance.

The findings were based on analysis of annual data on THA and TKA from the National Inpatient Sample of the Agency for Healthcare Research and Quality's (AHRQ's) Hospital Cost and Utilization Project for 1998 through 2007. This study was funded in part by AHRQ (HS16075) to the Center for Education and Research in Therapeutics (CERT) at the Weill Medical College of Cornell University. For more information on the CERTs program, visit http://www.certs.hhs.gov.

More details are in "In-hospital patient falls after total joint arthroplasty," by Stavros G. Memtsoudis, M.D., Ph.D., Christopher J. Dy, M.D., M.S.P.H., Yan Ma, Ph.D., and others in the November 2011 online Journal of Arthroplasty.