A retrospective review of fall risk factors in the bone marrow transplant inpatient service

Abstract

Purpose The purpose of this study was to compare medications and potential risk factors between patients who experienced a fall during hospitalization compared to those who did not fall while admitted to the Blood and Marrow Transplant inpatient setting at The James Cancer Hospital. Secondary objectives included evaluation of transplant-related disease states and medications in the post-transplant setting that may lead to an increased risk of falls, post-fall variables, and number of tests ordered after a fall. Methods This retrospective, case-control study matched patients in a 2:1 ratio of nonfallers to fallers. Data from The Ohio State University Wexner Medical Center (OSUWMC) reported fall events and patient electronic medical records were utilized. A total of 168 adult Blood and Marrow Transplant inpatients with a hematological malignancy diagnosis were evaluated from 1 January 2010 to 30 September 2012. Results Univariable and multivariable conditional logistic regression models were used to assess the relationship between potential predictor variables of interest and falls. Variables that were found to be significant predictors of falls from the univariable models include age group, incontinence, benzodiazepines, corticosteroids, anticonvulsants and antidepressants, and number of days status-post transplant. When considered for a multivariable model age group, corticosteroids, and a cancer diagnosis of leukemia were significant in the final model. Conclusion Recent medication utilization such as benzodiazepines, anticonvulsants, corticosteroids, and antidepressants placed patients at a higher risk of experiencing a fall. Other significant factors identified from a multivariable analysis found were patients older than age 65, patients with recent corticosteroid administration and a cancer diagnosis of leukemia.

Risk factors for falls in hospitalized patients with cancer: A systematic review and meta-analysis

“…Risk factors for demographic characteristics of falls in patients with cancer were analyzed in this study. Four studies 4 , 9 , 17 , 18 were mentioned age as a factor and found that patients who developed falls were significantly older ( MD ​= ​3.74, 95% CI 0.72–6.77; I 2 ​= ​60%; P ​= ​0.02) ( Fig. 2 ).…”

“…1 ). Eventually, five studies 4 , 9 , 16 , 17 , 18 fulfilled the inclusion criteria and were included in the meta-analysis. Four studies 4 , 9 , 16 , 17 were case–control studies and one study 18 was a cohort study.…”

“…Eventually, five studies 4 , 9 , 16 , 17 , 18 fulfilled the inclusion criteria and were included in the meta-analysis. Four studies 4 , 9 , 16 , 17 were case–control studies and one study 18 was a cohort study. A total of 1237 patients with cancer were enrolled in the included trials; of these, 450 patients had a fall ( Table 1 ).…”

“…Three articles 4 , 9 , 16 scored seven stars and one articles 18 scored six stars. Only one article 17 scored five stars. The details of the quality assessment are presented in Appendix S2 .…”

Nurses as Agents of Safety: Identifying unique contributors to falls in hospitalized Adult Hematology Patients: A Retrospective Study

“…This limits the generalizability to the target population of hospitalized adult patients with hematologic malignancy. Finally, the higher risk for falls among this population is a limitation to the generalizability of this study to other oncology patients [9]. Patients with hematologic malignancy undergo multiple chemotherapy treatments leading to a prolonged duration of severe cytopenias.…”