Inpatients on Insulin Have Elevated Risk of Falling

SAN DIEGO — Insulin was a surprise among the medications commonly associated with inpatient falls in a large single-center controlled study of 230 patients.

“Previous community studies have found a connection between diabetes and falling. In our study, diabetes was not associated with falling, but use of insulin was. The question is whether insulin is a marker of more severe diabetes, or if these patients have low blood sugars or peripheral neuropathy that is increasing the risk of falling,” said Caroline O'Neil, research coordinator in the infectious diseases division at Washington University, St. Louis.

Patients who fell were more likely than controls who did not fall to be taking hydantoin anticonvulsants (odds ratio 3.6), haloperidol (OR 3.4), benzodiazepines (OR 2.1), and insulin (OR 1.5). Certain combinations of medications increased the risk even more, especially the combination of hydantoins and insulin (OR 11.4) and benzodiazepines and haloperidol (OR 5.7). The data were presented in a poster at the annual meeting of the Society for Healthcare Epidemiology of America.

In the study, led by Dr. Victoria J. Fraser, the researchers evaluated 230 inpatients who had fallen at Barnes Jewish Hospital in St. Louis. The study also included 690 control patients who did not fall. The mean age of patients who fell was 62 years, 54% were male, and their average length of stay was 12 days.

The study was funded with grant support from the National Institutes of Health and the Centers for Disease Control and Prevention. Ms. O'Neil said that she had no financial conflicts to disclose.

Patients taking a combination of hydantoins and insulin had an 11.4-fold increased risk of falling.

Source MS. O'NEIL