Risk factors for falls in hospitalized patients with cancer: A systematic review and meta-analysis

Falls experienced by adult cancer survivors: a scoping review

PURPOSE

Accidental falls among adult cancer survivors are a health concern. Falls impose economic burdens and detrimental consequences to cancer survivors. This review aimed to synthesize findings from published research to explore the relationship between falls and cancer diagnosis and treatment among cancer survivors.

MATERIALS AND METHODS

A scoping review was conducted using four databases (Medline, EMBASE, CINAHL, and Scopus) for the years 2001-2021. A total of 425 abstracts were identified after removing duplicates. A second search for the years 2022-2023 was completed where 80 abstracts were identified. Abstract screening, full-text review, and data extraction were conducted. Study characteristics and key findings were extracted from full texts. Descriptive numerical summaries were presented, and narrative analyses were performed.

RESULTS AND CONCLUSIONS

A total of 42 articles were included in the scoping review which demonstrated (1) an increased prevalence of falls among cancer survivors, (2) the presence of cancer-specific fall risk factors, (3) a lack of cancer-specific fall prediction tools, and (4) few fall prevention interventions as part of usual care among cancer survivors. Younger cancer survivors were underrepresented. Cancer survivors should be aware of their risk of falls, and health professionals should ensure that fall prevention is part of usual care.

Fall risk factors and mitigation strategies for hematological malignancy patients: insights from a qualitative study using the reason model

PURPOSE

Our study aim was to understand the (human and organizational) factors influencing fall risk among people with hematological malignancies using the Reason model as a framework, providing insights that can inform the development of safe and effective fall management strategies.

METHODS

Purposive sampling was employed to conduct semi-structured interviews with 13 people with hematological malignancies and 12 nurses from the hematology department of a tertiary grade A hospital in Guangzhou from December 2023 to February 2024. The topic analysis method was utilized to analyze the interview data.

RESULTS

Factors influencing fall risk among people with hematological malignancies were categorized into four themes: (1) precondition of unsafe arts (lack of work experience in junior nurses, poor patient compliance, adverse drug reactions, inadequate ward facilities); (2) unsafe supervision (inadequate inspection management, inadequate accompanying capacity); (3) unsafe arts (variability in subjective assessment, lack of bidirectional education); and (4) organizational influences (limited nursing human resources, lack of organizational process management models).

CONCLUSION

The specific fall risk factors among people with hematological malignancies, as summarized based on the Reason model framework, provide a theoretical basis and direction for the construction of specialized fall risk assessment tools, aiming to improve the quality of fall management for inpatients and reduce the incidence of falls.

Enhancing Mobility and Well-Being in Older Adults with Cancer

OBJECTIVE

To analyze mobility challenges in older adult with cancer.

METHODS

Data from previous literature was extracted and analyzed pertaining to the topic of interest.

RESULTS

Mobility issues for the older adult with cancer are multi-factorial and are impacted by age-related changes, comorbidities, cancer itself, and cancer treatment.

CONCLUSIONS

Proven benefits have been suggested with mobility assessments, exercise and dietary interventions, and cancer rehabilitation programs however further research is needed to define integration and utilization of programs, facilitation of cancer survivors returning to work, inclusion of socially disadvantaged patients, program compliance, economic aspects, and caregiver involvement to improve quality of life across the cancer continuum.

IMPLICATIONS FOR NURSING PRACTICE

Oncology nurses are in a key role to impact the care of the older adult with cancer with mobility through patient assessment of mobility function, facilitation of patient referrals for supportive services and cancer rehabilitation and execution of nurse-led intervention programs.

Development and internal validation of a prediction model for patients with hematologic diseases of fall risk: a cohort study

BACKGROUND

To develop and internally validate a prediction model for identifying patients with hematologic diseases of fall risk.

RESEARCH DESIGN AND METHODS

This is a prospective cohort study from a prospective collection of data for 6 months. We recruited 412 patients with hematologic diseases in medical institutions and home environment of China. The outcome of the prediction model was fall or not. These variables were filtered via univariable logistic analysis, LASSO, and multivariable logistic analysis. We adopt an internal validation method of K-fold cross validation. The area under the ROC curve and the H-L test were used to evaluate the discrimination and calibration of the model.

RESULTS

Five influencing factors were identified multivariable logistic regression analysis. The established model equation is as follows: the H-L goodness-of-fit test of the model p > 0.05. The area under the ROC curve of train is 0.957 (95% CI: 0.936 ~ 0.978), and the area under the ROC curve of test is 0.962 (95% CI: 0.884 ~ 1), so the model calibration and discriminant validity are good.

CONCLUSION

Our equation has good sensitivity and specificity in predicting the fall risk of patients with hematologic diseases, and has certain positive significance for clinical assessment of their fall risk.

TRIAL REGISTRATION NUMBER

ChiCTR2200063940.

Validating the accuracy of the Hendrich II Fall Risk Model for hospitalized patients using the ROC curve analysis

This retrospective study was conducted at a medical center in southern Taiwan to assess the accuracy of the Hendrich II Fall Risk Model (HIIFRM) in predicting falls. Sensitivity, specificity, accuracy, and optimal cutoff points were analyzed using receiver operating characteristic (ROC) curves. Data analysis was conducted using information from the electronic medical record and patient safety reporting systems, capturing 303 fall events and 47,146 non-fall events. Results revealed that at the standard threshold of HIIFRM score ≥5, the median score in the fall group was significantly higher than in the non-fall group. The top three units with HIIFRM scores exceeding 5 were the internal medicine (50.6%), surgical (26.5%), and oncology wards (14.1%), indicating a higher risk of falls in these areas. ROC analysis showed an HIIFRM sensitivity of 29.5% and specificity of 86.3%. The area under the curve (AUC) was 0.57, indicating limited discriminative ability in predicting falls. At a lower cutoff score (≥2), the AUC was 0.75 (95% confidence interval: 0.666-0.706; p < 0.0001), suggesting acceptable discriminative ability in predicting falls, with an additional identification of 101 fall events. This study emphasizes the importance of selecting an appropriate cutoff score when using the HIIFRM as a fall risk assessment tool. The findings have implications for fall prevention strategies and patient care in clinical settings, potentially leading to improved outcomes and patient safety.