-Original-

Incidence and Risk Factors for Subsequent Adverse Events among Outpatients after an In-Hospital Fall

Eitaro Kodani^1,2, Yukiko Takeda³, Misako Iida³, Yukiko Takagi³, Tami Okumura³, Eriko Miyao^1,3 and Masami Akeda³

¹Department of Medical Safety Management, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
²Department of Cardiovascular Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
³Nursing Department, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan

Background: Information is limited on the incidence and risk factors for further serious conditions after an in-hospital fall. Using data from the incident-accident reports, we assessed the incidence and risk factors for subsequent adverse events (SAEs) among outpatients after in-hospital falls.
Methods: Incident-accident reports from April 2017 to March 2024 at Nippon Medical School Tama Nagayama Hospital were reviewed to identify outpatient falls. Data on patient characteristics and fall-related details were collected. Multivariable logistic regression analysis was performed to identify risk factors for SAEs.
Results: We analyzed data from 118 outpatients with in-hospital falls (mean age: 76.4±11.7 years; male: 56.8%): 39 (33.1%) experienced SAEs, including 5 fractures (4.2%), 13 functional disorders (11.0%), 17 surgical procedures (14.4%), and 17 admissions (14.4%). Multivariable analysis showed that males had a significantly higher odds ratio (OR) for SAEs than females, even after adjusting for age (OR, 2.80; 95% CI, 1.21-6.48; P=0.016). For each SAE, the floor of the fall, number of previous falls, and site of the fall were significantly associated with a subsequent fracture, functional disorder, and surgical procedure after an in-hospital fall, respectively.
Conclusions: The incidence rate of SAEs among outpatients with in-hospital falls was 33.1%. Male sex was the only significant risk factor for SAEs, and factors contributing to individual SAE types were distinct. To prevent further adverse outcomes after in-hospital falls, medical staff should pay more attention to patients with these risk factors.

J Nippon Med Sch 2025; 92: 349-359

Keywords
in-hospital fall, outpatient, risk factor, adverse event, safety management

Correspondence to
Eitaro Kodani, MD, PhD, Department of Medical Safety Management, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
kodani@nms.ac.jp

Received, January 13, 2025
Accepted, April 23, 2025