• Anesthesiology · Aug 2016

    Observational Study

    Preoperative Falls and Their Association with Functional Dependence and Quality of Life.

    • Vanessa L Kronzer, Rose D Tang, Allison P Schelble, Ben AbdallahArbiA, Troy S Wildes, Sherry L McKinnon, Furqaan Sadiq, Nan Lin, Daniel L Helsten, Anshuman Sharma, Susan L Stark, and Michael S Avidan.
    • From the Department of Anesthesiology (V.L.K., R.D.T., A.P.S., A.B.A., T.S.W., S.L.M., F.S., D.L.H., A.S., M.S.A.) and Program in Occupational Therapy (S.L.S.), Washington University School of Medicine, St. Louis, Missouri; and Department of Mathematics, Washington University, St. Louis, Missouri (N.L.).
    • Anesthesiology. 2016 Aug 1; 125 (2): 322332322-32.

    BackgroundNo study has rigorously explored the characteristics of surgical patients with recent preoperative falls. Our objective was to describe the essential features of preoperative falls and determine whether they are associated with preoperative functional dependence and poor quality of life.MethodsThis was an observational study involving 15,060 surveys from adult patients undergoing elective surgery. The surveys were collected between January 2014 and August 2015, with a response rate of 92%.ResultsIn the 6 months before surgery, 26% (99% CI, 25 to 27%) of patients fell at least once, and 12% (99% CI, 11 to 13%) fell at least twice. The proportion of patients who fell was highest among patients presenting for neurosurgery (41%; 99% CI, 36 to 45%). At least one fall-related injury occurred in 58% (99% CI, 56 to 60%) of those who fell. Falls were common in all age groups, but surprisingly, they did not increase monotonically with age. Middle-aged patients (45 to 64 yr) had the highest proportion of fallers (28%), recurrent fallers (13%), and severe fall-related injuries (27%) compared to younger (18 to 44 yr) and older (65+ yr) patients (P < 0.001 for each). A fall within 6 months was independently associated with preoperative functional dependence (odds ratio, 1.94; 99% CI, 1.68 to 2.24) and poor physical quality of life (odds ratio, 2.18; 99% CI, 1.88 to 2.52).ConclusionsPreoperative falls might be common and are possibly often injurious in the presurgical population, across all ages. A history of falls could enhance the assessment of preoperative functional dependence and quality of life.

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