Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others

Glind, Esther M.M. van de; Daams, Joost G.; Ploegmakers, Kimberley J.; Vries, Max de; Wermelink, Anne M.A.T.; Velde, Nathalie van der; Blain, Hubert; Bousquet, Jean; Bucht, Gösta; Caballero-Mora, Maria Angeles; Cammen, Tischa van der; Eklund, Patrik; Emmelot-Vonk, Mariëlle H.; Gustafson, Yngve; Hartikainen, Sirpa; Kenny, Rose Anne; Laflamme, Lucie; Landi, Francesco; Masud, Tahir; O’Byrne-Maguire, Irene; Petrovic, Mirko; Rodriguez, Leocadio; Seppälä, Lotta J.; Svensson, Olle; Szczerbińska, Katarzyna; Thaler, H

doi:10.1016/j.jamda.2017.12.099

Cited by 204 publications

(188 citation statements)

References 134 publications

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“…Additionally, it has been reported that patients with a high CCI score were prescribed more drugs than those with a low CCI score during/prior to their admission to acute care hospitals [9]. Polypharmacy, which is known as a risk factor for falls, might also have an impact on falls during hospitalization [40].…”

Section: Discussionmentioning

confidence: 99%

Malnutrition at Admission Predicts In-Hospital Falls in Hospitalized Older Adults

et al. 2020

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Malnutrition leads to poor prognoses, including a predisposition to falls. Few studies have investigated the relationship between malnutrition and falls during hospitalization. This study aimed to determine malnutrition’s association with falls during hospitalization. A retrospective observational study was conducted. Patients aged ≥65 years that were admitted to and discharged from a university hospital between April 2018 and March 2019 were examined. Patients with independent basic activities of daily living were included. Diagnosis of malnutrition was based on the European Society for Clinical Nutrition and Metabolism (ESPEN) criteria at admission. Disease information such as the Charlson Comorbidity Index (CCI) and reasons for hospitalization were reviewed. Kaplan–Meier curve and multivariate Cox regression analyses were performed. Data from 6081 patients (mean age: 74.4 ± 6.1 years; males: 58.1%) were analyzed. The mean CCI was 2.3 ± 2.8 points. Malnutrition was detected in 668 (11.0%) and falls occurred in 55 (0.9%) patients. Malnourished patients experienced a higher fall rate than those without malnutrition (2.4% vs. 0.7%, log-rank test p < 0.001). In multivariate analysis, malnutrition had the highest hazard ratio for falls among covariates (hazard ratio 2.78, 95% confidence interval 1.51–5.00, p = 0.001). In conclusion, malnutrition at the time of admission to hospital predicts in-hospital falls.

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Section: Discussionmentioning

confidence: 99%

Malnutrition at Admission Predicts In-Hospital Falls in Hospitalized Older Adults

et al. 2020

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“…Improved pain management could possibly be achieved using opioids or peripheral nerve blocks as part of the standard analgesic regime, but adverse effects such as an increased risk of falls upon initiation of opioid use as well as sedation, delirium, nausea, and urinary retention have been reported (Golladay et al 2017, Seppala et al 2018. Also, peripheral nerve blocks have limited additional value alongside LIA (Gudmundsdottir and Franklin 2017).…”

Section: Discussionmentioning

confidence: 99%

Why are patients still in hospital after fast-track, unilateral unicompartmental knee arthroplasty

et al. 2020

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Background and purpose — Previous studies have investigated risk factors related to prolonged length of stay following total knee arthroplasty (TKA), but little is known about specific factors resulting in continued hospitalization within the 1st postoperative days after unicompartmental knee arthroplasty (UKA). We investigated what specific factors prevent patients from being discharged on the day of surgery (DOS) and the first postoperative day (POD-1) following primary UKA in a fast-track setting. Patients and methods — We prospectively collected data on 100 consecutive and unselected medial UKA patients operated from December 2017 to May 2019. All patients were operated in a standardized fast-track setup with functional discharge criteria continuously evaluated from DOS and until discharge. Results — Median length of stay for the entire cohort was 1 day. 22% and 78% of all patients were discharged on DOS and POD-1, respectively. Lack of mobilization and pain separately delayed discharge in respectively 78% and 24% of patients on DOS. The main reasons for lack of mobilization were motor blockade (37%) and logistical factors (26%). For patients placed 1st or 2nd on the operating list, we estimate that the same-day discharge rate would increase to 55% and 40% respectively, assuming that pain and mobilization were successfully managed. Interpretation — One-fifth of unselected UKA patients operated in a standardized fast-track setup were discharged on DOS. Pain and lack of mobilization were the major reasons for continued hospitalization within the initial postoperative 24–48 hours. Strategies aimed at decreasing length of stay after UKA should strive to improve analgesia and postoperative mobilization.

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“…Nevertheless, other types of drugs might also increase the risk of falls (e.g. laxatives, antiepileptics, non-steroidal anti-inflammatory drugs, analgesics, or proton pumps inhibitors) (Seppala et al, 2018b). There is clear evidence that the combination of two or more risk drugs increases the risk of fall (Zia et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia

Malý¹,

Doseděl²,

Vosátka³

et al. 2019

JAB

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This study aimed to analyze the effect of fall risk-increasing drugs (FRIDs) and drug-related factors relative to falls through clinical pharmacy service in hospitalized patients, focusing on the relevance of clinical pharmacist evaluation in the context of physician assessment. A prospective study of inpatient falls was conducted in 2017 retrieving data from 4 hospitals in South Bohemia, Czech Republic. An online database was developed to collect patient and fall-related data, and fall evaluation records. Healthcare professionals classified the overall effect of drugs on falls using Likert scale. Univariate and multivariate correlations were performed with a significance level of p < 0.05. Out of the total 280 falls (mean age of patients 77.0 years), a mean of 2.8 diagnoses with fall-related risk, 8.8 drugs, and 4.1 FRIDs per fall were identified. Incidence of falls decreased quarterly (p < 0.001). Use of FRIDs were positively associated with increasing age (p = 0.007). Clinical pharmacists were more likely to identify pharmacotherapy as the relevant fall-related risk, compared to physicians evaluation (p < 0.001). An increasing total number of prescribed drugs as well as higher number of FRIDs increased the suspicion in both professionals in the context of drug-related causes of falls.

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Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others

Cited by 204 publications

References 134 publications

Malnutrition at Admission Predicts In-Hospital Falls in Hospitalized Older Adults

Malnutrition at Admission Predicts In-Hospital Falls in Hospitalized Older Adults

Why are patients still in hospital after fast-track, unilateral unicompartmental knee arthroplasty

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia

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