Development of predictive model and additional medical cost calculation for fracture and traumatic intracranial hemorrhage during hospitalization.

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K09229
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical and hospital managemen
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: Mikayo Toba 東京医科歯科大学, 医学部附属病院, 講師 (60463923)
• Co-Investigator(Kenkyū-buntansha): 森脇 睦子 東京医科歯科大学, 大学院医歯学総合研究科, 寄附講座准教授 (40437570) ; 尾林 聡 東京医科歯科大学, 医学部附属病院, 准教授 (10262180) ; 伏見 清秀 東京医科歯科大学, 大学院医歯学総合研究科, 教授 (50270913)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 医療安全管理 / 転倒転落 / 医療の質管理 / 病院管理

Outline of Final Research Achievements

We investigated occurrences of bone fractures and traumatic head injuries during hospitalization and the risk factors for in-hospital mortality in acute care hospitals.
The incidence rate of fractures during hospitalization was 0.32%, The fracture sites of the vertebral bones,femurs,and ribs accounted for more than 70% of the total incidents.The in-hospitalW mortality rate was 9.5%, and the in-hospital mortality risk factors revealed that cases of traumatic head injury, femoral fracture, humeral fracture, and independent walking upon admission, in conjunction with having a BMI <18.5 and being male, increased in-hospital mortality risk.The incidence rate of traumatic head injury was 0.046% and in-hospital mortality was 17.9%. surgery for traumatic head injury, psychotropic drugs, having a low BMI, and being male were factors increasing the risk of mortality.

Free Research Field

医療安全

Academic Significance and Societal Importance of the Research Achievements

世界的に高齢化が進んでいるなかで、転倒転落の発生防止は日本のみならず世界的な課題となっている。なかでも、骨折や外傷性頭部損傷を引き起こすような転倒転落の発生防止は患者のQOL,予後、医療経済的な観点からも喫緊の課題である。また、入院中の病的骨折以外の骨折および外傷性頭部損傷の原因の多くは転倒・転落等のアクシデントに起因するものと推測される。本研究結果は入院中の転倒・転落で骨折または外傷性頭部損傷が発生した際に重篤な転期（在院死亡）となるリスクの高い患者の識別に応用できる可能性がある。