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Accidents in the institutionalized elderly: Injuries and consequences

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Abstract

A total of 308 major and 519 minor accidents involving 588 patients occurred during one year at a somatic long- term care hospital and its associated nursing homes. In relation to the number of patients, the incidence of accidents was nearly three times higher in the nursing homes than in the hospital. The most prevalent injuries in female patients were fractures and hematomas, while open wounds were more frequent among male patients. Hip fractures were about as common in women as in men, while fractures of the extremities were three times more frequent in women. The majority of the accidents occurred during daytime, in the patient’s room and in many cases soon after admission. Most of the injuries were caused by falls and in more than 90% no staff was present. Accidents were reported most frequently in October — December, and least often in July — September. Two thirds of the severely injured had to be transferred to an emergency hospital for surgery or other treatment. Patients who had had major accidents also had a higher mortality rate six months after the accidents as compared to a control group. The medical and functional consequences for the patients were considerable. Measures to reduce the number of accidents among geriatric patients are therefore urgently needed. (Aging Clin. Exp. Res. 4: 125- 133, 1992)

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References

  1. Statistiska Centralbyråns årsbok (The Year Book of the Central Bureau of Statistics. Causes of Death). 1984, pp. 326-329.

  2. Zetterberg C., Mellström D., Rundgren Å, Andersson G., Frennered K., Hansson T.: Höftfrakturer hos äldre. Bakgrundsfaktorer. Läkartidningen 80: 2043–2050, 1983.

    CAS  Google Scholar 

  3. Udén G.: Inpatient accidents in hospitals. J. Am. Geriatr. Soc. 33: 833–841, 1985.

    PubMed  Google Scholar 

  4. LKELP. Basarsstatistik. Verksamhet och personal. Sammanställning av vårddagar, vårdplatser, läkarbesök, tjänster mm. Landstingsförbundet och Socialstyrelsen 1985.

  5. Svensson M-L., Rundgren Å., Larsson M., Odén A., Sund V., Landahl S.: Accidents in the institutionalized elderly: A risk analysis. Aging Clin. Exp. Res. 3: 181–192, 1991.

    CAS  Google Scholar 

  6. Rinder L., Roupe S., Steen B., Svanborg A.: 70-year-old people in Gothenburg. A population study in an industrialized Swedish city. I. General presentation of the study. Acta Med. Scand. 198: 397–407, 1975.

    Article  PubMed  CAS  Google Scholar 

  7. Hultén A., Kerstell J., Olsson R., Svanborg A.: A method to calculate nursing load. Scand. J. Rehabil. Med. 1: 117–125, 1969.

    PubMed  Google Scholar 

  8. Ashley M.J., Gryfe C.J., Amies A.: A longitudinal study of falls in an elderly population. II. Some circumstances of falling. Age Ageing 6: 211–220, 1977.

    Article  PubMed  CAS  Google Scholar 

  9. Berry G., Fisher R.H., Lang S.: Detrimental incidents including falls, in an elderly institutional population. J. Am. Geriatr. Soc. 19: 322–324, 1981.

    Google Scholar 

  10. Imms F.J., Edholm O.G.: Studies of gait and mobility in the elderly. Age Ageing 10: 147–156, 1981.

    Article  PubMed  CAS  Google Scholar 

  11. Parrish H.M., Weil T.P.: Patient accidents occurring in hospitals.: Epidemiologic study of 614 accidents. N.Y. State J. Med. 58: 838–846, 1958.

    PubMed  CAS  Google Scholar 

  12. Wild D., Nayak U.S.L., Isaacs B.: Description, classification and prevention of falls in old people at home. Rheumatol. Rehabil. 20: 153–159, 1981.

    Article  PubMed  CAS  Google Scholar 

  13. Gryfe C.I., Amies A., Ashley M.J.: A longitudinal study of falls in an elderly population. I. Incidence and morbidity. Age Ageing 6: 201–210, 1977.

    Article  PubMed  CAS  Google Scholar 

  14. Margulec I., Librach G., Schadel M.: Epidemiological study of accidents among residents of homes for the aged. J. Gerontol. 25: 342–346, 1970.

    Article  PubMed  CAS  Google Scholar 

  15. Morris E.V., Isaacs B.: The preventions of falls in a geriatric hospital. Age Ageing 9: 181–185, 1980.

    Article  PubMed  CAS  Google Scholar 

  16. Morris E.V., Isaacs B., Brislen W.: Falls in the elderly in hospital. Nurs. Times 77: 1522–1524, 1981.

    PubMed  CAS  Google Scholar 

  17. Prudham D., Evans J.G.: Factors associated with falls in the elderly. A community study. Age Ageing 10: 141–146, 1981.

    Article  PubMed  CAS  Google Scholar 

  18. Waller J.A.: Falls among the elderly, human and environmental factors. Accid. Anal. Prev. 10: 21–33, 1978.

    Article  Google Scholar 

  19. Boyce W.J., Vessey M.P.: Habitual physical inertia and other factors in relation to risk of fracture of the proximal femur. Age Ageing 17: 319–327, 1988.

