Prospective investigation of the incidence of falls, dizziness and syncope in haemodialysis patients

Roberts, Russell; Jeffrey, Corinne; Carlisle, Gary; Brierley, Elizabeth J.

doi:10.1007/s11255-006-9088-3

Cited by 34 publications

(32 citation statements)

References 17 publications

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“…Earlier studies have demonstrated an increased risk for falls in dialysis patients (4,18,28,(32)(33)(34)(35)(36)(37). Age, diabetes, motor strength, medication use (including antidepressants), a failed walking test, previous fall episodes, and visual impairment are all risk factors for falls (33)(34)(35)(36)(37)(38)(39). Fall prevention is important because the incidence of hip fracture with fall and the 1-year mortality rate related to a hip fracture are increased in the dialysis population (36).…”

Section: Patient Fallsmentioning

confidence: 99%

“…Age, diabetes, motor strength, medication use (including antidepressants), a failed walking test, previous fall episodes, and visual impairment are all risk factors for falls (33)(34)(35)(36)(37)(38)(39). Fall prevention is important because the incidence of hip fracture with fall and the 1-year mortality rate related to a hip fracture are increased in the dialysis population (36). Cook and colleagues (33) studied dialysis patients older than age 65 and demonstrated that 47% of patients fell during a 1-year period and 19% sustained injuries.…”

Section: Patient Fallsmentioning

confidence: 99%

“…About 40% of the time the professional respondents stated they did not know the cause of the fall. Several strategies may help to reduce the risk for falls (34)(35)(36)(37)(38)(39), including monitoring orthostatic BP, staff education, use of evidence-based tools for fall assessment (such as assessment of gait and vision), gait assistance for high-risk patients, controlling clutter, and use of in-floor patient weight scales.…”

Section: Patient Fallsmentioning

confidence: 99%

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Patient and Facility Safety in Hemodialysis

Garrick

Kliger

Stefanchik

2012

Clinical Journal of the American Society of Nephrology

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SummaryPatient safety is the foundation of high-quality health care. More than 350,000 patients receive dialysis in the United States, and the safety of their care is ultimately the responsibility of the facility medical director. The medical director must establish a culture of safety in the dialysis unit and lead the quality assessment and performance improvement process. Several lines of investigation, including surveys of patients and dialysis professionals, have helped to identify important areas of safety risk in dialysis facilities. Among these are lapses in communication, medication errors, patient falls, errors in machine and membrane preparation, failure to follow established policies, and lapses in infection control. The quality assessment and performance improvement process should include a dedicated safety team to focus on specifically identified areas of risk and to establish outcome goals guided by best practices and agreed-upon measures of success. A safety questionnaire can be given to patients and staff and the responses evaluated to improve understanding of the prevailing attitudes and concerns about safety. By sharing these results, openly acknowledging the challenges, and using a blame-free root cause process to identify action plans, the facility can begin to establish a culture of safety.

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Section: Patient Fallsmentioning

confidence: 99%

Section: Patient Fallsmentioning

confidence: 99%

Section: Patient Fallsmentioning

confidence: 99%

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Patient and Facility Safety in Hemodialysis

Garrick

Kliger

Stefanchik

2012

Clinical Journal of the American Society of Nephrology

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“…Falls are an important risk factor for fractures, future falls, and death in geriatric populations. Frequency of syncope, presyncope, or dizziness did not differ between hemodialysis (HD) patients age 65 years or older, but those older than age 65 were more likely to fall (38% versus 4%) (7). There was a greater pre-to postdialysis decrease in standing systolic BP in older than younger patients that did not vary between older patients who fell and those who did not, suggesting that orthostatic hypotension cannot fully explain falls.…”

