Abstract 15665: Fall Risk and Outcomes in Cardiovascular Disease - A Community Study
Background: As the population with cardiovascular disease (CVD) ages, fall risk is an increasing clinical concern. Whether fall risk is associated with outcomes is not well determined.
Methods: Olmsted County, MN residents with incident (first-ever) CVD events (heart failure (HF), myocardial infarction (MI) or atrial fibrillation (AF)) from 8/2005-12/2011 who were hospitalized on or after the event date with a complete Hendrich II Fall Risk Model score were identified. The assessment is administered in-hospital and components include gender, mental status, incontinence, medications and a functional mobility assessment. A score of 0-1, 2-4 and 5+ was considered low, moderate and high fall risk, respectively. Andersen-Gill models and Cox regression were used to determine associations of the score with hospitalizations and death, respectively.
Results: 2887 incident CVD patients (1415 AF, 684 HF, 788 MI; mean (SD) age 71 (15); 54% male) met inclusion criteria. Approximately 23% of patients had a high fall risk score and 38% an intermediate score. Over a mean follow-up of 4.5 years, 7898 hospitalizations and 1260 deaths occurred. Increasing fall risk score was associated with an increased risk of hospitalization and death (Figure). After adjustment for age, comorbidities and time from CVD event to fall risk score, an intermediate score was associated with a 22% increased risk of hospitalization (HR: 1.22; 95% CI: 1.10-1.35) and a 33% increased risk of death (HR: 1.33; 95% CI: 1.15-1.54) compared to a low score. A high fall risk score was associated with a 44% increased risk of hospitalization (HR: 1.44; 95% CI: 1.25-1.66) and a 2.8 fold increased risk of death (HR: 2.77; 95% CI: 2.35-3.27) compared to a low score.
Conclusion: Approximately 23% of incident hospitalized CVD patients have a high risk for falls. An intermediate or high fall risk score was associated with an increased risk of hospitalization and death, underscoring the need for strategies to decrease fall risk.
Author Disclosures: S.M. Manemann: None. A.M. Chamberlain: None. C. Boyd: None. S.A. Weston: None. R. Jiang: None. V.L. Roger: None.
- © 2016 by American Heart Association, Inc.