Fall

Fall

To drop or descend under the force of gravity, as to a lower place through loss or lack of support.

Findings support the idea that motor and, to some degree, cognitive functions are needed to successfully negotiate obstacles, and provide new insights into the ability of older adults to successfully negotiate obstacles. Furthermore, results suggest that when it comes to the physical properties of obstacles, not all is as expected, and low obstacles may impose a greater danger to tripping than obstacles that have a higher height 1).


Fall-related surgery was performed by the orthopedics (OP) and neurosurgery (NS) faculties at a 2 to 1 ratio. The major underlying brain diseases were a combination of white matter disease (WMD) and Alzheimer’s disease (AD) (79%) followed by dementia with Lewy bodies. In contrast, for NS, the most common surgery was for patients with alcoholism (50%) followed by a combination of WMD and AD 2).


de Souza et al., analyzed 1071 fall incidents in a hospital. The incidence of falls in inpatient units was 1.7 per 1000 patient days. Among the recorded falls, 95.3% occurred in patients who had been previously assessed as being at high or moderate risk of falls; 61.5% were using medications associated with increased risk of falls. Regarding age, 70.8% of the falls occurred in patients aged ≥60 years. Falls occurred mostly (72.6%) in inpatients units, and in 63.4% of the incidents the fall was witnessed by a family member/companion or a health team professionals. No injuries were recorded in 71.4% of the patients. Serious adverse events or sentinel events, such as fractures or head trauma occurred in 2.1% of the patients. Of these, 80% were in the group aged ≥60 years; 83% of the head traumas and 58% of the fractures occurred in patients who had been assessed as being at high risk of falls. Fractures were associated (p = 0.026) with age 70-79 years.

At the hospital where the study was performed, new fall prevention strategies must focus on patients admitted to inpatient units, aged ≥60 years, assessed as being at high risk of falls, and using medications associated with increased risk of falls 3).


Despite the growing epidemic of falls, the true incidence of peripheral nerve injury (PNIs) in this patient population remains largely unknown.

Fall-Related Traumatic Brain Injury.

Fall prevention


1)

Eyal S, Kurz I, Mirelman A, Maidan I, Giladi N, Hausdorff JM. Successful Negotiation of Anticipated and Unanticipated Obstacles in Young and Older Adults: Not All Is as Expected. Gerontology. 2019 Aug 28:1-10. doi: 10.1159/000502140. [Epub ahead of print] PubMed PMID: 31461708.
2)

Sakakibara R, Iimura A, Ogata T, Terayama K, Katsuragawa S, Nagao T, Suzuki K, Izawa K, Nakajima K, Haruki SI, Tateno F, Aiba Y, Nemoto M, Nakagawa K. Brain Diseases and Fall-Related Surgery in Older Persons. Eur Neurol. 2022 Feb 14:1-5. doi: 10.1159/000521807. Epub ahead of print. PMID: 35158356.
3)

de Souza AB, Maestri RN, Röhsig V, Lorenzini E, Alves BM, Oliveira D, Gatto DC. In-hospital falls in a large hospital in the south of Brazil: A 6-year retrospective study. Appl Nurs Res. 2019 Aug;48:81-87. doi: 10.1016/j.apnr.2019.05.017. Epub 2019 Jun 14. PubMed PMID: 31266614.

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