title: Falls and balance confidence in persons with and without injection-related venous ulcers.
abstract: OBJECTIVE
  With aging of injection users and the high occurrence of venous disease in their legs, falls are a potential health problem. We examined falls and balance confidence in persons with (VU+) and without (VU-) injection-related venous ulcers (VUs).
  
  
  METHODS
  This study used a cross-sectional, retrospective, comparative design with 31 participants VU+ and 30 VU- recruited in a medical clinic. Participants' legs were assessed for clinical manifestations of venous disease. Participants completed background and fall questionnaires and the Activities-specific Balance Confidence (ABC) Scale.
  
  
  RESULTS
  Participants included 35 men and 26 women (mean age = 54 years); 93% were African American. Falling in the past year was reported by 65% of patients VU+ and 40% VU- (P = 0.048); 29 of these patients fell 2 or more times in the past year. Higher scores on the ABC Scale (N = 61) were significantly related to fewer falls (r = -0.68). Activities-specific Balance Confidence scores were lower/worse for the patients VU+ (P = 0.039). Area under the receiver operating curve for patients VU+ was significant; we found area under the curve of 0.84 and a cutoff score of 80.3% for ABC predictive of recurrent fallers with sensitivity of 84% and specificity of 83%. The ABC test had an internal consistency reliability of 0.97.
  
  
  CONCLUSIONS
  Persons VU+ reported worse balance confidence and more falls than those without these ulcers. The ABC test was related to falls. With aging of injection users and increased occurrence of VUs, examining balance confidence and falls is crucial in long-term patient safety.
authors.affiliation: College of Nursing, Wayne State University, Detroit, MI 48202, USA. bapieper@comcast.net
authors.forename: Barbara
authors.initials: B
authors.lastname: Pieper
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Templin
authors.forename: Allon
authors.initials: A
authors.lastname: Goldberg
authors.forename: Ellen
authors.initials: E
authors.lastname: DiNardo
authors.forename: Margaret
authors.initials: M
authors.lastname: Wells
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D007866:Leg / Q000098:blood supply; D007871:Leg Ulcer / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D012372:ROC Curve; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D012678:Sensation Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D015819:Substance Abuse, Intravenous / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014652:Vascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014680:Veins / Q000473:pathology