Orthostatic Hypotension and Falls in Hospitalized Older Adults

Schell, Kathleen; Lyons, Denise; Bodt, Barry A.

doi:10.1177/1054773820986682

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…Considering patients over 65 years old at hospital admission, 39.2% have orthostatic hypotension [17]. In our study, we found 49% occurrence of orthostatic hypotension, and when we consider only those with diabetes, the prevalence rises to 68%.…”

Section: Discussionsupporting

confidence: 45%

Orthostatic hypotension, falls and in-hospital mortality among elderly patients with and without type 2 diabetes

Beretta

Milan

Hoffmeister

et al. 2022

Journal of Hypertension

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Objectives: To evaluate the association of falls and inhospital mortality with the presence of orthostatic hypotension and type 2 diabetes mellitus (T2D). The study also aims to identify whether the orthostatic hypotension assessed at 1 min or at 3 min can predict falls and mortality, as a secondary objective to identify the predictors of fall during hospitalization. Methods:We performed a prospective study with patients admitted to a university hospital. The risk of falls was assessed using the Morse questionnaire and the presence of falls was verified by the patient's medical records during hospitalization. The orthostatic hypotension was determined by measuring blood pressure at three times, considering as orthostatic hypotension the reduction of at least 20 mmHg in SBP or 10 mmHg in DBP. In-hospital mortality was consulted in the medical records.Results: Patients with orthostatic hypotension were slower on Timed Up and Go test (TUG) (12.26 AE 3.16 vs. 16.08 AE 5.96 s, P ¼ 20 s) and presence of orthostatic hypotension. After adjustments, patients with T2D and orthostatic hypotension had a 2.7 times greater risk of in-hospital falls and 1.54 times greater odds of in-hospital mortality when compared with patients without T2D and orthostatic hypotension. Conclusion:In this sample, sedentary patients and those with lower TUG had a higher risk of falls. The prevalence of falls was higher in patients with T2D. The association of T2D with orthostatic hypotension significantly increased both the risk of falls and the risk of in-hospital mortality

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Section: Discussionsupporting

confidence: 45%

Orthostatic hypotension, falls and in-hospital mortality among elderly patients with and without type 2 diabetes

Beretta

Milan

Hoffmeister

et al. 2022

Journal of Hypertension

View full text Add to dashboard Cite

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“…In a retrospective study of older adults in two Acute Care of the Elderly units in a large healthcare system between 2015 and 2018 (n = 7,745), 39.2% had OH on the first reading. 12 The time needed for bedside staff to perform this assessment; the variation in measuring OVS with regards to the time of day, device, and position; the need for more than one set of measurements; and the realization that OH is often not reproducible challenges the value of requiring OVS in all inpatients.…”

Section: Nursing Research Commentary Evidence-based Practice or Researchmentioning

confidence: 99%

“…They recommended that orthostatic BPs be assessed in all patients because OH is often missed. In a retrospective study of older adults in two Acute Care of the Elderly units in a large healthcare system between 2015 and 2018 (n = 7,745), 39.2% had OH on the first reading 12…”

Section: Introductionmentioning

confidence: 99%

Staff knowledge of orthostatic vital signs measurement

Schell

Lyons

2022

Nursing

Self Cite

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Orthostatic hypotension (OH) is one cause of falls in the older adult population. [1][2][3][4][5] Falls during hospitalization is an important clinical problem with potential longterm adverse outcomes, especially for older adults. Consequences of falls include loss of independence, diminished quality of life, decreased socialization, increased risk of long-term-care facility placement, and increased caregiver burden. 6 An inpatient fall is considered a hospital-acquired condition, not reimbursable by Medicare and other payers. OVS assessment is a key clinical management guideline for individuals at risk for falls. The time necessary to measure orthostatic BP and the risk of inaccuracy warrant consideration of the practicality and usefulness of this assessment. Research shows that staff knowledge of OVS influences measurement accuracy.

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Exploring Gender Differences in Falls and Mobility Patterns Among Older Adults in Lebanon

Khatib,

Malham,

Sacre

et al. 2024

Preprint

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Introduction: Falls represent a significant public health concern affecting the elderly, yet epidemiological studies within Lebanese institutions are scarce. This study aimed to explore gender differences in falls and mobility patterns and assess causes, potential risks, and protective factors against falls among institutionalized elderly in the Chouf district, Lebanon. Methods This cross-sectional pilot study involved an elderly healthcare institution. Data were collected using an anonymous, custom-designed questionnaire and patient medical records. Fall risk was evaluated with the Tinetti Balance and Gait Assessment, the Timed Up and Go Test, the Morse Fall Assessment, and other tools. Relative risks were estimated using odds ratios (OR), and logistic regression was stratified by gender to control confounders and assess the associations between fall episodes and potential risk and protective factors. Results This study included 300 institutionalized elderly aged 65 years and older, with 57.7% females. The mean age was 79.27 ± 7.61. Among the participants, 197 (65.7%) reported at least one fall in the past twelve months, with a higher prevalence among women compared to men (69.9% vs. 59.8%). Elderly women exhibited higher levels of depression and consumed more sleeping pills and mood-enhancing medications, which were positively associated with increased falls (p = 0.003). Among elderly men, unsteady walking was positively associated with the history of falls (p = 0.004). Conclusion This study found a higher incidence of falls among institutionalized women, possibly associated with the intake of sleeping pills and mood stabilizers. These findings have positive implications for future research in Lebanon and neighboring countries, with the potential to inform preventive measures to reduce falls among the elderly.

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Orthostatic Hypotension and Falls in Hospitalized Older Adults

Cited by 3 publications

References 36 publications

Orthostatic hypotension, falls and in-hospital mortality among elderly patients with and without type 2 diabetes

Orthostatic hypotension, falls and in-hospital mortality among elderly patients with and without type 2 diabetes

Staff knowledge of orthostatic vital signs measurement

Exploring Gender Differences in Falls and Mobility Patterns Among Older Adults in Lebanon

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