Original Article

An analysis of falls occurring in a convalescence rehabilitation ward - a decision tree classification of fall cases for the management of basic movements -

Toshio Teranishi, RPT, PhD, Izumi Kondo, MD, PhD, Genichi Tanino, RPT, MSc, Hiroyuki Miyasaka, OTR, MSc, Hiroaki Sakurai, RPT, MSc, Junko Kaga, RPT, BA, Yukari Suzuki, RPT, PhD, Ayako Matsushima, RN, Minako Kawakita, RN, Shigeru Sonoda, MD, PhD
Jpn J Compr Rehabil Sci 4: 7-13, 2013

Purpose: A simple and discriminative method for evaluating the ability to maintain balance, the Standing test for Imbalance and DisEquilibrium (SIDE), was developed for fall risk management. As a preliminary step toward clinical application of the SIDE, this study aimed to determine a method of assessing the expected fall risk by analyzing fall cases using a decision tree classification for the management of basic movements.
Subjects and method: The subjects of this study were 513 patients who had been discharged from a convalescence rehabilitation ward over a one-year period (from January 1, 2010 to December 31, 2010). In cases when a fall occurred, we investigated the period from hospitalization and the classification of the patient, which was made with a decision tree describing the permitted activities of the patient and the management of the activities. The frequency of fall occurrence was determined by considering the number of patients who fell during every 15-day period during hospitalization.
Results: One hundred twenty patients fell during hospitalization. In total, 163 falls occurred. The incidence of falls was 4.65. Thirty patients suffered multiple falls. The falls occurred significantly more frequently during the first 15 days after admission. From classification by the decision tree, 62 falls occurred while the patients were being managed using physical restraints and/or sensors, 55 falls occurred during unpredictable actions of patients when the patients were not using physical restraints or sensors, and 26 falls occurred during permitted activities of patients.
Conclusion: Simple assessments of balance and adherence are necessary to reduce the occurrence of patient falls during the early period after admission.

Key words: convalescence rehabilitation ward, fall, classification, decision tree

Contents (volume 4)