Key result
Screening hospice inpatients for orthostatic hypotension yields non-reproducible results and provides no patient benefit.
Why the study?
Orthostatic hypotension has a reported prevalence of 40% in hospice settings and may cause dizziness, falls, and fractures, but the value of screening hospice inpatients is unclear.
Does screening for orthostatic hypotension provide clinical benefit in hospice inpatients?
Observational (n=59)
Does screening for orthostatic hypotension provide clinical benefit in hospice inpatients?
Routine screening for orthostatic hypotension in hospice inpatients is not supported due to poor reproducibility and lack of clinical benefit.
May not warrant routine orthostatic screening in hospice; leaves open symptom-guided assessment in select patients.
Orthostatic hypotension (OH) is defined as a reduction in systolic blood pressure of at least 20 mm Hg or a reduction in diastolic blood pressure of at least 10 mm Hg within three minutes of standing, with a reported prevalence of 40% in the hospice setting. Dizziness, falls and fractures have been attributed to OH and some cases of symptomatic OH might be reversible. This study explored the case for screening hospice inpatients for OH. Fifty-nine patients were screened up to five times and, whilst the detection rate was 27%, in no case was it reproducible. There was no statistical association between orthostatic symptoms and the detection of OH, and no patients benefited from the screening process. On closer examination of the literature, the current definition of OH might benefit from revision, sphygmomanometry is an unsatisfactory screening method and there is currently no case for screening hospice inpatients for OH.
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John C. Chambers (2005) conducted an observational in Orthostatic hypotension (n=59). Screening for orthostatic hypotension was evaluated on Detection of orthostatic hypotension. Screening hospice inpatients for orthostatic hypotension yielded a 27% detection rate that was not reproducible, showing no association with symptoms and providing no patient benefit.
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