CASE SERIES: FALL FREQUENCY & RISK FACTORS IN INTERVENTIONAL CATHERIZATION PATIENTS

https://youtu.be/699bJgDoLIc INTRODUCTION: Autonomic nervous system dysregulation is a major feature of coronary artery disease, and falls are attributable to related autonomic dysfunction. However, the prevalence of falls among adults with cardiovascular disease (CVD) has not been quantified, and research highlights the need to determine fall frequency and associated risk factors. METHODS: This retrospective case series identified adults who underwent interventional catherization in 2018 at a single hospital (N = 1285). Unique IDs were assigned to cases via a computer-generated random sequence. Fifty cases were selected for chart review and analysis using a case series study design. Investigators sought to determine if there are significant associations between contributing fall risk factors and frequency of fall-related emergency department visits; and test the hypotheses that the frequency of falls in interventional heart catheterization patients mostly associates with gait and balance risk factors. Pearson correlations and multiple linear regression were used to evaluate associations between fall frequency and risk factors. RESULTS: Fifty participants (mean age 67.2 ± 11.3; 29 males) had the following risk factors: gait/balance impairments, cardiovascular contributors, and comorbidities. Among patients, 25 had motor conditions, 24 kidney disease, 19 sensory impairments, 15 lung disease, and 11 neurological conditions. 43 patients had an emergency department visit between January 1, 2013 and December 31, 2021. 24% of patients had a fall after their invasive procedure; and 10% before their invasive procedure. Among participants with gait and balance risk factors, there were more patients with motor conditions (M = .50, SD = .51) than those with sensory impairment (M = .46, SD = .71). There were more patients (M = .28, SD = .45) with nonarrhythmic contributing fall risk factors than those (M = .24, SD = .43) with arrhythmic contributing fall risk factors. Pearson correlation showed a positive relationship (r = .28) between sensory impairment and arrhythmic contributing fall risk factors. Multiple linear regression assessed whether patient factors, comorbidities, and gait, balance, and cardiovascular fall-risk factors predicted fall-related emergency department visits in interventional catherization patients. The baseline number of ER visits is 0.799 when all predictors are zero. Arrhythmic risk factors showing the strongest effect (B = 2.069, β = 0.429). 43% of the fall variance is explained by patient variables; comorbidities; gait and balance fall risk factors; and cardiovascular fall risk factors. The results of ANOVA were significant, F (10, 39) = 3.06, p = .006. With the exclusion of patient variables (gender and age), the results of ANOVA were more significant, F (9, 40) = 3.30, p = .004. CONCLUSION: Adults with CVD, especially interventional catherization patients, have multidomain impairments and multimorbidity that collectively heighten their fall risk.