4705 - Identifying falls-related variables and risk factors in hospitalised cancer patients

Background

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.

Methods

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.

Results

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%).

Conclusions

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

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.