Research Reports from National Health Insurance Service Ilsan Hospital Provide New Insights into Orthopedics (Risk Factors and Characteristics of In-Hospital Falls After Spine Surgery): Health and Medicine – Orthopedics

NewsRx Medical Devices Daily

2024 APR 18 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Medical Devices Daily -- A new study on orthopedics is now available. According to news reporting out of Goyang, South Korea, by NewsRx editors, research stated, “Falls after orthopaedic surgery can cause serious injuries, which lengthen hospital stays and increase medical expenses. This has prompted hospitals to implement various fall-prevention protocols. The aims of this study were to determine the incidence of in-hospital falls after spine surgery, to analyze the overall risk factors, to discern factors that have a major influence on falls, and to evaluate the effectiveness of the fall-prevention protocol that we implemented.”

Our news journalists obtained a quote from the research from National Health Insurance Service Ilsan Hospital: “This was a retrospective, single-center study including patients who underwent spine surgery from January 2011 to November 2021 at the National Health Insurance Service Ilsan Hospital (NHISIH) in Goyang, Republic of Korea. Reported falls among these patients were examined. Patient demographics; surgery type, date, and diagnosis; and fall date and time were evaluated. Overall, 5,317 spine surgeries were performed, and 128 in-hospital falls were reported (overall incidence: 2.31%). From the multivariable analyses, older age and American Society of Anesthesiologists (ASA) score were identified as independent risk factors for in-hospital patient falls (multivariable adjusted hazard ratio [aHR] for age 70 to 79 years, 1.021 [95% confidence interval (CI), 1.01 to 1.031]; for age 80 years, 1.035 [1.01 to 1.06]; and for ASA score of 3, 1.02 [1.01 to 1.031]). Similar results were seen in the subgroup who underwent primary surgery. Within 2 weeks following surgery, the highest frequency of falls occurred at 3 to 7 days postoperatively. The lowest fall rate was observed in the evening (6 to 10 p.m.). Morbidities, including rib, spine, and extremity fractures, were recorded for 14 patients, but none of these patients underwent operative treatment related to the fall. The NHISIH implemented a comprehensive nursing care service in May 2015 and a fall protocol in May 2017, but the annual incidence rate did not improve. The fall rate was higher after thoracolumbar surgeries (2.47%) than after cervical surgeries (1.20%). Moreover, a higher fall rate was observed in thoracolumbar cases with a greater number of fusion levels and revision spine surgeries.”

According to the news reporters, the research concluded: “Patients with advanced age, more comorbidities, a greater number of fusion levels, and revision surgeries and who are female are more vulnerable to in-hospital falls after spine surgery. Novel strategies that target these risk factors are warranted. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.”

For more information on this research see: Risk Factors and Characteristics of In-Hospital Falls After Spine Surgery. JBJS Open Access, 2024,9(2). (JBJS Open Access - http://journals.lww.com/jbjsoa). The publisher for JBJS Open Access is Ovid Technologies (Wolters Kluwer Health).

A free version of this journal article is available at https://doi.org/10.2106/jbjs.oa.23.00096.

Our news editors report that additional information may be obtained by contacting Jae-Won Shin, Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, South Korea. Additional authors for this research include Heon Jung Park, Yung Park, Joong-Won Ha, Jung Hwa Hong, Hak-Sun Kim, Kyung-Soo Suk, Seong-Hwan Moon, Si-Young Park, Byung-Ho Lee, Ji-Won Kwon.