Fall Predictors in Hospitalized Patients Living with Cancer: A Case-Control Study

Abstract

Purpose to identify fall predictors and develop an assessment tool to be used for screening hospitalized cancer patients at risk for fall. Methods a retrospective case-control study was conducted in 2018 at a cancer center in Northern Italy. The study participants were 448 adult cancer patients admitted to the oncology ward from 2009 to 2013. The cases group consisted of 112 patients presenting at least one fall, while controls were randomly chosen by matching each case for age, sex and admission period with three patients who did not fall. Data for the fall predictors were extracted from the electronic medical records. Conditional logistic regression was used to evaluate the association between patient’s characteristics and fall risk. Results the overall prevalence of patients having at least one candidate fall predictor was high (98%). Seven of the studied variables showed an independent association with fall risk at multivariate analysis. These were tumor site, the presence of neurologic diseases, gait imbalance disorders, fatigue and the assumption of certain medications such as diuretics, hypnotics and opioids (odds ratios and 95% confidence intervals in brackets were 3.78 (1.78-8.13), 2.26 (1.08-4.77), 4.22 (1.87-9.52), 2.76 (1.45-5.26), 2.66 (1.52-4.66), 2.41 (1.20-4.85), and 3.03 (1.68-5.45), respectively). Conclusions results of our study highlight the need for developing risk assessment tools based on the characteristics of cancer centres. The validation with a prospective independent cohort is necessary before implementing our screening tool in clinical practice.