In-Hospital Falls at Landspítali: Associations Between Nutritional Risk Screening Results and Fall-Related Patient Outcomes

Abstract

Introduction: In-hospital falls are very prevalent around the world. The risk of falling is higher among people 65 years or older. Few studies have investigated the association between in-hospital falls and malnutrition, or the risk of malnutrition, and they indicate that malnutrition is a risk factor for in-hospital falls.Methods: Data on in-hospital falls of inpatients (n=429) 65 years or older in Landspítali - University Hospital in 2023 were extracted from the Hospital’s medical register and incident register. The patients were divided into three groups based on their risk of malnutrition: low, moderate, and high risk. Fall frequency, hospital admission rates, fall-related injuries, patients’ condition when falls occurred, length of hospital stay, discharge destination, and in-hospital mortality were compared between the groups.Results: Among the studied cohort, 34% were at high risk of malnutrition. This study found a high prevalence of hip fractures among inpatients at high risk of malnutrition, with 72.7% of patients who sustained a hip fracture after the fall classified as high risk. Additionally, these patients exhibited higher rates of disorientation (OR 0.42, 95% CI 0.228-0.755, p 0.004) and increased in-hospital mortality (OR 0.24, 95% CI 0.083-0.691, p 0.008). Conversely, those at low risk of malnutrition were more likely to be discharged home (OR 2.93, 95% CI 1.551-5.516, p<0.001). No significant difference was found in fall frequency, hospital admission rates, number of fall-related injuries, and length of hospital stay between those at risk of malnutrition.Conclusion: This study highlights that a high risk of malnutrition is a significant risk factor for adverse outcomes following in-hospital falls, including increased risk of mortality. The results of this study indicate the need for proactive nutritional assessment and interventions to improve patient outcomes in elderly inpatients.