Page 236 - Hospital Authority Convention 2017

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2017

F8.7 Young HA Investigators Presentations 14:30 Room 421

Analysis on the High Risk Factors for Elderly Fall in Hospital Settings
Yau KY, Ching CY, Leung WY, Wu A
Department of Occupational Therapy, Caritas Medical Centre, Hong Kong
Introduction
Fall was one of the major causes of morbidity and mortality in older people (Ching et al., 2013). For elderly aged more than 65
years old in Hong Kong, the prevalence of fall was as high as 19.3-20% (Chu, Chi & Chiu, 2005) (Fong, Siu, Yeung, Cheung &
Chan, 2011). Previous research showed that about one out of five fallers needed to seek medical attention and one out of 10
resulted in a fracture (Gillespie et al., 2012).

Objective
To analyse the potential high fall risk factors from the fall assessment conducted by occupational therapists (OT).

Methodology
This was a retrospective clinical review. 6,735 cases from acute wards (89%), rehabilitation wards (10%) and geriatric
day hospital (0.2%) were referred to OT for fall assessment during January 2015 to September 2016. The fall assessment
consisted of two 20-item checklists evaluate environmental hazards and identify any risky behaviours. Modified Barthel Index
(MBI) was conducted in addition.
Results
Among the 6,735 cases, the proportions of male and female were 50.5% and 49.5% respectively. The mean age was 77.93
and the mean MBI score was 48.2.
As revealed by independent t-test, male demonstrated significantly more risk-taking behaviour than female (t=8.651, p<0.001).
Pearsons’r Analysis showed a positive correlation between age and fall risk (r=0.03, p=0.013), which indicated that fall risk
was increasing with age. With the use of One-Way ANOVA, it was found that those who scored 21-60 in MBI posed the
highest fall risk (F= 403.421, p<0.001).

At the same time, five most common risky behaviours were identified: Not seeking for help when need (40.2%), unsafe
transfer (39.2%), performing activities beyond abilities and limits (32.0%), sudden/hurry pace transfer (22.2%) and not
complying with staff’s safety advice and instructions (21.6%).

Findings showed that those with MBI score between 21 and 60, which meant requiring moderate assistance in activities of
daily life (ADL), demonstrated the highest fall risk. More risky behaviour and hence higher fall risk was noted in male and
advancing age. This implied that ADL training is one of the essential components in fall preventive intervention. Future OT
development may focus on tailor-made training that target risky behaviours. Intensive training for cases who scored 21-60 in
MBI may reduce the frequency of fall in elderly.
Wednesday, 17 May

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