Abstract：
OBJECTIVE: To identify and quantify risk factors for in-hospital falls in medical patients.
METHODS: Six databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, and Google Scholar) were systematically screened until April 11, 2023, to identify relevant articles.
METHODS: All titles and abstracts of the retrieved articles were independently screened by 2 researchers who also read the full texts of the remaining articles. Quantitative studies that assessed risk factors for falls among adult patients acutely hospitalized were included in the review. Publications that did not capture internal medicine patients or focused on other specific populations were excluded.
METHODS: Information on study characteristics and potential risk factors were systematically extracted. Risk of bias was assessed using the Quality in Prognosis Studies tool. Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology guidelines were followed for reporting.
RESULTS: The main outcome was any in-hospital falls. Using a random-effects meta-analysis model, association measures for each risk factor reported in 5 or more studies were pooled. Separate analyses according to effect measure and studies adjusted for sex and age at least were performed. Of 5067 records retrieved, 119 original publications from 25 countries were included. In conclusion, 23 potential risk factors were meta-analyzed. Strong evidence with large effect sizes was found for a history of falls (odds ratio [OR], 2.54; 95% confidence interval [CI], 1.63-3.96; I2, 91%), antidepressants (pooled OR, 2.25; 95% CI, 1.92-2.65; I2, 0%), benzodiazepines (OR, 1.97; 95% CI, 1.68-2.31; I2, 0%), hypnotics-sedatives (OR, 1.90; 95% CI, 1.53-2.36; I2, 46%), and antipsychotics (OR, 1.61; 95% CI, 1.33-1.95; I2, 0%). Furthermore, evidence of associations with male sex (OR, 1.22, 95% CI, 0.99-1.50; I2, 65%) and age (OR, 1.17, 95% CI, 1.02-1.35; I2, 72%) were found, but effect sizes were small.
CONCLUSIONS: The comprehensive list of risk factors, which specifies the strength of evidence and effect sizes, could assist in the prioritization of preventive measures and interventions.
METHODS: Six databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, and Google Scholar) were systematically screened until April 11, 2023, to identify relevant articles.
METHODS: All titles and abstracts of the retrieved articles were independently screened by 2 researchers who also read the full texts of the remaining articles. Quantitative studies that assessed risk factors for falls among adult patients acutely hospitalized were included in the review. Publications that did not capture internal medicine patients or focused on other specific populations were excluded.
METHODS: Information on study characteristics and potential risk factors were systematically extracted. Risk of bias was assessed using the Quality in Prognosis Studies tool. Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology guidelines were followed for reporting.
RESULTS: The main outcome was any in-hospital falls. Using a random-effects meta-analysis model, association measures for each risk factor reported in 5 or more studies were pooled. Separate analyses according to effect measure and studies adjusted for sex and age at least were performed. Of 5067 records retrieved, 119 original publications from 25 countries were included. In conclusion, 23 potential risk factors were meta-analyzed. Strong evidence with large effect sizes was found for a history of falls (odds ratio [OR], 2.54; 95% confidence interval [CI], 1.63-3.96; I2, 91%), antidepressants (pooled OR, 2.25; 95% CI, 1.92-2.65; I2, 0%), benzodiazepines (OR, 1.97; 95% CI, 1.68-2.31; I2, 0%), hypnotics-sedatives (OR, 1.90; 95% CI, 1.53-2.36; I2, 46%), and antipsychotics (OR, 1.61; 95% CI, 1.33-1.95; I2, 0%). Furthermore, evidence of associations with male sex (OR, 1.22, 95% CI, 0.99-1.50; I2, 65%) and age (OR, 1.17, 95% CI, 1.02-1.35; I2, 72%) were found, but effect sizes were small.
CONCLUSIONS: The comprehensive list of risk factors, which specifies the strength of evidence and effect sizes, could assist in the prioritization of preventive measures and interventions.
摘要：
目的：确定和量化内科患者住院期间跌倒的危险因素。
方法：六个数据库(MEDLINE，Embase,Cochrane系统评价数据库，Cochrane中央控制试验登记册,CINAHL,和GoogleScholar）进行了系统筛选，直到2023年4月11日，以识别相关文章。
方法：检索到的文章的所有标题和摘要均由两名研究人员独立筛选，他们还阅读了其余文章的全文。评估急性住院成年患者跌倒危险因素的定量研究包括在该综述中。未捕获内科患者或关注其他特定人群的出版物被排除在外。
方法：系统提取研究特征和潜在危险因素的信息。使用预后研究质量（QUIPS）工具评估偏倚风险。报告遵循PRISMA和MOOSE指南。
结果：主要结局是任何院内跌倒。使用随机效应元分析模型，我们汇总了5项或更多研究中报告的每个危险因素的关联指标.根据效果测量进行单独分析，并至少进行针对性别和年龄进行调整的研究。在检索到的5067条记录中，包括来自25个国家的119份原始出版物。总之,对23个潜在危险因素进行Meta分析。对于跌倒病史，发现了具有较大效应大小的有力证据（OR2.54;95％CI1.63-3.96;I291％），抗抑郁药（合并OR2.25；95%置信区间[95%CI]1.92-2.65；I20%），苯二氮卓类药物（OR1.97；95%CI1.68-2.31；I20%），催眠药-镇静剂（OR1.90；95%CI1.53-2.36；I246%），和抗精神病药（OR1.61；95%CI1.33-1.95；I20%）。此外，发现了与男性（OR1.22，95％CI0.99-1.50，I265％）和年龄（OR1.17，95％CI1.02-1.35，I272％）相关的证据，但效果大小很小。
结论：风险因素的综合列表，它规定了证据的强度和效果的大小，可以帮助确定预防措施和干预措施的优先次序。
方法：六个数据库(MEDLINE，Embase,Cochrane系统评价数据库，Cochrane中央控制试验登记册,CINAHL,和GoogleScholar）进行了系统筛选，直到2023年4月11日，以识别相关文章。
方法：检索到的文章的所有标题和摘要均由两名研究人员独立筛选，他们还阅读了其余文章的全文。评估急性住院成年患者跌倒危险因素的定量研究包括在该综述中。未捕获内科患者或关注其他特定人群的出版物被排除在外。
方法：系统提取研究特征和潜在危险因素的信息。使用预后研究质量（QUIPS）工具评估偏倚风险。报告遵循PRISMA和MOOSE指南。
结果：主要结局是任何院内跌倒。使用随机效应元分析模型，我们汇总了5项或更多研究中报告的每个危险因素的关联指标.根据效果测量进行单独分析，并至少进行针对性别和年龄进行调整的研究。在检索到的5067条记录中，包括来自25个国家的119份原始出版物。总之,对23个潜在危险因素进行Meta分析。对于跌倒病史，发现了具有较大效应大小的有力证据（OR2.54;95％CI1.63-3.96;I291％），抗抑郁药（合并OR2.25；95%置信区间[95%CI]1.92-2.65；I20%），苯二氮卓类药物（OR1.97；95%CI1.68-2.31；I20%），催眠药-镇静剂（OR1.90；95%CI1.53-2.36；I246%），和抗精神病药（OR1.61；95%CI1.33-1.95；I20%）。此外，发现了与男性（OR1.22，95％CI0.99-1.50，I265％）和年龄（OR1.17，95％CI1.02-1.35，I272％）相关的证据，但效果大小很小。
结论：风险因素的综合列表，它规定了证据的强度和效果的大小，可以帮助确定预防措施和干预措施的优先次序。
