Abstract
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.
Keywords
List of abbreviations:
CI (confidence interval), HA (hip arthroplasty), KA (knee arthroplasty), OA (osteoarthritis), OAI (Osteoarthritis Initiative), OR (odds ratio)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: February 03, 2018
Footnotes
The Osteoarthritis Initiative (OAI) is a public-private partnership composed of 5 contracts (contract nos. N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This article was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI Study Investigators, the National Institutes of Health, or the private funding partners. The investigators of the present study are not members of the OAI investigative team.
Disclosures: G.J. Golladay reports receiving consultancy fees, royalties, and research support from OrthoSensor, Inc. He also owns stock in OrthoSensor, Inc. He is a member of the editorial board of Journal of Arthroplasty; serves as Chair of the American Association of Hip and Knee Surgeons Membership and Publications Committee; and a board member of the Virginia Orthopaedic Society. The other author has nothing to disclose.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
