Purpose: Falls are the leading cause of injury among hospitalized patients, particularly among older patients. We investigated the association between serum phosphate (s-phosphate) levels and the risk of in-hospital falls.
Patients and Methods: This retrospective observational cohort study included all patients aged over 50 years who were admitted to Yongin Severance Hospital in South Korea between January 2018 and March 2021. Demographic, anthropometric, and biochemical parameters were recorded on admission. S-phosphate levels were classified into three groups: below normal (< 2.8 mg/dL), normal (2.8– 4.4 mg/dL), and above normal (≥ 4.5 mg/dL). The normal group was further stratified into tertiles (2.8– 3.2, 3.3– 3.7, and 3.8– 4.4 mg/dL). The incidence of in-hospital falls was compared between the five groups. Logistic regression analyses were performed to assess the association between s-phosphate levels and the incidence of falls during the hospital stay, with clinical factors included as covariates in the multivariable models.
Results: A total of 15,485 patients (female: 52.1%) with a median age of 70.0 years (interquartile range: 60.0– 79.0 years) were included in the analysis, of whom 295 (1.9%) experienced a fall during the hospital stay. The incidence of falls was significantly higher among patients with lower s-phosphate levels, and this relationship also applied among patients with s-phosphate levels within the normal range as well. The association between lower s-phosphate levels and increased risk of falls remained significant in the adjusted analyses.
Conclusion: A lower s-phosphate level on admission was independently associated with an increased risk of in-hospital falls. Further studies are needed to determine whether the s-phosphate level on admission could improve prediction of the risk of in-hospital falls.

Keywords: in-hospital falls, older adults, blood biochemistry, risk prediction


中文翻译：

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50 岁以上住院患者低血清磷酸盐水平与跌倒风险之间的关联：一项回顾性观察队列研究

目的：跌倒是住院患者，尤其是老年患者受伤的主要原因。我们调查了血清磷酸盐（s-磷酸盐）水平与院内跌倒风险之间的关系。
患者和方法：这项回顾性观察性队列研究纳入了 2018 年 1 月至 2021 年 3 月期间在韩国龙仁 Severance 医院收治的所有 50 岁以上的患者。在入院时记录人口统计学、人体测量学和生化参数。S-磷酸水平分为三组：低于正常（< 2.8 mg/dL）、正常（2.8-4.4 mg/dL）和高于正常（≥ 4.5 mg/dL）。正常组进一步分层为三分位数（2.8-3.2、3.3-3.7 和 3.8-4.4 mg/dL）。比较了五组之间的院内跌倒发生率。进行逻辑回归分析以评估 s-磷酸盐水平与住院期间跌倒发生率之间的关联，临床因素包括在多变量模型中作为协变量。
结果：共有 15,485 名患者（女性：52.1%），中位年龄为 70.0 岁（四分位距：60.0-79.0 岁），其中 295 名（1.9%）在住院期间出现跌倒。s-磷酸盐水平较低的患者跌倒的发生率明显较高，这种关系也适用于s-磷酸盐水平在正常范围内的患者。在调整后的分析中，较低的 s-磷酸盐水平与跌倒风险增加之间的关联仍然显着。
结论：入院时较低的 s-磷酸盐水平与住院跌倒风险增加独立相关。需要进一步的研究来确定入院时的 s-磷酸盐水平是否可以提高对住院跌倒风险的预测。

关键词：院内跌倒，老年人，血液生化，风险预测