Factors associated with falls in patients with cancer hospitalized for palliative care

In geriatrics, most risk factors associated with falls have been identified and management strategies developed accordingly. This is not the case in palliative care. The incidence rate of falls, the consequences related to falls, and other related factors were determined in elderly cancer patients hospitalized for palliative care in an exploratory study.

All consecutive patients hospitalized with advanced cancer were included over a 1-year period. Each fall was identified and detailed by a routinely collected incident report. Associations between variables and falls were assessed.

Mean age of the 198 patients (116 F) was 71.0 +/- 12.1 years. Of these, 36 had a fall at least once. Delirium occurred significantly more often in fallers (p = 0.029). There was a nonsignificant trend for a higher number of prescribed drugs in fallers (n = 8.5 +/- 3.7 versus 7.5 +/- 3.2; p = 0.4) who received significantly more neuroleptics (47.2% versus 29%; p = 0.035). Environmental hazards made little contribution to patients' falls.

Characteristics of falls in palliative care appear different from those evidenced in geriatric wards. To prevent delirium while prescribing neuroleptic drugs with the greatest caution should help decrease the number of falls in this highly vulnerable group of patients.