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J Geriatr Oncol. 2017 Sep;8(5):363-367. doi: 10.1016/j.jgo.2017.07.003. Epub 2017 Jul 22.

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

Author information

1
Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
2
Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan. Electronic address: tkonuma@ims.u-tokyo.ac.jp.
3
Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.

Abstract

OBJECTIVES:

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.

MATERIALS AND METHODS:

We retrospectively analyzed 397 consecutive admissions to the hematology unit at our institute which included 201 adult patients with hematologic disease.

RESULTS AND CONCLUSIONS:

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.

KEYWORDS:

Allogeneic hematopoietic cell transplantation; Anemia; Chemotherapy; Fall; Fall-related injury; Hematologic disease; Older; Thrombocytopenia

PMID:
28743506
DOI:
10.1016/j.jgo.2017.07.003
[Indexed for MEDLINE]

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