Factors explaining falls in elderly subjects leading to acute-care hospitalization

OBJECTIVE: Falls are a frequent reason for hospitalization in short-stay ge riatric units. Paradoxically, the factors determining such hospitalization remain unknown. The objective of our study was to identify the explanatory factors of falls leading to acute-care hospitalization of elderly subjects. PATIENTS AND METHODS: We prospectively compared patients hospitalized for f alls and those hospitalized for another reason in a short-stay geriatric un it. Data were collected over a 6-month period starting with a questionnaire and a physical examination. RESULTS: Patients admitted for falls were predominantly women (76.9%) livin g alone (76.9%). Falls depended mainly on intrinsic factors. The precipitat ing factor was a medical condition (84%) and acute (96%). The pattern of mu ltiple disease conditions was not specific for patients who fell. Inversely , osteoarthritis and visual and auditory deficits with direct effects on mo tor functions were correlated with falls. The environment played a determin ing role, but was primarily a predisposing and not a precipitating factor a s is was directly the cause of falls in only 4% of cases. The loss of self- sufficiency for daily activities was also significantly more frequent in pa tients who fell. DISCUSSION: The explanatory factors of falls as the reason for hospitalizat ion of elderly subjects in short-stay geriatric units are intrinsic factors . They are associated with a precipitating factor which is usually an acute medical condition and a chronic multiple disease state having an effect on postural balance leading to the fall. These factors are combined in a cont ext of social and environmental isolation. (C) 2000, Masson, Paris.