Frequency and Predictors of Falls Among Adults With Heart Failure: A Prospective Study |
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| Affiliation: | 1. Oregon Health & Science University, School of Nursing, Portland, OR, USA;2. Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA;3. Portland Veteran''s Affairs Hospital, Portland, OR, USA;4. Oregon Health & Science University, Department of Medicine, Portland, OR, USA;5. Oregon Health & Science University, Hillsboro Medical Center, Hillsboro, OR, USA;6. Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA;7. Australian Catholic University, Melbourne, Australia;8. Oregon Health & Science University, Knight Cancer Institute, Portland, OR, USA;1. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut;2. Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia;1. Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA;2. Zena and Michael A. Wiener Cardiovascular Institute and Department of Population Health Science and Policy, Mount Sinai, New York, NY, USA;1. Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain;2. Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain;3. CIBERCV, Instituto de Salud Carlos III, Madrid, Spain;4. UW Medicine Heart Institute, University of Washington, Seattle, Washington;5. Cardiology Department, Hospital Clínico Universitario, INCLIVA Valencia, Spain;6. Departament of Medicine, Universidad de Valencia, Spain;7. Scuola Superiore Sant''Anna, Pisa, Italy;8. Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy;1. Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC;2. Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD;3. Department of Internal Medicine, Sections on Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC;4. Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC;5. Novant Health Heart and Vascular Institute, Charlotte, NC;6. Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA;7. Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, NC;8. Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC;9. Department of Orthopaedic Surgery, Physical Therapy Division, Duke University School of Medicine, Durham, NC;1. Baylor Heart and Vascular Institute, Dallas, TX, USA;2. Imperial College, London, UK;3. British Heart Foundation Centre of Research Excellence. School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK |
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| Abstract: | 
ObjectiveAdults with heart failure (HF) may be at high risk for falling due to age, comorbidities and frailty; however, few studies have examined falls in HF. The purpose of this study was to quantify the frequency and predictors of falls over 1 year among adults with HF.MethodsWe conducted a prospective study of adults with New York Heart Association (NYHA) functional class I–IV HF. After baseline assessment of physical frailty and clinical characteristics, participants self-reported falls every 3 months during 1 year. Comparative statistics were used to identify baseline differences between those who fell vs those who did not. A stepwise negative binomial regression model was used to identify predictors of fall rate over 1 year.ResultsThe sample (n = 111) was 63.4 ± 15.7 years old, 48% were women, 28% had HF with preserved ejection fraction, and 41% were frail. Over 1 year, 43 (39%) of participants reported at least 1 fall and 28 (25%) of participants reported 2+ falls. Among those who fell, 29 (67%) reported injurious falls. Those who fell had significantly higher body mass indexes and were more likely to have NYHA class III/IV, type 2 diabetes and HF with preserved ejection fraction and to meet slowness and physical exhaustion criteria than those who did not fall. The fall rate was elevated among those with type 2 diabetes and those meeting the slowness and physical exhaustion criteria for physical frailty.ConclusionsNearly 40% of adults with HF experienced a fall within 1 year. Screening for comorbidities, slowness and exhaustion may help to identify those at risk for a fall. |
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