Toshimitsu Kasuga1, Fumiko Aruga2, Koichi Ono2, Yoshimune Hiratsuka3, Akira Murakami3. 1. Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.. Electronic address: tkasuga@juntendo.ac.jp. 2. Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan. 3. Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Abstract
OBJECTIVE: To investigate the association between visual impairment and the risk of falls in hospitalized patients. DESIGN: Individually matched case-control study. METHODS: The medical records of patients who fell while hospitalized at Juntendo Tokyo Koto Geriatric Medical Center (JTKGMC) from January to December 2014 were reviewed retrospectively. Among them, 36 patients who were recorded as visiting the Ophthalmology Outpatient Clinic from 1 year before to 1 year after the fall were included as cases. As the control subjects, 36 individually matched patients were chosen who were hospitalized in the same beds in the same hospital wards. Visual impairment and blindness were defined according to U.S. criteria. Conditional logistic regression analysis was used for both univariate and multivariate analyses. Based on previous reports, multivariate analysis was performed with adjustment for age, sex, a history of falls, and use of walking aids. This study was approved by the institutional review board of JTKGMC and was performed according to the tenets of the Declaration of Helsinki. RESULTS: The crude odds ratio (OR) for visual impairment was 6.0 (95% confidence interval [CI]: 0.72-49.83). For a history of falls and use of walking aids, the crude OR (95% CI) was 2.5 (0.97-6.44) and 2.8 (0.88-8.64), respectively. After adjustment for age, sex, a history of falls, and use of walking aids, the association between falls and visual impairment was significant (OR: 13.9; 95% CI: 1.0004-194.41). CONCLUSION: These findings suggest that visual impairment could be an independent risk factor for falls among hospitalized patients.
OBJECTIVE: To investigate the association between visual impairment and the risk of falls in hospitalized patients. DESIGN: Individually matched case-control study. METHODS: The medical records of patients who fell while hospitalized at Juntendo Tokyo Koto Geriatric Medical Center (JTKGMC) from January to December 2014 were reviewed retrospectively. Among them, 36 patients who were recorded as visiting the Ophthalmology Outpatient Clinic from 1 year before to 1 year after the fall were included as cases. As the control subjects, 36 individually matched patients were chosen who were hospitalized in the same beds in the same hospital wards. Visual impairment and blindness were defined according to U.S. criteria. Conditional logistic regression analysis was used for both univariate and multivariate analyses. Based on previous reports, multivariate analysis was performed with adjustment for age, sex, a history of falls, and use of walking aids. This study was approved by the institutional review board of JTKGMC and was performed according to the tenets of the Declaration of Helsinki. RESULTS: The crude odds ratio (OR) for visual impairment was 6.0 (95% confidence interval [CI]: 0.72-49.83). For a history of falls and use of walking aids, the crude OR (95% CI) was 2.5 (0.97-6.44) and 2.8 (0.88-8.64), respectively. After adjustment for age, sex, a history of falls, and use of walking aids, the association between falls and visual impairment was significant (OR: 13.9; 95% CI: 1.0004-194.41). CONCLUSION: These findings suggest that visual impairment could be an independent risk factor for falls among hospitalized patients.
Authors: Prem Nichani; Graham E Trope; Yvonne M Buys; Samuel N Markowitz; Sherif El-Defrawy; Gordon Ngo; Michelle Markowitz; Ya-Ping Jin Journal: CMAJ Open Date: 2021-03-17