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

摘要

? 2017 Elsevier Inc. ? 2017 Elsevier Inc. 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 8.65 g/dl (range, 6.3–12.7), 38 × 10 9 /l (range, 7–454), and 2.85 g/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 65 years (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. 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 8.65 g/dl (range, 6.3–12.7), 38 × 10 9 9 /l (range, 7–454), and 2.85 g/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 65 years (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.