Falls in hemodialysis patients: Prospective study of incidence, risk factors, and complications

Desmet, Charlotte; Beguin, Claire; Swine, Christian; Jadoul, Michel

doi:10.1053/j.ajkd.2004.09.027

Cited by 153 publications

(163 citation statements)

References 23 publications

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“…Cook and colleagues (33) studied dialysis patients older than age 65 and demonstrated that 47% of patients fell during a 1-year period and 19% sustained injuries. In a separate prospective study, Desmet and colleagues (34) reported that during 12 months, 12 of 380 dialysis patients (mean age, 70.9 years) experienced a fall with fracture, and the overall fall rate was 1.18 falls/patientyear. This rate is many times higher than that in the nondialysis elderly population (0.32-0.7 falls/patient-year).…”

Section: Patient Fallsmentioning

confidence: 99%

“…Earlier studies have demonstrated an increased risk for falls in dialysis patients (4,18,28,(32)(33)(34)(35)(36)(37). Age, diabetes, motor strength, medication use (including antidepressants), a failed walking test, previous fall episodes, and visual impairment are all risk factors for falls (33)(34)(35)(36)(37)(38)(39). Fall prevention is important because the incidence of hip fracture with fall and the 1-year mortality rate related to a hip fracture are increased in the dialysis population (36).…”

Section: Patient Fallsmentioning

confidence: 99%

“…About 40% of the time the professional respondents stated they did not know the cause of the fall. Several strategies may help to reduce the risk for falls (34)(35)(36)(37)(38)(39), including monitoring orthostatic BP, staff education, use of evidence-based tools for fall assessment (such as assessment of gait and vision), gait assistance for high-risk patients, controlling clutter, and use of in-floor patient weight scales.…”

Section: Patient Fallsmentioning

confidence: 99%

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Patient and Facility Safety in Hemodialysis

Garrick

Kliger

Stefanchik

2012

Clinical Journal of the American Society of Nephrology

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SummaryPatient safety is the foundation of high-quality health care. More than 350,000 patients receive dialysis in the United States, and the safety of their care is ultimately the responsibility of the facility medical director. The medical director must establish a culture of safety in the dialysis unit and lead the quality assessment and performance improvement process. Several lines of investigation, including surveys of patients and dialysis professionals, have helped to identify important areas of safety risk in dialysis facilities. Among these are lapses in communication, medication errors, patient falls, errors in machine and membrane preparation, failure to follow established policies, and lapses in infection control. The quality assessment and performance improvement process should include a dedicated safety team to focus on specifically identified areas of risk and to establish outcome goals guided by best practices and agreed-upon measures of success. A safety questionnaire can be given to patients and staff and the responses evaluated to improve understanding of the prevailing attitudes and concerns about safety. By sharing these results, openly acknowledging the challenges, and using a blame-free root cause process to identify action plans, the facility can begin to establish a culture of safety.

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Section: Patient Fallsmentioning

confidence: 99%

Section: Patient Fallsmentioning

confidence: 99%

Section: Patient Fallsmentioning

confidence: 99%

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Patient and Facility Safety in Hemodialysis

Garrick

Kliger

Stefanchik

2012

Clinical Journal of the American Society of Nephrology

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“…in age-matched populations (15)(16)(17) and have an overall lower level of independent functioning (18 -20) and increased burden of cognitive impairment (21)(22)(23). Fall incidence rates have been estimated between 1.2 to 1.6 falls per person-year for dialysis patients whoa re older than 65 yr (16,23).…”

Section: Frailtymentioning

confidence: 99%

Dialysis in Late Life

Jassal¹,

Watson²

2009

Clinical Journal of the American Society of Nephrology

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As a result of the changing dialysis demographics, nephrologists are increasingly faced with problems traditionally considered to be geriatric issues. The specialty of nephrology has often been seen as using intensive, expensive, and complex technologies for patient care. Dialysis programs have evolved into highly efficient, fast-paced units that accommodate a rapid turnover of patients. They are in direct contrast to geriatric programs, which use geriatric principles to offer simple, multidimensional, holistic care to frail older patients. Finding the balance between nephrology and geriatric skill sets is a particular challenge for up-and-coming nephrologists who have an interest in geriatric nephrology. This mini-review addresses some of the challenges, increases awareness of specific issues, and highlights new opportunities in this field.

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“…Studies have shown that the incidence of falls in HD patients is about 1.2-1.6 per patient-year, or 0.2-0.37 per patient-year for patients with severe conditions requiring emergency care (20)(21)(22). A recent prospective cohort study showed that the incidence of falls may increase to 1.7 per patient-year for older PD patients (23).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD

Wang

Cheng

Lin

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives This study compared the risk of subdural hematoma (SDH) and subsequent mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients with ESRD.Design, setting, participants, & measurements Claims data were obtained from the National Health Insurance Administration Research Database in Taiwan. This retrospective cohort study comprised 10,136 PD patients and 10,136 HD patients with newly diagnosed ESRD from 1998 to 2010. Patients were matched by propensity score and year of dialysis initiation. Incidence rates and hazard ratios of SDH as well as odds ratios of subsequent 30-day deaths from SDH were evaluated from the date of the first dialysis session to the date when SDH was diagnosed, or the date of renal transplantation, death, withdraw from insurance, or the end of the follow-up period (December 31, 2011).Results Median (25th percentile, 75th percentile) follow-up times for SDH events were 3.61 years (1.91, 6.33) and 3.33 years (1.83, 5.66) in the HD and PD cohorts, respectively. The overall SDH incidence rate (95% confidence interval [95% CI]) was 61.4% higher in the HD cohort than in the PD cohort (34. Conclusions HD patients have a higher risk of developing SDH than PD patients. Both patient groups have a high risk of mortality. Routine education on fall prevention is needed for dialysis patients.

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Falls in hemodialysis patients: Prospective study of incidence, risk factors, and complications

Cited by 153 publications

References 23 publications

Patient and Facility Safety in Hemodialysis

Patient and Facility Safety in Hemodialysis

Dialysis in Late Life

Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD

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