    Article  PubMed  CAS  Google Scholar 

  20. Pyykkö I., Jäntti P., Alto H.: Postural control in elderly subjects. Age Ageing 19: 215–221, 1990.

    Article  PubMed  Google Scholar 

  21. Swain D.G., Nightingale P.G., Gama R., Buckley B.M.: Cardiac enzyme changes in elderly fallers. Age Ageing 19: 207–211, 1990.

    Article  PubMed  CAS  Google Scholar 

  22. Gross Y.T., Shimamoto Y., Rose C.L., Frank B.: Why do they fall? Monitoring risk factors in nursing homes. J. Gerontol. Nurs. 16: 20–25, 1990.

    Google Scholar 

  23. Nickens H.: Intrinsic factors in falling among the elderly. Arch. Intern. Med. 145: 1089–1093, 1985.

    Article  PubMed  CAS  Google Scholar 

  24. Tinker G.H.: Accidents in a geriatric department. Age Ageing 8: 196–198, 1979.

    Article  PubMed  CAS  Google Scholar 

  25. Robbins A.S., Rubenstein L.Z., Josephson K.R., Schulman B.L., Osterweil D., Fine G.: Predictors of falls among elderly people. Results of two population-based studies. Arch. Intern. Med. 149: 1628–1633, 1989.

    Article  PubMed  CAS  Google Scholar 

  26. Vlahov D., Myers A.H., al-Ibrahim M.S.: Epidemiology of falls among patients in a rehabilitation hospital. Arch. Phys. Med. Rehabil. 71: 8–12, 1990.

    PubMed  CAS  Google Scholar 

  27. Kalchthaler T., Bascon R.A., Quintos V.: Falls in the institutionalized elderly. J. Am. Geriatr. Soc. 26: 424–428, 1978.

    PubMed  CAS  Google Scholar 

  28. Murphy J., Isaacs B.: The postfall syndrome. A study of 36 elderly patients. Gerontology 28: 265–270, 1982.

    Article  PubMed  CAS  Google Scholar 

  29. Wild D., Nayak U.S.L., Isaacs B.: Prognosis of falls in old people at home. J. Epidemiol. Comm. Health 35: 200–204, 1981.

    Article  CAS  Google Scholar 

  30. Fiesta J.: Nursing Liability — The patient who falls. Orthopaedic Nursing 3: 59–61, 1985.

    Article  Google Scholar 

  31. Mallinson W.J.W., Green M.F.: Covert muscle injury in aged patients admitted to hospital following falls. Age Ageing 14: 174–178, 1985.

    Article  PubMed  CAS  Google Scholar 

  32. Innes E., Turman W.G.: Evaluation of patient falls. Qual. Rev. Bul. 9: 30–35, 1983.

    CAS  Google Scholar 

  33. Morse J.M, Prowse M.D., Morrow N., Federspeil G.: A retrospective analysis of patient falls. Can. J. Public Health 76: 116–118, 1985.

    PubMed  CAS  Google Scholar 

  34. Catchen H.: Inpatient accidents among the hospitalized elderly. Gerontologist 23: 273–276, 1983.

    Article  PubMed  CAS  Google Scholar 

  35. Nevitt M.C., Cummings S.R., Kidd S., Black D.: Risk factors for recurrent nonsyncopal falls. JAMA 261: 2663–2668, 1989.

    Article  PubMed  CAS  Google Scholar 

  36. Gustafson Y., Berggren D., Brännström B., Bucht G., Norberg A., Hansson L-I., Winblad B.: Acute confusional states in elderly patients treated for femoral neck fracture. J. Am. Geriatr. Soc. 36: 525–530, 1988.

    PubMed  CAS  Google Scholar 

  37. Malt U.: The long-term psychiatric consequences of accidental injury. A longitudinal study of 107 adults. Br. J. Psychiatry 153: 810–818, 1988.

    Article  PubMed  CAS  Google Scholar 

  38. Scott C.J.: Accidents in hospital with special reference to old people. Health Bull. (Edinb.) 18: 330–335, 1976.

    Google Scholar 

  39. Fife D., Rappaport E.: What role do injuries play in the deaths of old people? Accid. Anal. Prev. 19: 225–230, 1987.

    Article  PubMed  CAS  Google Scholar 

  40. Clayer M.T., Bauze R.J.: Morbidity and mortality following fractures of the femoral neck and trochanteric region: analysis of risk factors. J. Trauma 29: 1673–1678, 1989.

    Article  PubMed  CAS  Google Scholar 

  41. Schaie K.W., Willis S.L.: Adult development and ageing. Little Brown and Company, Boston, Toronto 1986, pp. 415–417.

    Google Scholar 

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Authors and Affiliations

  1. Department of Geriatric and Long-Term Care Medicine, University of Göteborg, Vasa Hospital, 411 33, Göteborg, Sweden

    Marie-Louise Svensson R.N., Å. Rundgren, M. Larsson & S. Landahl

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  1. Marie-Louise Svensson R.N.
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  2. Å. Rundgren
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  3. M. Larsson
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  4. S. Landahl
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Svensson, ML., Rundgren, Å., Larsson, M. et al. Accidents in the institutionalized elderly: Injuries and consequences. Aging Clin Exp Res 4, 125–133 (1992). https://doi.org/10.1007/BF03324079

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