Identifying Fall Risk of Patients Receiving Hematopoietic Cell Transplant

Abstract

Background and Purpose/Objective: Few studies have examined the efficacy of fall risk assessment tools for patients undergoing hematopoietic cell transplant (HCT). The purpose of this study was to determine whether the Hendrich II Fall Risk Model (HFRM II) can distinguish patients who fell from those who did not fall in the inpatient HCT population. Methods: Observational study. Design: Retrospective chart review. Setting: Academic medical center. Patients: Patients undergoing HCT who fell during the first 100 days posttransplant. Intervention: None. Measurements: Independent-sample t tests were performed to determine differences in HFRM II score, age, pulse, systolic and diastolic blood pressure, platelet count, hemoglobin concentration, and hematocrit for fallers compared with nonfallers. Chi-square tests of independence determined differences regarding sex, assistive device used on the day of fall, transplant type, and physical therapy. Logistic regression analysis detected odds of falling dependent on transplant type, pulse rate, and HFRM II score. Results: Forty-seven patients who fell within 100 days after HCT were control matched by transplant date with 2 nonfallers each. Significant differences included HFRM II mean score (5.36 for fallers vs 3.41 for nonfallers; t = 4.510, P < .001) and mean pulse rates (100.09 vs 88.70 bpm; t = 3.398, P = .001). Patients with allogeneic HCT were 3.46 times more likely to have fallen than those with autologous HCT (P = .007). Limitations: Potential selection bias of retrospective review. Conclusions: HCT patients with higher HFRM II scores, greater pulse rate, or allogeneic transplant were more likely to fall.