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INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2001; 16: 965±968. DOI: 10.1002/gps.463 Recurrent falls are associated with increased length of stay in elderly psychiatric inpatients Elaine Greene 1,2 *, Conal J. Cunningham 1 , Andrew Eustace 1 , Nick Kidd 1 , Anthony W.Clare 2 and Brian A. Lawlor 1,2 1 Mercers Institute for Research on Ageing, St James's Hospital, James's St, Dublin 8, Ireland 2 St Patrick's Hospital, James's St, Dublin 8, Ireland SUMMARY Objectives To identify factors which may contribute to prolonged length of stay in an elderly psychiatric inpatient setting. Design Retrospective case note study. Methods A list of all patients over the age of 65 discharged from a private psychiatric hospital over a three-year period excluding those with a length of stay of over 365 days was obtained n 1147). A random sample of 150 patients was selected from the study population. A case note study was then performed looking at a number of variables which have been postulated to affect length of stay. The resulting data was analysed using multivariate statistics. Results There was no statistically signi®cant association found between baseline factors including age, gender, cognitive impairment, marital status, order of admission and preadmission living arrangement) and length of stay. Having recurrent falls whilst an inpatient was associated with prolonged hospital stay p 0.0006). Conclusion Experiencing recurrent falls whilst an inpatient is associated with prolonged length of stay. Recurrent falls in the elderly may be associated with both physical illness and the use of psychotropic medications. A prospective study exam- ining factors contributing to falls would be important in decreasing fall risk and reducing length of stay. Copyright # 2001 John Wiley & Sons, Ltd. key words Ð recurrent falls; length of stay; elderly; retrospective case-note study INTRODUCTION Elderly patients are often perceived as spending excessive amounts of time as inpatients in psychiatric units. Several factors may in¯uence length of stay LOS) in this population. Many different parameters have been studied including diagnosis, co-morbidity, cognitive impairment, treatment differences and sociodemographic factors. Results of studies on the effect of diagnosis on LOS have varied. Depression was found to contribute to prolonged LOS in some studies Conwell et al., 1989; Draper, 1994; Snowdon, 1997). Age of onset of depression Conwell et al., 1989) and severity of depression Draper, 1994) have been correlated with increased LOS. Other studies have found that diagnosis has little effect on LOS Creed et al., 1997, Moss and Wilson, 1995, Zisselman et al., 1996). The elderly population are more likely to suffer with comorbid medical problems which may cause dif®culties with treatment Ormel et al., 1997) and may therefore indirectly lead to pro- longed length of stay by making rehabilitation more dif®cult. Those with chronic medical conditions may be more likely to develop medical complications during their stay urinary tract infections UTI), respiratory tract infections RTI), delirium and adverse drug events) and some may ultimately require transfer to medical inpatient care. There have been varying reports on the effect of cognitive impairment on LOS. In one recent study it was shown to prolong hospital stay Kales et al., 1999) others have found that level of cognitive function has little Received 23 August 2000 Copyright # 2001 John Wiley & Sons, Ltd. Accepted 21 February 2001 *Correspondence to: Elaine Greene, Mercers Institute for Research on Ageing, St James's Hospital, James's St, Dublin 8, Ireland. Tel: 01) 4162640. Fax: 01)4541796. E-mail: [email protected]

Recurrent falls are associated with increased length of stay in elderly psychiatric inpatients

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