精神專科醫院住院病人跌倒的危險因子

Risk Factors for Inpatient Falls at a Mental Hospital

目的：本研究的目的主要是探討與精神科住院病人跌倒相關的危險因子。方法：某精神專科醫院2007年至2013年5,894個住院病人中，有545個病人至少經歷了一次以上的跌倒，其中包含397位男性，148位女性。資料整理後分析相關跌倒危險因子。結果：男性病人(OR=1.58)，超過60歲(OR=21.42)，以及雙極性疾患病人(OR=14.14)容易有3次以上跌倒。女性病人(OR=3.59)，跌倒3次以上(OR=5.14)，以及住在慢性病房病人(OR=5.30)容易發生嚴重傷害的跌倒。結論：建議精神醫療照顧者應注意精神科病人跌倒危險因子，針對高風險病人給予更多的協助。

Objective:The objectives of this study were to identify predictors of falls and to measure the severity of injuries among psychiatry inpatients. Methods: We first examined a five-year adverse event registry data of a psychiatric teaching hospital, which is a 450-bed long-term acute care facility located in northern Tai- wan. Out of 5,894 registered patients, 545 patients fell at least once, and 27.2% of them were women. We next compared the difference between groups of falls ver- sus non-fall and single fall versus repeat falls in demographic characteristics, psy- chiatric diagnosis and injury severity. Results:Patients who were male in sex (OR = 1.58, p< 0.05), those who were 60 years or older (Odds ratio, OR = 21.42, p< 0.001), and those with bipolar disorder (OR = 14.14, p< 0.001) were signifi- cantly more likely to have repeated (3 or more) falls. More serious injuries were significantly more common in female patients (OR = 3.59, p< 0.05), in patients with repeated (3 or more) falls (OR = 5.14, p < 0.01), and in patients who were admitted to chronic wards (OR = 5.30, p < 0.01). Conclusion:The risk factors for falls in psychiatric inpatients included older age and a diagnosis of schizophre- nia, bipolar disorder, dementia, or substance dependence. The risk factors for re- peated falls included older age, male gender, and a diagnosis of schizophrenia, bipolar disorder, or dementia. Risk factors for major injuries included female gen- der, repeated falls, and living in a chronic ward.