Analysis of factors associated with severity categories of fall-related injuries among inpatients at a tertiary grade A hospital in Zhejiang province from 2015 to 2025: a retrospective observational study

Objectives Understanding the factors associated with the severity categories of fall-related injuries and intervening on modifiable determinants can mitigate the risk of serious fall injuries, thereby enhancing patient safety, reducing length of hospital stay and alleviating the economic burden imposed by these injuries. This study aims to identify factors associated with the severity categories of fall-related injuries and to explore differences in the clinical characteristics of patients who sustain such injuries.

Design A retrospective observational study.

Setting A tertiary care hospital in Zhejiang Province, China.

Participants This study included 1030 inpatient fall incidents that occurred between January 2015 and March 2025, drawn from the nursing adverse event reporting system.

Outcome measures Based on the fall-related injury outcomes recorded in the nursing adverse event reporting system. Descriptive statistics were employed to analyse the current status of fall-related injuries. Univariable and multivariable analyses were conducted to explore factors associated with the severity categories of fall-related injuries.

Results The incidence of fall-related injuries in this study was 60.6% and the incidence of serious fall injuries was 12.1%. Logistic regression analysis identified factors associated with the severity categories of fall-related injuries. The analysis revealed that patients aged ≥65 years (minor injuries OR=1.82; serious injuries OR=1.76), women (OR=1.59; 1.90), tripping falls (OR=3.94; 4.48), impact to the knee (OR=4.00) or trunk (OR=4.28; 5.34) and ambulatory status prior to the fall (OR=1.71; 1.97) were all associated with more severe fall injuries.

Conclusions These findings underscore the need to strengthen fall and fall-related injury prevention efforts among inpatients, particularly among patients aged ≥65 years and women. Clinical professionals should prioritise protecting high-risk populations through fall prevention and control to reduce the risk of fall-related injuries.