Vela Cory M, Grate Lisa M, McBride Ali, Devine Steven, Andritsos Leslie A
1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
2 University of Cincinnati Medical Center, Cincinnati, OH, USA.
J Oncol Pharm Pract. 2018 Jun;24(4):272-280. doi: 10.1177/1078155217697485. Epub 2017 Mar 16.
Purpose The purpose of this study was to compare medications and potential risk factors between patients who experienced a fall during hospitalization compared to those who did not fall while admitted to the Blood and Marrow Transplant inpatient setting at The James Cancer Hospital. Secondary objectives included evaluation of transplant-related disease states and medications in the post-transplant setting that may lead to an increased risk of falls, post-fall variables, and number of tests ordered after a fall. Methods This retrospective, case-control study matched patients in a 2:1 ratio of nonfallers to fallers. Data from The Ohio State University Wexner Medical Center (OSUWMC) reported fall events and patient electronic medical records were utilized. A total of 168 adult Blood and Marrow Transplant inpatients with a hematological malignancy diagnosis were evaluated from 1 January 2010 to 30 September 2012. Results Univariable and multivariable conditional logistic regression models were used to assess the relationship between potential predictor variables of interest and falls. Variables that were found to be significant predictors of falls from the univariable models include age group, incontinence, benzodiazepines, corticosteroids, anticonvulsants and antidepressants, and number of days status-post transplant. When considered for a multivariable model age group, corticosteroids, and a cancer diagnosis of leukemia were significant in the final model. Conclusion Recent medication utilization such as benzodiazepines, anticonvulsants, corticosteroids, and antidepressants placed patients at a higher risk of experiencing a fall. Other significant factors identified from a multivariable analysis found were patients older than age 65, patients with recent corticosteroid administration and a cancer diagnosis of leukemia.
目的 本研究的目的是比较在詹姆斯癌症医院血液和骨髓移植住院部住院期间发生跌倒的患者与未发生跌倒的患者之间的药物使用情况和潜在风险因素。次要目标包括评估移植后可能导致跌倒风险增加的与移植相关的疾病状态和药物、跌倒后变量以及跌倒后所做检查的数量。方法 这项回顾性病例对照研究以2:1的比例将未跌倒者与跌倒者进行匹配。利用俄亥俄州立大学韦克斯纳医学中心（OSUWMC）报告的跌倒事件和患者电子病历数据。对2010年1月1日至2012年9月30日期间共168例诊断为血液系统恶性肿瘤的成人血液和骨髓移植住院患者进行了评估。结果 采用单变量和多变量条件逻辑回归模型来评估感兴趣的潜在预测变量与跌倒之间的关系。单变量模型中发现的跌倒显著预测变量包括年龄组、失禁、苯二氮䓬类药物、皮质类固醇、抗惊厥药和抗抑郁药以及移植后状态天数。在多变量模型中考虑时，年龄组、皮质类固醇和白血病癌症诊断在最终模型中具有显著性。结论 近期使用苯二氮䓬类药物、抗惊厥药、皮质类固醇和抗抑郁药等药物会使患者跌倒风险更高。多变量分析确定的其他显著因素是年龄大于65岁的患者、近期使用皮质类固醇的患者以及白血病癌症诊断患者。
