Medical conditions and medications as risk factors of falls in the inpatient older people: a case-control study

Objective: The majority of inpatient falls are older people who have various medical conditions and are on several medications. The purpose of this study was to examine the association between medical conditions and medications and falls in older people in hospital. Method: Using a case-control design, we selected older people (aged 65 or over) who were reported to the Taiwan Patient-Safety Reporting System for the fall incidents in a large academic hospital in 2006 (n = 165). They were individually (1:1) matched for gender, age, and period of hospitalization with the control non-faller group. Bivariate and multivariate logistic regressions were used to compare the cases and controls to examine the association of medical conditions and medication exposure within 24 h before the falls. Results: Bivariate analyses showed that older people with cancer, or exposure medications such as zolpidem, benzodiazepines, narcotics, and antihistamines were significantly more likely to have falls during hospitalization. After controlling for cancer, zolpidem, narcotics, and antihistamine, we found benzodiazepine (Odds ratio (OR) = 2.26, 95% confidence interval (CI) = 1.21-4.23) and benzodiazepine doses >= 1 mg/day in diazepam equivalents (OR 2.14, 95% CI = 1.04-4.39) were still significantly associated with the falls of older people in the hospital. Conclusions: Strategies to prevent falls in older people in hospital should include minimizing the use of zolpidem, benzodiazepine, narcotics, and antihistamines, especially in cancer patients. Copyright (C) 2010 John Wiley & Sons, Ltd.