Fall-related injuries in elderly cancer patients treated with neurotoxic chemotherapy: A retrospective cohort study

Abstract

Background: Fall-related injuries are a well-described cause of morbidity and mortality in the

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

“…19 Miscellaneous Use of diabetes medications was significantly associated with an increased risk of falling (aOR 3.2, 95% Ci 1.3-7.9) 20 The rate of fall-related injuries for patients receiving a doublet of neurotoxic chemotherapy (9.15 per 1,000 personmonths) was significantly higher than for those receiving a single neurotoxic agent (7.76 per 1,000 person-months) or a nonneurotoxic agent (5.19 per 1,000 person-months). 7 Nasal preparations (eg, treatment of asthma or allergic rhinitis) (aOR 1.49, 95% Ci 1.07-2.08) and antiglaucoma ophthalmic preparations (aOR 1.51, 95% Ci 1.10-2.09) were statistically significantly associated with an emergency department visit due to a recurrent fall.…”

“…Besides typical FRIDs such as central nervous system (CNS)-acting agents (benzodiazepines, sedatives, hypnotics, antidepressants, and antipsychotic drugs), in recent years relatively new classes (eg, anti-Alzheimer's agents, neurotoxic chemotherapeutic agents, and nasal preparations) were identified as having significant association with falls. [5][6][7] Meanwhile, results of several sporadic cohort studies showed that the degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic and pharmacodynamic (PK/PD) properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class), and/or characteristics of medication use (eg, number of medications and drug-drug interactions [DDIs], dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). However, an up-to-date review has not been Multivariate analysis of risk factors for falls in 7,908 hospitalized patients showed that benzodiazepines with very short and short half-life were positively associated with falls during hospital stays.…”

“…Results of that case-control study showed strong positive associations at 0 days for all classes of medication (β-blockers, angiotensin-converting enzyme inhibitors, calcium antagonists, thiazides). Surprisingly, only thiazides showed significant ORs of falling during elapsed times of [1][2][3][4][5][6][7][8][9][10][11][12][13][14] 16 A study showed that the current prescribing of angiotensin system-blocking medications, including angiotensin-converting enzyme inhibitors and angiotensinreceptor blockers, had a protective effect against fall risk in older people. 29 This prospective cohort study in 520 community-dwelling older people indicated that people taking angiotensin system-blocking medications were less likely to fall (OR 0.68, 95% CI 0.48-0.97; P,0.05) after adjusting for potential confounders.…”

“…A retrospective cohort analysis using the records of 65,311 patients with breast, colon, lung, or prostate cancer treated with chemotherapy revealed that the rate of fall-related injuries for patients receiving a doublet of neurotoxic chemotherapy (9.15 per 1,000 person-months) was significantly higher than for those receiving a single neurotoxic agent (7.76 per 1,000 person-months) or a nonneurotoxic agent (5.19 per 1,000 person-months). 7 …”

The correlation of specific medication groups and falls risk in elderly. A medication logbook survey

“…This occurs mainly due to their side effects; such as sedation, dizziness, postural disturbances, altered gait and balance, or impaired cognition and these drugs are usually called fall-risk-increasing drugs (FRIDs) 9 . Numerous studies have evaluated the association of medication use with the risk of falling in elderly patients [10][11][12] .…”