The frequency of falls in patients with advanced cancer followed in an outpatient palliative care center.

Authors

null

Maxine De la Cruz

The University of Texas MD Anderson Cancer Center, Houston, TX

Maxine De la Cruz, Neha Didwaniya, Kimberson Tanco, SeongHoon Shin, Akhila Sunkepally Reddy, Maria Teresa San Miguel Arregui, Herlinda Moreno, Eduardo Bruera, Gary B. Chisholm, Janet L. Williams

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX, 1515 Holcombe Blvd. Unit 1414, Houston, TX, Biostatistics Department, The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

No funding sources reported

Background: Falls are a concern in patients who are frail, have advance age or severe underlying medical condition as a significant cause of morbidity and reduced quality of life. It has been reported to occur in up to 50% of palliative care patients in different settings. Our aim was to determine the frequency of falls and identify its predictors and correlates in patients with advanced cancer. Methods: We reviewed 1,984 consecutive patients with advanced cancer seen in the outpatient supportive care center and determined the frequency of patient reported falls within the last month prior to the visit. Baseline patient characteristics, symptom severity scores in the Edmonton Symptom Assessment Scale (ESAS), medication use, functional status, and use of assistive devices were used to identify factors that are predictive of falls using backwards stepwise logistic regression. Results: 1,041 (52%) were female, 1,377 (69%) were non-Hispanic-white, 343 (17%) had peripheral neuropathy, 237 (12%) were on psychotropic medications, and 1,140 (58%) were on opioids. There were 211 (11%) patient reported falls. Presence of brain metastasis, use of assistive device, ECOG, ESAS depression, and weight prior to visit were significantly associated with patient reported falls in the multivariate model. Conclusions: One tenth of patients seen in the outpatient supportive care clinic reported falls. Our findings showing that falls to be associated with brain metastasis, assistive device, functional status, ESAS depression and weight are useful in stratifying high risk patients. They also show that certain medications deemed as risk factors in other populations were not associated with falls.

Multivariable logistic regression analysis of predictors of falls in advanced cancer patients.
Odds ratio estimates (c=0.72)
Effect OR 95% Wald
confidence limits
P value
Age (per year) 1.003 0.991 1.015 0.6274
Brain mets (Y vs N) 2.394 1.442 3.973 0.0007
Assistive device 2.695 1.872 3.881 <.0001
Wt prior to visit (per kg) 1.008 1.001 1.016 0.0352
ECOG 1.469 1.145 1.885 0.0025
Depression (per ESAS point) 1.075 1.018 1.135 0.0092

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Abstract Details

Meeting

2013 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

General Poster Session B: Practice of Quality and Health Reform

Track

Practice of Quality,Health Reform: Implications for Costs and Quality

Sub Track

Patient Safety

Citation

J Clin Oncol 31, 2013 (suppl 31; abstr 225)

Abstract #

225

Poster Bd #

E7

Abstract Disclosures

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