In-hospital patient falls after total joint arthroplasty: incidence, demographics, and risk factors in the United States

Abstract

In-hospital falls (IFs) increase morbidity, cost, and may result in litigation. We analyzed the Nationwide Inpatient Sample to quantify the incidence of IFs in patients who underwent hip and knee arthroplasty and to define trends, patient's demographics, risk factors, complications, and hospital cost. Patients operated on between 1998 and 2007 were identified and grouped depending on the presence of a diagnosis of IF. Of those, 0.85% had an IF, representing 2.1 falls per 1000 inpatient days. The incidence of IF increased from 0.4% to 1.3% during the study period. Independent risk factors included revision surgery, advanced age, male sex, minority race, and the presence of comorbidities. Patients having IF had a longer hospital stay and were less likely to be discharged to their primary residence. In-hospital mortality, complications, and cost were higher in patients sustaining IF. Given the associated morbidity, mortality, and increased cost, resources should be allocated to minimize the risk of IF in this population.

Fig. 1

The annual incidence of in-patient falls during the study period.

Fig. 2

Prevalence of comorbidities amongst patients with and without in-patient falls.