• Shane M Patman, Diane Dennis, and Kylie Hill.
• School of Physiotherapy and Institute for Health and Rehabilitation Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia. shane.patman@nd.edu.au
• Aust Crit Care. 2011 Aug 1; 24 (3): 167-74.

BackgroundFalling among adults in acute care is an important problem with falls rates in tertiary hospitals ranging from 2% to 5%. Factors that increase the risk of falling, such as advanced age, altered mental status, medications that act on the central nervous system and poor mobility, often characterise individuals who survive a prolonged intensive care unit (ICU) admission.PurposeTo measure the incidence of falls and describe the characteristics of fallers among intensive care survivors.MethodsA comprehensive retrospective chart review was undertaken of 190 adults who were intubated and ventilated for ≥ 168 h and survived their acute care stay. Using a standardised form, several variables were extracted including falls during hospitalisation and risk factors such as age, severity of illness, and length of stay in intensive care and hospital.FindingsThirty-two (17%, 95% confidence interval 11.5-22.2%) patients fell at least once on the in-patient wards following their ICU stay. Compared with non-fallers, fallers were younger (53.2 ± 17.9 vs. 44.1 ± 18.3 years; p=0.009) and had a shorter duration of inotropic support in ICU (84 ± 112 vs. 56 ± 100 h; p=0.040). The majority of fallers were aged less than 65 years (84%). Both fallers and non-fallers had similar APACHE II scores (20 ± 8 vs. 21 ± 7; p=0.673), length of stay in intensive care (14.2 ± 8.7 vs. 14.0 ± 9.7 days; p=0.667) and hospital length of stay (43.9 ± 33.1 vs. 41.0 ± 38.8 days; p=0.533).ConclusionFalling during hospitalisation is common in intensive care survivors. Compared with non-fallers, fallers were younger and required inotropes for a shorter duration. Those who survive a prolonged admission to an ICU may benefit from specific assessment of balance and falls risk by the multidisciplinary team.Copyright © 2011 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

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