Association between self-reported falling risk and risk of hospitalization for patients with chronic obstructive pulmonary disease

Katherine C Ritchey; Abebaw M Yohannes; Emily R Locke; Sunny Chen; Tracy Simpson; Catherine Battaglia; Ranak B Trivedi; Erik R Swenson; Jeff Edelman; Vincent S Fan

doi:10.1016/j.rmed.2023.107466

Association between self-reported falling risk and risk of hospitalization for patients with chronic obstructive pulmonary disease

Respir Med. 2023 Dec:220:107466. doi: 10.1016/j.rmed.2023.107466. Epub 2023 Nov 18.

Authors

Affiliations

¹ Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, USA; Division of Geriatrics and Gerontology, Department of Medicine, University of Washington School of Medicine, 325 9th Ave, Box 359755, Seattle, WA, 98104-2499, USA. Electronic address: Katherine.ritchey2@va.gov.
² Department of Physical Therapy, School of Health Professions Building, University of Alabama at Birmingham, 1716 9th Avenue South, Birmingham, AL, 35233, USA. Electronic address: amyohann@uab.edu.
³ Center of Innovation for Veteran-Centered and Value-Driven Care VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, USA. Electronic address: Emily.locke@va.gov.
⁴ Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, USA.
⁵ Center of Excellence in Substance Addiction Treatment and Education (CESATE), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA; Department of Psychiatry, University of Washington School of Medicine, 959 NE Pacific Street Box 356560, Seattle, WA, 98195-6560, USA. Electronic address: tracy.rosen@va.gov.
⁶ Eastern Colorado VA Health Care System, 1700 N. Wheeling, Aurora, CO, 80045, USA; University of Colorado Anschutz Medical Campus, 13001 E. 17th Pl, Aurora, CO, 80045, USA. Electronic address: Catherine.battaglia@va.gov.
⁷ Center for Innovation to Implementation, VA Palo Alto Health Care System, 795. Willow Road, Menlo Park, CA, 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA.
⁸ Division of Pulmonary and Critical Care, Department of Medicine, University of Washington School of Medicine, Seattle, WA 1959 NE Pacific Street, Seattle, WA, 98159, USA; Pulmonary and Critical Care, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA. Electronic address: erik.swenson@va.gov.
⁹ Division of Pulmonary and Critical Care, Department of Medicine, University of Washington School of Medicine, Seattle, WA 1959 NE Pacific Street, Seattle, WA, 98159, USA; Pulmonary and Critical Care, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA. Electronic address: jeffery.edelman@va.gov.
¹⁰ Division of Pulmonary and Critical Care, Department of Medicine, University of Washington School of Medicine, Seattle, WA 1959 NE Pacific Street, Seattle, WA, 98159, USA; Pulmonary and Critical Care, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA. Electronic address: Vincent.fan@va.gov.

PMID: 37981244
DOI: 10.1016/j.rmed.2023.107466

Abstract

Rationale: The association between self-report falling risk in persons with COPD and hospitalization has not been previously explored.

Objective: To examine whether self-reported risk is associated with hospitalizations in patients with COPD.

Methods: A secondary analysis from a prospective observational cohort study of veterans with COPD. Participants completed questions from the Stopping Elderly Accidents, Deaths and Injuries (STEADI) tool kit at either baseline or at the end of the 12-month study. A prospective or cross-sectional analysis examined the association between responses to the STEADI questions and risk of all-cause or COPD hospitalizations.

Results: Participants (N = 388) had a mean age of 69.6 ± 7.5 years, predominately male (96 %), and 144 (37.1 %) reported having fallen in the last year. More than half reported feeling unsteady with walking (52.6 %) or needing to use their arms to stand up from a chair (61.1 %). A third were concerned about falling (33.3 %). Three questions were associated with all-cause (not COPD) hospitalization in both unadjusted and adjusted cross-sectional analysis (N = 213): "fallen in the past year" (IRR 1.77, 95 % CI 1.10 to 2.86); "unsteady when walking" (IRR 1.88, 95 % CI 1.14 to 3.10); "advised to use a cane or walker" (IRR 1.89, 95 % CI 1.16 to 3.08).

Conclusions: The prevalence of self-reported falling risk was high in this sample of veterans with COPD. The association between falling risk and all-cause hospitalization suggests that non-COPD hospitalizations can negatively impact intrinsic risk factors for falling. Further research is needed to clarify the effects of all-cause hospitalization on falling risk in persons with COPD.

Keywords: COPD; Fall risk screening; Older adults; STEADI; Veterans.

Published by Elsevier Ltd.

Publication types

Observational Study

MeSH terms

Aged
Cross-Sectional Studies
Hospitalization
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Disease, Chronic Obstructive*
Self Report