Key result
A high fall risk score in patients hospitalized with recent cardiovascular disease was associated with an increased risk of death (HR 3.49; 95% CI 2.52-4.85) and 30-day readmission.
Why the study?
Does an elevated fall risk score predict death and hospital readmissions in patients hospitalized with recent incident cardiovascular disease?
Cohort (n=2,456)
No
Does an elevated fall risk score predict death and hospital readmissions in patients hospitalized with recent incident cardiovascular disease?
Answers are grounded in this paper and cite their sources.
An elevated fall risk score is a strong, independent predictor of death and hospital readmission in patients hospitalized with recent incident cardiovascular disease.
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.
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Manemann et al. (2018) conducted a cohort in Recent incident cardiovascular disease (heart failure, myocardial infarction, or atrial fibrillation) (n=2,456). High fall risk score (Hendrich II model) vs. Low fall risk score was evaluated on Death (HR 3.49, 95% CI 2.52-4.85). A high fall risk score in patients hospitalized with recent cardiovascular disease was associated with an increased risk of death (HR 3.49; 95% CI 2.52-4.85) and 30-day readmission.
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