Atrial fibrillation: an independent risk factor for nonaccidental falls in older patients.
BACKGROUND
Nonaccidental falls are often the result of a combination of factors including cardiovascular disorders such as orthostatic hypotension and unspecified cardiac arrhythmias. The objective of this study was to determine if there is an association between atrial fibrillation (AF) and nonaccidental falls.


METHODS
We reviewed the records of 442 consecutive patients >65 years old who presented to the Emergency Department at the University of Utah Medical Center with a complaint of fall.


RESULTS
Two-hundred eleven patients presented with nonaccidental fall, 231 patients with accidental fall. Patients with nonaccidental fall were more likely to be older, have a history of hypertension and neurological disorders, and taking five or more medications when compared to patients with accidental fall. Despite a similar prevalence of sinus rhythm at presentation, the prevalence of a history of AF was significantly higher in patients with nonaccidental fall compared to patients with accidental fall (26% vs 15%; P = 0.003). After adjusting for clinically and statistically significant predictors with a multivariate logistic regression analysis, AF, neurological disorders, and age ≤81 years were independent predictors of nonaccidental fall. In patients ≤81 years old (median age), the risk of nonaccidental falls was 2.5 times greater in patients with a history of AF when compared to those without a history of AF (odds ratio = 2.53 [confidence interval 95% 1.3-5], P = 0.007).


CONCLUSIONS
AF is an independent risk factor for nonaccidental falls. Our results emphasize the need to screen for AF in patients presenting with nonaccidental fall.
Division of Geriatrics, University of Utah, Medical Center, Salt Lake City, Utah, USA.
Natalie A
NA
Sanders
Joya A
JA
Ganguly
Tawni L
TL
Jetter
Marcos
M
Daccarett
Stephen L
SL
Wasmund
Michelino
M
Brignole
Mohamed H
MH
Hamdan
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007024:Hypotension, Orthostatic / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D008297:Male; D009422:Nervous System Diseases / Q000150:complications / Q000188:drug therapy; D019338:Polypharmacy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents; D014150:Antipsychotic Agents