Citation

Gray-Miceli D, Ratcliffe SJ, Thomasson A, Quigley P, Li K, Craelius W. J. Patient Saf. 2016; ePub(ePub): ePub.

Affiliation

From the *Division of Nursing Science and Institute for Health, Health Care Policy and Aging Research, Rutgers University, School of Nursing and John A. Hartford Post-Doctoral Scholar, Newark, New Jersey; †Center for Clinical Epidemiology and Biostatistics, ‡University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania; §VISN 8, Patient Safety Center of Inquiry, Veterans Administration; and ∥Department of Industrial and Systems Engineering, ¶Biomedical Engineering, Rutgers University, Piscataway, New Jersey.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/PTS.0000000000000274

PMID

27768653

Abstract

BACKGROUND: Patients at greatest risk for fall-related injuries are older adults with orthostatic hypotension (OH), a condition which drops blood pressure. This study sought to determine salient demographic and patient-level factors increasing risk for OH among a sample of elderly fallers.

METHODS: Data analysis for this retrospective study sought to assess the relationship between various demographic and clinical risk factors and the likelihood of OH. Because fallers could experience multiple falls, generalized estimating equations were used to account for patient-level correlations.

RESULTS: One hundred seventeen falls occurred in 47 patients, who were primarily female with a mean age of 90.7 years. Falls resulted in 18 cases of OH. Orthostatic hypotension cases were less likely to have a gait in a steady line (5.6% vs 55.6%, P = 0.001). Patients with decreased muscular coordination were almost 5 times more likely to experience OH than those with no coordination problems (odds ratio = 4.86, P = 0.02). Patients with gait in a steady line were less likely to experience OH after a fall (OR = 0.06, P = 0.006).

CONCLUSIONS: Orthostatic hypotension is potentially modifiable once detected. Evidenced-based protocol for assessment and management of OH among patients with gait and balance impairment is presented.

Language: en