Atrial Fibrillation Boosted Fall Risk in Elderly Patients

Abstract

SAN FRANCISCO – A history of atrial fibrillation more than tripled the risk of a nonaccidental fall in elderly people, an emergency department study showed.Of 459 consecutive elderly patients who presented to a large emergency department with a chief complaint of a fall, 225 had a fall deemed to be nonaccidental – that is, a fall not explained by mitigating circumstances such as being knocked over by another person.A history of atrial fibrillation (AF) was present in 20.4% of those with a nonaccidental fall, compared with 10.6% of the 234 elderly patients who presented with an accidental fall, Joya A. Ganguly, MD, reported at the annual meeting of the Heart Rhythm Society.The study population had a median age of 81 years. Patients younger than 81 who had nonaccidental falls were 3.36 times as likely to have a history of AF, compared with those who had accidental falls. However, among patients older than 81 years, AF was only 1.3 times as prevalent in nonaccidental fallers as in accidental fallers, an insignificant difference, according to Dr. Ganguly of the University of Utah, Salt Lake City.Patients with a nonaccidental fall were an average of 4 years older than those who presented with an accidental fall. Patients with a nonaccidental fall were also more likely to have a neurologic disorder and to be on three or more medications.In contrast, there was no difference between patients in the nonaccidental and accidental fall groups in blood pressure, heart rate, orthostatic hypotension, prior pacemaker placement, a history of heart failure, or the prevalence of AF at presentation, which was about 8% in both groups.Dr. Ganguly concluded that these study findings suggest elderly patients with a history of AF might be good candidates for fall-prevention education programs along the lines of the national program recently proposed by investigators at the University of Southern California as a cost-effective intervention (Clin. Geriatr. Med. 2010;26:751–66).She disclosed no conflict of interest.Bruce Jancin is with the Denver bureau of Elsevier Global Medical News. SAN FRANCISCO – A history of atrial fibrillation more than tripled the risk of a nonaccidental fall in elderly people, an emergency department study showed. Of 459 consecutive elderly patients who presented to a large emergency department with a chief complaint of a fall, 225 had a fall deemed to be nonaccidental – that is, a fall not explained by mitigating circumstances such as being knocked over by another person. A history of atrial fibrillation (AF) was present in 20.4% of those with a nonaccidental fall, compared with 10.6% of the 234 elderly patients who presented with an accidental fall, Joya A. Ganguly, MD, reported at the annual meeting of the Heart Rhythm Society. The study population had a median age of 81 years. Patients younger than 81 who had nonaccidental falls were 3.36 times as likely to have a history of AF, compared with those who had accidental falls. However, among patients older than 81 years, AF was only 1.3 times as prevalent in nonaccidental fallers as in accidental fallers, an insignificant difference, according to Dr. Ganguly of the University of Utah, Salt Lake City. Patients with a nonaccidental fall were an average of 4 years older than those who presented with an accidental fall. Patients with a nonaccidental fall were also more likely to have a neurologic disorder and to be on three or more medications. In contrast, there was no difference between patients in the nonaccidental and accidental fall groups in blood pressure, heart rate, orthostatic hypotension, prior pacemaker placement, a history of heart failure, or the prevalence of AF at presentation, which was about 8% in both groups. Dr. Ganguly concluded that these study findings suggest elderly patients with a history of AF might be good candidates for fall-prevention education programs along the lines of the national program recently proposed by investigators at the University of Southern California as a cost-effective intervention (Clin. Geriatr. Med. 2010;26:751–66). She disclosed no conflict of interest. Bruce Jancin is with the Denver bureau of Elsevier Global Medical News.