Citation

Manemann SM, Chamberlain AM, Boyd CM, Miller DM, Poe KL, Cheville A, Weston SA, Koepsell EE, Jiang R, Roger VL. Circ. Cardiovasc. Qual. Outcomes 2018; 11(8): e004199.

Affiliation

Division of Physical Medicine and Rehabilitation (K.L.P., A.C., E.E.K., V.L.R.), Mayo Clinic, Rochester, MN.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1161/CIRCOUTCOMES.117.004199

PMID

30354374

Abstract

Background As the population with cardiovascular disease ages, geriatric conditions are of increasing relevance. A possible geriatric prognostic indicator may be a fall risk score, which is mandated by The Joint Commission to be measured on all hospitalized patients. The prognostic value of a fall risk score on outcomes after dismissal is not well known. Thus, we aimed to determine whether a fall risk score is associated with death and hospital readmissions in patients with a recent incident cardiovascular disease event.

METHODS and Results In this retrospective cohort study, Olmsted County, MN patients with incident heart failure, myocardial infarction, or atrial fibrillation between August 1, 2005, and December 31, 2011, who were hospitalized within 180 days after the event were studied. Fall risk was measured by the Hendrich II fall risk model. Patients were followed for death or readmission within 30 days or 1 year. Among 2456 hospitalized patients with recent incident cardiovascular disease (549 heart failure, 784 myocardial infarction, 1123 atrial fibrillation; mean [SD] age, 71 [15] years; 55% men), the fall risk score was high in 22% of patients and moderate in 38%. The risk of death was increased if the fall risk score was increased, independent of age and comorbidities (moderate hazard ratio, 1.51; 95% CI, 1.09-2.08; high hazard ratio, 3.49; 95% CI, 2.52-4.85). Similarly, the risk of 30-day readmissions was substantially increased with a greater fall risk score (moderate hazard ratio, 1.29; 95% CI, 1.03-1.62; high hazard ratio, 1.63; 95% CI, 1.23-2.15).

RESULTS were similar for readmissions within 1 year.

CONCLUSIONS More than half of hospitalized patients with recent incident cardiovascular disease have an elevated fall risk score, which is associated with an increased risk in readmissions and death. These results delineate an approach for risk stratification and management that may prevent readmissions and improve survival.

Language: en

Keywords

cardiovascular diseases; death; humans; patient readmission; risk