Guerard Emily J, Deal Allison M, Williams Grant R, Jolly Trevor A, Nyrop Kirsten A, Muss Hyman B
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC.
J Oncol Pract. 2015 Nov;11(6):470-4. doi: 10.1200/JOP.2014.003517. Epub 2015 Jul 14.
Falls in older adults are common. Screening for falls is quick, simple, and important because falls increase the risk of morbidity and mortality in older patients with cancer. The aim of this study was to evaluate oncology providers' recognition of and response to falls in older patients with cancer.
From a sample of older patients with cancer who completed a geriatric assessment blinded to oncology providers, we identified patients who self-reported falls within the past 6 months. Their history and physical and/or clinic notes completed by an oncology provider were reviewed for the following: documentation of falls, gait assessment, referral to geriatrics or physical and/or occupational therapy, and measurement of 25-hydroxy vitamin D level.
In our sample of older patients with cancer who reported at least one recent fall (N = 125), the average age was 72 years (range, 65 to 93 years), 78% were female, and 62% had a breast cancer diagnosis. Chart reviews showed that 13 (10%) had falls documented, 25 (20%) had a gait assessment, eight (6%) were referred, and 21 (17%) had vitamin D level measured.
We found that only 10% of older patients with cancer who self-reported a recent fall had appropriate medical record documentation. Oncologists are often the primary care providers for older patients and are largely unfamiliar with the frequency and impact of falls in this population. There is a need to increase awareness of falls prevalence and consequences among oncology providers in order to provide timely interventions to reduce the risks associated with falls.
老年人跌倒很常见。跌倒筛查快速、简单且重要,因为跌倒会增加老年癌症患者发病和死亡的风险。本研究的目的是评估肿瘤学医护人员对老年癌症患者跌倒的认知及应对情况。
从完成了对肿瘤学医护人员保密的老年综合评估的老年癌症患者样本中,我们确定了在过去6个月内自我报告有跌倒经历的患者。审查了肿瘤学医护人员填写的他们的病史、体格检查和/或临床记录,以查看以下内容:跌倒记录、步态评估、转介至老年医学科或物理和/或职业治疗科,以及25-羟维生素D水平的测量。
在我们报告至少有一次近期跌倒的老年癌症患者样本(N = 125)中,平均年龄为72岁(范围为65至93岁),78%为女性,62%被诊断患有乳腺癌。病历审查显示,13例(10%)有跌倒记录,25例(20%)进行了步态评估,8例(6%)被转介,21例(17%)测量了维生素D水平。
我们发现,自我报告近期有跌倒经历的老年癌症患者中,只有10%有适当的病历记录。肿瘤学家通常是老年患者的初级保健提供者,并且在很大程度上不熟悉该人群跌倒的频率和影响。有必要提高肿瘤学医护人员对跌倒患病率和后果的认识,以便提供及时的干预措施,降低与跌倒相关的风险。