Predictors of serious consequences of falls in residential aged care: analysis of more than 70,000 falls from residents of Bavarian nursing homes.

BACKGROUND/OBJECTIVE Falls are common in nursing homes and cause a high burden of injuries. The objective of this study was to analyze factors associated with serious consequences of falls in nursing home residents. DESIGN Prospective observational study. SETTING Falls were recorded over 1 year, covering all residents from 528 nursing homes in Bavaria, Germany. PARTICIPANTS The database consisted of 70,196 falls. MEASUREMENTS The standardized form included information about date, time, sex, age, functional status, location of fall, activity leading to the fall, footwear, and about potential consequences, such as transfer to hospital or a suspected fracture. Transfer to hospital was the main outcome and served as surrogate for a serious fall. The association of potential risk factors with hospital transfer after a fall was estimated in multiple logistic regression models. RESULTS Serious falls were associated with increasing age, being female, and less restricted functional status. Walking compared with transferring, and particularly the morning hours were also associated with a serious fall. Compared with midday, for example, the time period between 6 am and 8 am was associated with a more than 60% increased chance of transfer to hospital. Inappropriate footwear and weekends were associated with serious falls only in women. CONCLUSION Some observed factors or indicators associated with transfer to hospital are modifiable and targeted interventions may reduce injuries or costs after a fall.