Section: Fallsmentioning

confidence: 97%

Renal Replacement Therapy in the Elderly Population

Berger¹,

Hedayati

2012

Clinical Journal of the American Society of Nephrology

100

101

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Summary ESRD has become an important problem for elderly patients. The segment of the ESRD population age 65 years or older has grown considerably, and this growth is expected to accelerate in coming years. Nephrologists caring for the elderly with advanced kidney disease will encounter patients with comorbid conditions common in younger patients, as well as physical, psychological, and social challenges that occur with increased frequency in the aging population. These challenging factors must be addressed to help inform decisions regarding the option to initiate dialysis, the choice of dialysis modality, whether to pursue kidney transplantation, and end-of-life care. This article will highlight some common problems encountered by elderly patients with ESRD and review data on the clinical outcomes of elderly patients treated with different modalities of dialysis, outcomes of kidney transplantation in the elderly, and nondialytic management of CKD stage 5.

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“…However dialysis patients have not been studied about falls in depth. Few studies have investigated the incidence rate and fall risk factors in elderly HD patients (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Fall Incidence and Risk Factors in Hemodialysis Patients

Yekta¹,

Fatollahierad²,

Hassabi³

et al. 2016

Turk Neph Dial Transpl

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OBJECTIVE:The aims of this study were to assess the incidence, risk factors and complications of falls in the hemodialysis (HD) population. MATERIAL and METHODS:Using a prospective study design, chronic HD patients aged ≥50 years were recruited. The baseline characteristics and laboratory markers of all study participants were recorded. Participants were followed prospectively for 12 weeks. Patients were questioned thrice weekly about fall incidents. RESULTS:A total of 34 patients (mean age 69.1 year) participated in this study. A total of 16 falls occurred in nine (26%) patients over 12 weeks of follow-up with an incidence rate of 1.30 falls/patientyear. By applying univariate logistic regression analysis, previous fall history (odds ratio 10.5, P-value= 0.008), high parathyroid hormone level (odds ratio 1.032, P-value= 0.016) and impaired balance (odds ratio 9.00, P-value= 0.01) were identified as significant risk factors for falls. CONCLUSION:We concluded that high parathyroid hormone levels might be an important predictor of falling in HD patients in addition to impaired balance and previous fall history. As such, parathyroid hormone is a crucial factor to target for future intervention strategies aimed at reducing the fall incidence in the HD population. GEREÇ ve yÖNTEMLER:İleriye yönelik olarak ≥50 yaşta kronik hemodiyaliz hastaları çalışmaya alındı. Temel özellikler ve laboratuvar sonuçları tüm katılımcılarda kaydedildi. Katılımcılar 12 hafta boyunca takip edildi ve düşmeyle ilgili olarak haftada üç kez sorgulandı.BULGULAR: Çalışmaya toplam 34 hasta (ortalama yaş: 69,1) katıldı. Genel olarak,12 haftalık takip boyunca 1,30 düşüş/hasta-yıl oranıyla 9 hastada (26%) 16 düşüş gerçekleşti.Tek değişkenli regresyon analizi kullanılarak, önceki düşme (risk oranı 10,5, P değeri= 0,008), yüksek paratiroid hormonu düzeyi (risk oranı 1,032, P değeri= 0,016) ve denge sorunu (risk oranı 9,00, P değeri= 0,01) düşme için en temel riskler olarak saptandı. SONUÇ:Hemodiyaliz hastalarında yüksek paratiroid hormonu düzeyleri denge sorunu ve önceki düşmenin yanında düşmenin öngörülmesinde en önemli faktörlerden biri olabilir. Bu nedenle paratiroid hormonu, hemodiyaliz hastalarında düşmelerin azalması yönünde gelecekteki müdahale stratejilerinde hedef alınabilecek temel bir faktördür.

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Prospective investigation of the incidence of falls, dizziness and syncope in haemodialysis patients

Cited by 34 publications

References 17 publications

Patient and Facility Safety in Hemodialysis

Patient and Facility Safety in Hemodialysis

Renal Replacement Therapy in the Elderly Population

Fall Incidence and Risk Factors in Hemodialysis Patients

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