背景：醫療院所中所發生的意外事件，以病人跌倒所佔的比例最高。影響跌倒的相關因子很多，而藥物為其中一個因素。本研究的目的為探討住院病人跌倒與用藥的關聯性。
方法：本研究採回溯性個案控制方法。收集本醫院2003年住院期間內發生有正式紀錄之跌倒病人意外事件報告。將會影響跌倒的相關變項：病患性別、年齡、主要診斷碼（ICD）等變項控制後，以電腦進行對照組之配對。比較跌倒病人與對照組，於跌倒前一天、前兩天及前三天內（對照組是以出院日為主），使用與跌倒相關藥物之情況。
結果：本院於2003年有紀錄的住院跌倒病人共有125位，對照組病人同樣為125位。跌倒病人中男性與女性比例約為2：1，平均年齡為63.13 歲（標準差15.10）。跌倒組與對照組兩組之年齡與性別均無顯著差異；住院天數為跌倒組24.48天（標準差22.74），對照組則為10.65天（標準差11.53），具有顯著差異（p<0.001）。兩組在用藥的使用上，只有四個類別有差異：包括鎮靜安眠劑、利尿劑、Alpha-阻斷劑與抗憂鬱劑。依個別藥品分析，皆以服用Lorazepam tab, Glycerin inj.與Tamsulosin tab在統計上有顯著差異。服用Lorazepam tab跌倒組為20人（16.0%），對照組為4人（3.2%）（p<0.001）；使用Glycerin注射劑跌倒組為4人（3.2%），對照組為0人（p=0.045）；服用Tamsulosin tab跌倒組為5人（4.0%），對照組為0人（p=0.024）。
結論：由本研究結果可知，於住院期間發生跌倒之男性高於女性一倍之多，年齡則普遍在60歲以上，顯示性別及年齡與跌倒之間存在有相關性。在藥物的使用方面，跌倒組有較高比例使用Lorazepam tab, Glycerin inj.與Tamsulosin tab。此結果可提醒醫事人員對於臨床上服用可能造成跌倒藥物的高危險病人，需特別注意病人用藥安全，並對病人或家屬給予衛教指導，以達臨床服務之品質提升、住院天數縮短及醫療費用降低等目標。
Background: Patient falls have the highest incident rate in a hospital. Medication is one of the factors that could influence patient falls. The purpose of this research is to study the correlation between medication and patient falls among inpatients.
Method: In this retrospective case-control study, inpatients falls with official records in 2003 were collected as the patient fall group. The control group included inpatients matched for patient fall group in terms of sex, age, and main identification code of diagnosis (ICD). The usage of fall-related medication before patient falls was compared between the patient fall and the control group.
Result: In 2003, there were 125 patient falls reported in official records. Among them, the ratio of male to female is 2:1 and the mean age is 63.13±15.10 years old. The duration of hospital stay in the patient fall group (24.48±22.74 days) was significantly longer than the control group (10.65±11.53 days) (p<0.001). Hypnotics, diuretics, alpha-blockers and antidepressants were prescribed significantly higher in the patient fall group than the control group. The prescriptions of Lorazepam tablet, Glycerin injection, and Tamsulosin tablet were distinctly higher in the patient fall group.
Conclusion: Our research results demonstrate that there are correlations between patient falls and a few factors, i.e. patients’ age, sex, and medications. The results suggest the healthcare providers should pay attention to those patients who take fall-related medications. The findings also encourage providing necessary health education about patient fall to patient or family members. It eventually improves the quality of clinical service, shortens the hospital stay, and lowers the medical cost.
