Anemia increases risk for falls in hospitalized older adults: an evaluation of falls in 362 hospitalized, ambulatory, long-term care, and community patients.
OBJECTIVE
The objective of this study was to determine if a relationship exists between the presence of anemia and the occurrence of falls during hospitalization in ambulatory older adults from long-term care and community settings. All individuals were hospitalized for acute conditions not related to a fall.


METHODS
Three hundred sixty-two hospitalized, ambulatory older (59-104 years) adults.


METHODS
Laboratory values (hemoglobin [Hb], hematocrit [Hct]), routine laboratory tests, pertinent medical history, and demographics.


RESULTS
Ambulatory hospitalized patients who fell were compared to controls (no falls during hospitalization) of similar age (P = .283) and gender distribution (P = .554). Patients who fell had significantly lower Hb (P < .00005), lower Hct (P < .00005) and were more likely to be anemic (56% vs 38%, P = .001) than controls. A logistic regression model examined the effect of Hb level and anemia on falls and included the covariates of age, gender, place of residence, and race. The model described a 22% decreased risk of falls for every 1.0 g/dL increase in Hb (P < .0005) and an overall 1.9-fold increased risk of falls in anemic patients (P < .001). Patient age, gender, and place of residence were not related to the risk of falls during hospitalization.


CONCLUSIONS
These findings suggest a potentially important link between anemia and the risk of falls during hospitalization in ambulatory older patients. Further studies are needed to determine if the risk of falls can be modified by correction of anemia and to determine the applicability of these findings to older adults in different settings.
Dharmarajan
T S
TS
Department of Medicine, Our Lady of Mercy Medical Center, Bronx, NY, USA. dharmarajants@yahoo.com
Avula
Sai
S
Norkus
Edward P
EP
D000046:Academic Medical Centers; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D044469:Racial Groups / Q000706:statistics & numerical data; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D017678:Sex Distribution
D006454:Hemoglobins; D012709:Serum Albumin