In-Hospital Patient Falls After Total Joint Arthroplasty: Incidence, Demographics, and Risk Factors in the United States

Memtsoudis, Stavros G.; Dy, Christopher J.; Ma, Yan; Chiu, Ya-Lin; Gonzalez Della Valle, Alejandro; Mazumdar, Madhu

doi:10.1016/j.arth.2011.10.010

« Previous Next »The Journal of Arthroplasty
Volume 27, Issue 6 , Pages 823-828.e1, June 2012

In-Hospital Patient Falls After Total Joint Arthroplasty:

Incidence, Demographics, and Risk Factors in the United States

Stavros G. Memtsoudis, MD, PhD
- Department of Anesthesiology, Hospital for Special Surgery, New York, New York
Christopher J. Dy, MD, MSPH
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
Yan Ma, PhD
- Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, New York
Ya-Lin Chiu, MS
- Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, New York
Alejandro Gonzalez Della Valle, MD
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
- Reprint requests: Alejandro Gonzalez Della Valle, MD, Hospital for Special Surgery, 535 East 70th St, New York, NY 10021.
Madhu Mazumdar, PhD
- Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, New York

Received 15 February 2011; accepted 7 October 2011. published online 24 November 2011.

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.

Keywords: total joint anthroplasty, complications, in-patient falls, safety