Risk factors and characteristics of falls among hospitalized adult patients with hematologic diseases

• Published in: Journal of geriatric oncology Vol. 8; no. 5; pp. 363 - 367
• Main Authors: Miwa, Yoriko, Yamagishi, Yasuko, Konuma, Takaaki, Sato, Tomoko, Narita, Hatsuko, Kobayashi, Koji, Takahashi, Satoshi, Tojo, Arinobu
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.09.2017
• Subjects: Accidental Falls - statistics & numerical data; Adult; Aged; Aged, 80 and over; Allogeneic hematopoietic cell transplantation; Anemia; Catheterization - statistics & numerical data; Chemotherapy; Fall; Fall-related injury; Female; Hematologic disease; Hematologic Diseases - therapy; Hematopoietic Stem Cell Transplantation - statistics & numerical data; Hemoglobins - metabolism; Humans; Hypnotics and Sedatives - adverse effects; Hypoalbuminemia - etiology; Length of Stay - statistics & numerical data; Male; Middle Aged; Older; Retrospective Studies; Risk Factors; Thrombocytopenia; Time Factors; Wounds and Injuries - etiology; Young Adult; Thrombocytopenia; Chemotherapy; Anemia; Allogeneic hematopoietic cell transplantation; Hematologic disease; Fall; Fall-related injury; Older
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2017.07.003

Falls and fall-related injuries are major problems in hospitals. In hematologic patients, both disease and its treatment, including chemotherapy and allogeneic hematopoietic cell transplantation (allo-HCT), can cause anemia, febrile neutropenia, and bleeding tendency, which may result in falls and fall-related injuries. We retrospectively analyzed 397 consecutive admissions to the hematology unit at our institute which included 201 adult patients with hematologic disease. A total of 56 fall events were observed in 43 patients, and the incidence of falls was 2.49 per 1000 person-days. The median hemoglobin, platelet, and serum albumin levels prior to fall events were 8.65g/dl (range, 6.3–12.7), 38×109/l (range, 7–454), and 2.85g/dl (range, 1.6–4.3), respectively. Despite the presence of thrombocytopenia among the majority of patients who fell, no serious injury was observed. Multiple variable logistic regression analysis demonstrated that age older than 65years (hazard ratio [HR], 2.86; 95% confidence interval [CI], 1.17–6.99, P=0.02), admission for allo-HCT (HR, 9.48; 95% CI, 3.35–26.80, P<0.001), hypnotic medication (HR, 3.57; 95% CI, 1.56–8.20, P=0.002), urinary or intravenous catheter placement (HR, 2.34; 95% CI, 1.08–5.09, P=0.03), and hypoalbuminemia (HR, 2.30; 95% CI, 1.07–4.96, P=0.03) were significantly associated with increased fall risk. These findings indicated that special attention should be paid to patients with such risk factors during their treatment.