Impact of Hearing Loss on Patient Falls in the Inpatient Setting

Am J Prev Med. 2020 Jun;58(6):839-844. doi: 10.1016/j.amepre.2020.01.019.

Abstract

Introduction: The objectives of this study were to investigate an association between the risk of patient falls and self-reported hearing loss and to examine whether self-reported hearing loss with versus without hearing aids predicts patient falls in an inpatient setting.

Methods: This retrospective cohort analysis was conducted in 2018 in a large, urban, academic medical center. Participants included unique inpatients (N=52,805) of adults aged >18 years between February 1, 2017, and February 1, 2018. Outcome measures were falls in the inpatient setting and hearing loss with versus without hearing aids as predictors for patient falls.

Results: Self-reported hearing loss was associated with falls in the inpatient setting (OR=1.74, 95% CI=1.46, 2.07, p<1.43 × 10-9). Among patients with hearing impairment, a lack of hearing aids increased the risk for falls in the inpatient setting (OR=2.70, 95% CI=1.64, 4.69, p<1.41 × 10-5). After accounting for the risk of fall using the Morse Fall Scale (which does not include hearing impairment) and controlling for age and sex, patients with hearing loss and no hearing aids were significantly more likely to fall (OR=2.44, 95% CI=1.002, 5.654, p<0.042), but patients with hearing loss who did have hearing aids were not significantly more likely to fall (p<0.889). Hearing loss together with the Morse Fall Scale better predicted falls than the Morse Fall Scale alone (p<0.017).

Conclusions: In the inpatient setting, there was a positive association between hearing loss and falls. However, among patients with hearing loss, only those without hearing aids were significantly more likely to fall, accounting for the Morse Fall Scale score and demographics characteristics. These findings support adding hearing loss as a modifiable risk factor in risk assessment tools for falls and exploring the use of amplification devices as an intervention.

MeSH terms

  • Academic Medical Centers
  • Accidental Falls / statistics & numerical data*
  • Adult
  • Aged
  • Female
  • Hearing / physiology
  • Hearing Aids / statistics & numerical data*
  • Hearing Loss / pathology*
  • Hospitalization
  • Humans
  • Inpatients / statistics & numerical data*
  • Male
  • Middle Aged
  • Predictive Value of Tests*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Self Report*
  • Young Adult