Falls among patients in cancer rehabilitation unit uncommon, typically cause no harm
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Key takeaways:
- Less than 5% of unique individuals experienced falls during inpatient rehabilitation, and 86% suffered no harm.
- Individuals experiencing a fall tended to be younger (median age, 62 years vs. 66 years).
Falls in an inpatient cancer rehabilitation unit occurred less frequently than previous studies have estimated and usually caused patients no harm, according to data published in JCO Oncology Practice.
The findings suggest mobilization of these patients is safe, researchers wrote.
“A study analyzing data from the National Database of Nursing Quality Indicators found rates ranging from 0.2 to 13.3 falls per 1,000 days are the average nationwide,” Ekta Gupta, MD, assistant professor in the department of palliative care and rehabilitation medicine at The University of Texas MD Anderson Cancer Center, and colleagues wrote. “Our study’s finding of 3.76 falls per 1,000 patient-days is within the reported range in our country, and lower than other studies for rehabilitation units, which suggests these patients are safe to mobilize.”
Background and methodology
Falls in hospitals can lead to injuries and other adverse events, and some studies have shown that patients with cancer or undergoing inpatient rehabilitation are at an increased risk for falls.
Researchers conducted a retrospective review of the frequency and degree of harm of falls in inpatient cancer rehabilitation unit among patients admitted from January 2012 to February 2016.
Researchers also evaluated fall circumstances and characteristics of patients who fell, including cancer type, risk score according to the MD Anderson Cancer Center Adult Inpatient Fall Risk Assessment Tool, length of stay and risk factors.
Results, next steps
Researchers noted 72 unique individual falls among 1,571 unique individuals (4.6%), for an incidence of 3.76 falls for every 1,000 patient-days; 86% of those who fell experienced no harm.
Risk factors for falls included presence of patient-controlled analgesia pump (P = .03), pump such as insulin or wound vacuum-assisted closure (P < .01), nasogastric, gastric or chest tube (P = .05) and higher Fall Risk Assessment Tool score (P < .01).
Those who fell appeared to be younger than those who did not fall (median age, 62 years vs. 66 years), had a longer stay at an inpatient rehabilitation unit stay (13 days vs. 9 days) and had a lower Charlson comorbidity index (6 vs. 8).
Researchers specifically noted the presence of medical devices as a potential risk factor while noting the need for additional data to better understand specific risk factors.
“The presence of a medical device — specifically PCA pump, other pump or tube — may contribute to fall risk in patients with cancer undergoing [inpatient rehabilitation] and should be evaluated for removal before rehabilitation if possible,” researchers wrote. “More research is needed to explore the risk factors further, and these data suggest that minimizing the use of medical devices may help decrease fall risk for patients with cancer during their inpatient stay.”
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Gupta E, et al. JCO Oncol Pract. 2023;doi:10.1200/OP.23.00188.
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