Background Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital. Objectives To systematically summarise existing evidence on the incidence and risk factors for post-hospital falls among older adults. Methods A systematic review and meta-analysis was conducted. Six electronic databases were searched to identify cohort studies investigating the incidence and risk factors for post-hospital falls in older adults. The incidence and risk factors for post-hospital falls were extracted. The meta-analysis was used to calculate pooled incidences and 95% confidence intervals (CI). The meta-regression and subgroup meta-analysis were conducted to explore sources of heterogeneity in incidence proportions across the eligible studies. A qualitative synthesis was performed for the post-hospital falls risk factors. Results Eighteen studies from eight countries (n = 9,080,568) were included. The pooled incidence proportion of any and recurrent post-hospital falls was 14% (95% CI: 13%–15%) and 10% (95% CI: 5%–14%), respectively. Follow-up period, study quality, study country, setting, percentage of female subjects, percentage of subjects with previous falls and the primary data collection method for falls significantly contributed to the 64.8% of the heterogeneity in incidence proportions. Twenty-six risk factors for post-hospital falls were identified in the eligible studies, where biological factors were the most commonly identified factors. The highest risks were reported for previous falls, previous fractures, delirium and neurological diseases. Conclusion The findings of this study suggested future post-hospital falls prevention should prioritise the needs of older adults with the dominant risk factors. Further investigations into the period-specific incidence and socioeconomic and environmental risk factors for post-hospital falls are also required.

中文翻译：

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老年人院后跌倒发生率和危险因素：系统评价和荟萃分析

背景 对于最近出院的老年人来说，院后跌倒是一个重大的健康问题。目的 系统总结关于老年人院后跌倒发生率和危险因素的现有证据。方法进行系统评价和荟萃分析。搜索了六个电子数据库，以确定调查老年人院后跌倒发生率和危险因素的队列研究。提取出院后跌倒的发生率和危险因素。荟萃分析用于计算汇总发生率和 95% 置信区间 (CI)。进行荟萃回归和亚组荟萃分析以探索符合条件的研究中发病率比例的异质性来源。对院后跌倒危险因素进行了定性综合。结果 纳入了来自 8 个国家的 18 项研究（n = 9,080,568）。任何和复发性院后跌倒的合并发生率分别为 14%（95% CI：13%–15%）和 10%（95% CI：5%–14%）。随访期、研究质量、研究国家、环境、女性受试者百分比、既往跌倒受试者百分比和跌倒的主要数据收集方法显着促成了发病率异质性的 64.8%。在符合条件的研究中确定了 26 个院后跌倒的危险因素，其中生物学因素是最常见的确定因素。据报道，先前跌倒、先前骨折、谵妄和神经系统疾病的风险最高。结论 本研究的结果表明，未来的院后跌倒预防应优先考虑具有主要危险因素的老年人的需求。还需要进一步调查特定时期的发病率以及院后跌倒的社会经济和环境风险因素。