ABSTRACT
BACKGROUND: Falls by orthopaedic patients may lead to negative outcomes such as injury, prolonged hospitalization, delayed rehabilitation, and increased costs. QUESTIONS/PURPOSES: We examined the impact of a multidisciplinary Falls-prevention Program (FPP) on the incidence of inpatient falls and fall-related injuries in an orthopaedic hospital during a 6-year period. METHODS: Patient data and fall incident report data were reviewed to identify risk factors associated with falls and fall-related injuries. A cost analysis was performed to calculate costs incurred as a result of falls. RESULTS: A total of 415 falls occurred during a 5-year period preintervention. The fall rate preintervention was significantly higher than the fall rate postintervention (3.49 versus 2.68 per 1000 bed days). Eighty-five falls occurred in the 12 months preintervention. A total of 15.29% (13 of 85) of falls resulted in minor injuries, and 9.42% (eight of 85) resulted in major injuries. The total cost incurred during this period as a result of falls was $117,754.12. Of this, 95.5% resulted from patients who sustained a hip fracture (n = 4). The total cost of implementing the FPP was $15,694.46. In the 12 months postintervention, 52 falls occurred. Twenty-five percent (13 of 52) of falls resulted in minor injuries, and 5.76% (two of 52) resulted in major injuries (no hip fractures). The total costs accrued during this period as a result of falls was $811.70. CONCLUSIONS: After implementation of a FPP, there were significant decreases in fall incidence, fall-related morbidity, and consequent costs. LEVEL OF EVIDENCE: Level III, economic and decision analyses. See the Guidelines for Authors for a complete description of levels of evidence.
Subject(s)
Accidental Falls/economics , Accidental Falls/prevention & control , Cost of Illness , Hospital Costs , Hospitalization , Accidental Falls/statistics & numerical data , Aged , Aged, 80 and over , Bones of Lower Extremity/injuries , Costs and Cost Analysis , Female , Fractures, Bone/epidemiology , Hip Fractures/epidemiology , Humans , Male , Middle Aged , Prospective Studies , Risk FactorsABSTRACT
Salmonella septic arthritis in healthy individuals is a rare phenomenon. However, septic arthritis of the native adult ankle joint in healthy patients has not been previously described in the published data. This is a case report of a 70-year-old farmer who presented with a 2-week history of a painful, swollen right ankle and an inability to bear weight. He had no history of ankle injury or any predisposing conditions. Joint aspirations were positive for Salmonella enteritidis that was successfully treated with right ankle arthrotomy and washout, along with a 6-week course of intravenous antibiotic therapy.
