PURPOSE 

To evaluate the correlates of serious falls in hospitalized patients and the resource utilization associated with such falls.

PATIENTS AND METHODS 

This retrospective case-control study was performed in an urban tertiary care hospital.

RESULTS 

Univariate correlates of falls (P<0.05) included severity of underlying disease, Charlson comorbidity score, and Confusion Assessment Method (CAM) score.

In multivariate conditional logistic regression analyses, only the Charlson index (P<0.006) and the CAM score (P<0.03) were independent correlates of a fall.

Exposure to any of a number of drugs did not predict falls, but the power to detect drug effects was limited.

A combination of the Charlson comorbidity and CAM scores identified a population at substantially increased risk of fall, including 50% (31/62) of fallers, versus 16% (10/62) of controls.

In multivariate analyses, falls were also independently correlated with increases in length of stay (P<0.004) and total charges (P<0.008).

Fallers stayed 12 days longer and had charges $4,233 higher than controls, after adjustment for potential clinical and nonclinical confounders.

CONCLUSION 

Falls during hospitalization are commoner in confused patients and those with greater comorbidity.

This profile differs from that of fallers in the community, probably because hospitalized patients are sicker.

Injurious falls are associated with substantially increased resource utilization.