TY - JOUR
T1 - Preoperative Falls Predict Postoperative Falls, Functional Decline, and Surgical Complications
AU - Kronzer, Vanessa L.
AU - Jerry, Michelle R.
AU - Ben Abdallah, Arbi
AU - Wildes, Troy S.
AU - Stark, Susan L.
AU - McKinnon, Sherry L.
AU - Helsten, Daniel L.
AU - Sharma, Anshuman
AU - Avidan, Michael S.
N1 - Publisher Copyright:
© 2016 The Authors
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background Falls are common and linked to morbidity. Our objectives were to characterize postoperative falls, and determine whether preoperative falls independently predicted postoperative falls (primary outcome), functional dependence, quality of life, complications, and readmission. Methods This prospective cohort study included 7982 unselected patients undergoing elective surgery. Data were collected from the medical record, a baseline survey, and follow-up surveys approximately 30 days and one year after surgery. Results Fall rates (per 100 person-years) peaked at 175 (hospitalization), declined to 140 (30-day survey), and then to 97 (one-year survey). After controlling for confounders, a history of one, two, and ≥ three preoperative falls predicted postoperative falls at 30 days (adjusted odds ratios [aOR] 2.3, 3.6, 5.5) and one year (aOR 2.3, 3.4, 6.9). One, two, and ≥ three falls predicted functional decline at 30 days (aOR 1.2, 2.4, 2.4) and one year (aOR 1.3, 1.5, 3.2), along with in-hospital complications (aOR 1.2, 1.3, 2.0). Fall history predicted adverse outcomes better than commonly-used metrics, but did not predict quality of life deterioration or readmission. Conclusions Falls are common after surgery, and preoperative falls herald postoperative falls and other adverse outcomes. A history of preoperative falls should be routinely ascertained.
AB - Background Falls are common and linked to morbidity. Our objectives were to characterize postoperative falls, and determine whether preoperative falls independently predicted postoperative falls (primary outcome), functional dependence, quality of life, complications, and readmission. Methods This prospective cohort study included 7982 unselected patients undergoing elective surgery. Data were collected from the medical record, a baseline survey, and follow-up surveys approximately 30 days and one year after surgery. Results Fall rates (per 100 person-years) peaked at 175 (hospitalization), declined to 140 (30-day survey), and then to 97 (one-year survey). After controlling for confounders, a history of one, two, and ≥ three preoperative falls predicted postoperative falls at 30 days (adjusted odds ratios [aOR] 2.3, 3.6, 5.5) and one year (aOR 2.3, 3.4, 6.9). One, two, and ≥ three falls predicted functional decline at 30 days (aOR 1.2, 2.4, 2.4) and one year (aOR 1.3, 1.5, 3.2), along with in-hospital complications (aOR 1.2, 1.3, 2.0). Fall history predicted adverse outcomes better than commonly-used metrics, but did not predict quality of life deterioration or readmission. Conclusions Falls are common after surgery, and preoperative falls herald postoperative falls and other adverse outcomes. A history of preoperative falls should be routinely ascertained.
KW - Accidental falls
KW - Elective surgical procedures
KW - Outcome assessment
KW - Patient-reported outcomes
KW - Postoperative period
KW - Preoperative period
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U2 - 10.1016/j.ebiom.2016.08.039
DO - 10.1016/j.ebiom.2016.08.039
M3 - Article
C2 - 27599969
AN - SCOPUS:84992560005
SN - 2352-3964
VL - 12
SP - 302
EP - 308
JO - EBioMedicine
JF - EBioMedicine
ER -