Article

OBJECTIVE: To identify preoperative risk factors associated with
posthospitalization falls over an approximate 2-year postoperative period in
patients undergoing both hip and knee arthroplasty.
DESIGN: A longitudinal cohort
design. SETTING: Communities surrounding 4 urban university-based medical
centers. PARTICIPANTS: Adults (N = 596) with hip or knee arthroplasty over a
9-year period and followed yearly. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: The primary outcome measure was a self-reported history of falls over
the 2-year postoperative period. A fall was recorded when the participant
reported landing on the floor or ground. Preoperative predictors of falls derived
from previous evidence included preoperative fall history, depressive symptom
severity, narcotic use, age, activity level, and comorbidity. Multinomial
regression analysis was performed to determine factors that predicted either a
single fall or multiple falls during a 2-year postoperative period. RESULTS:
Preoperative predictors of multiple postoperative falls were a preoperative
history of falls, depressive symptoms, and hip vs knee arthroplasty. Patients
with hip arthroplasty were more than twice as likely (odds ratio, 2.26; 95%
confidence interval, 1.21-4.20) as patients with knee arthroplasty to have
multiple self-reported falls in the first 2 postoperative years. No predictors
were found for persons who reported falling only once postoperatively. Findings
were generally supported in a sensitivity analysis. CONCLUSIONS: Clinicians
involved in the pre- and postoperative care of persons undergoing hip or knee
arthroplasty can use these findings to inform fall risk screening and
intervention delivery to reduce fall risk in patients who are at risk for
multiple falls after hip or knee arthroplasty.
CI - Copyright (c) 2018 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS