Risk factors for falls in patients treated with chemotherapy

Falls are a serious concern for hospitalized patients, as they can lead to a decline in quality of life (QOL) and increased nursing care needs. Chemotherapy-induced peripheral neuropathy (CIPN) increases the risk of falls; however, only a few reports have investigated CIPN in conjunction with other factors. This study aimed to identify risk factors for falls in hospitalized patients undergoing chemotherapy.

We retrospectively analyzed 21,717 hospitalized patients, including 443 who received chemotherapy, at Matsuyama Shimin Hospital between April 2016 and March 2023. Multivariate logistic regression analysis was performed to assess the fall risk in hospitalized patients who received chemotherapy.

Among 21,717 hospitalized patients, 930 (4.3%) experienced at least one fall. Multivariate logistic regression identified 13 factors, including age, sex, BMI, and mobility assistance. Notably, chemotherapy showed the highest odds ratio among these factors (OR 3.40, 95% CI 2.49-4.65). In the chemotherapy subgroup (n = 443), multivariate analysis identified five factors (body mass index (BMI); decline in judgment, comprehension, and memory; treatment with hypoglycemic drugs; treatment with high-risk CIPN drugs; and lung cancer). The fall rate was significantly higher in patients who received both hypoglycemic drugs and high-risk CIPN drugs (37.5%, 6/16) than in those who received either factor alone (14.1%, 27/192; p < 0.05).

Chemotherapy was identified as an independent risk factor for falls. Among patients receiving chemotherapy, both hypoglycemic drugs and high-risk CIPN drugs were associated with an increased risk of falls, and the fall rate was significantly higher in those treated with both drugs. Therefore, these patients should be carefully monitored for fall risk.