Falls are one of the best safety indicators in hospitalized cancer patients. In 2013, a security group was created to promote a culture for patient safety, to prevent, register and analyses falls at 3 cancer centers of Catalan Institute of Oncology. WHO defined falls as the result of an incident that precipitates the patients down involuntarily, includes slipping, tripping and loss of body balance. A systematic review by Wildes (2015), risk factors for hospitalized cancer patients are different from the general patient. Objective: Identify predisposing factors to fall and define the profile of the hospitalized cancer patient with higher risk to fall.
A cross-sectional, multisite study. Inclusion: patients hospitalized in 3 centers during 2017. Data recruited as voluntary report of falls in a computerized system. Variables: socio-demographic, clinical and environmental factors.
118 falls were reported; 48(40.68%) in Hospitalet; 36(30.51%) in Badalona and 34(28.81%) in Girona. Falls rate was 2.53‰, with lesion was 0.41‰ and severe lesion was 1.35% in one center. Nurses initially classified patients according to Stratify®: high risk 68(59.13%) and 47(40.87%) low-risk. A previous history of fall in last 6 months was for 18(15.25%). By diagnosis 39(33.06%) was lung and head-neck, hematologic 27(22.88%) and colorectal & GI 22(18.68%). The main cause of fall were loss of balance 31(26.50%), lack of strength/ weakness 26(22.22%) and slide 20(17.09%). Location at the hospital was 65 (55.08%) in oncology services, 29(24.58%) in hematology unit and 24(20.34%) in palliative care. Contributing factors was a risky medication 113(96.58%). Factors as being alone 69(58.47%), impairment of mobility 86(73.5%) and patient does not perceived any risk 101(89.38%).
Lung or head-neck neoplasia, medication of risk, mobility problems and the low perception of risk were the common factors resulting associated with a fall. Pautex 2008 indicated a similar rate than our for cancer patients. Room to improve for identification of the patient according to their risk is not enough but, some activities after assessment are needed. Stratify® does not fit properly to define factors related to cancer like anemia, fatigue, chemotherapy or pain.
Clinical trial identification
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Has not received any funding.
All authors have declared no conflicts of interest.