Perioperative Medicine  |   August 2016
Preoperative Falls and Their Association with Functional Dependence and Quality of Life
Author Notes
  • From the Department of Anesthesiology (V.L.K., R.D.T., A.P.S., A.B.A., T.S.W., S.L.M., F.S., D.L.H., A.S., M.S.A.) and Program in Occupational Therapy (S.L.S.), Washington University School of Medicine, St. Louis, Missouri; and Department of Mathematics, Washington University, St. Louis, Missouri (N.L.).
  • Submitted for publication December 8, 2015. Accepted for publication April 13, 2016.
    Submitted for publication December 8, 2015. Accepted for publication April 13, 2016.×
  • Address correspondence to Dr. Avidan: Department of Anesthesiology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8054, St. Louis, Missouri 63110. avidanm@anest.wustl.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Clinical Science / Central and Peripheral Nervous Systems / Ethics / Medicolegal Issues / Renal and Urinary Systems / Electrolyte Balance / Quality Improvement
Perioperative Medicine   |   August 2016
Preoperative Falls and Their Association with Functional Dependence and Quality of Life
Anesthesiology 8 2016, Vol.125, 322-332. doi:10.1097/ALN.0000000000001167
Anesthesiology 8 2016, Vol.125, 322-332. doi:10.1097/ALN.0000000000001167
Abstract

Background: No study has rigorously explored the characteristics of surgical patients with recent preoperative falls. Our objective was to describe the essential features of preoperative falls and determine whether they are associated with preoperative functional dependence and poor quality of life.

Methods: This was an observational study involving 15,060 surveys from adult patients undergoing elective surgery. The surveys were collected between January 2014 and August 2015, with a response rate of 92%.

Results: In the 6 months before surgery, 26% (99% CI, 25 to 27%) of patients fell at least once, and 12% (99% CI, 11 to 13%) fell at least twice. The proportion of patients who fell was highest among patients presenting for neurosurgery (41%; 99% CI, 36 to 45%). At least one fall-related injury occurred in 58% (99% CI, 56 to 60%) of those who fell. Falls were common in all age groups, but surprisingly, they did not increase monotonically with age. Middle-aged patients (45 to 64 yr) had the highest proportion of fallers (28%), recurrent fallers (13%), and severe fall-related injuries (27%) compared to younger (18 to 44 yr) and older (65+ yr) patients (P < 0.001 for each). A fall within 6 months was independently associated with preoperative functional dependence (odds ratio, 1.94; 99% CI, 1.68 to 2.24) and poor physical quality of life (odds ratio, 2.18; 99% CI, 1.88 to 2.52).

Conclusions: Preoperative falls might be common and are possibly often injurious in the presurgical population, across all ages. A history of falls could enhance the assessment of preoperative functional dependence and quality of life.