title: Preoperative Falls and Their Association with Functional Dependence and Quality of Life.
abstract: BACKGROUND
  No study has rigorously explored the characteristics of surgical patients with recent preoperative falls. Our objective was to describe the essential features of preoperative falls and determine whether they are associated with preoperative functional dependence and poor quality of life.
  
  
  METHODS
  This was an observational study involving 15,060 surveys from adult patients undergoing elective surgery. The surveys were collected between January 2014 and August 2015, with a response rate of 92%.
  
  
  RESULTS
  In the 6 months before surgery, 26% (99% CI, 25 to 27%) of patients fell at least once, and 12% (99% CI, 11 to 13%) fell at least twice. The proportion of patients who fell was highest among patients presenting for neurosurgery (41%; 99% CI, 36 to 45%). At least one fall-related injury occurred in 58% (99% CI, 56 to 60%) of those who fell. Falls were common in all age groups, but surprisingly, they did not increase monotonically with age. Middle-aged patients (45 to 64 yr) had the highest proportion of fallers (28%), recurrent fallers (13%), and severe fall-related injuries (27%) compared to younger (18 to 44 yr) and older (65+ yr) patients (P < 0.001 for each). A fall within 6 months was independently associated with preoperative functional dependence (odds ratio, 1.94; 99% CI, 1.68 to 2.24) and poor physical quality of life (odds ratio, 2.18; 99% CI, 1.88 to 2.52).
  
  
  CONCLUSIONS
  Preoperative falls might be common and are possibly often injurious in the presurgical population, across all ages. A history of falls could enhance the assessment of preoperative functional dependence and quality of life.
authors.affiliation: From the Department of Anesthesiology (V.L.K., R.D.T., A.P.S., A.B.A., T.S.W., S.L.M., F.S., D.L.H., A.S., M.S.A.) and Program in Occupational Therapy (S.L.S.), Washington University School of Medicine, St. Louis, Missouri; and Department of Mathematics, Washington University, St. Louis, Missouri (N.L.).
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Kronzer
authors.forename: Rose D
authors.initials: RD
authors.lastname: Tang
authors.forename: Allison P
authors.initials: AP
authors.lastname: Schelble
authors.forename: Arbi
authors.initials: A
authors.lastname: Ben Abdallah
authors.forename: Troy S
authors.initials: TS
authors.lastname: Wildes
authors.forename: Sherry L
authors.initials: SL
authors.lastname: McKinnon
authors.forename: Furqaan
authors.initials: F
authors.lastname: Sadiq
authors.forename: Nan
authors.initials: N
authors.lastname: Lin
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Helsten
authors.forename: Anshuman
authors.initials: A
authors.lastname: Sharma
authors.forename: Susan L
authors.initials: SL
authors.lastname: Stark
authors.forename: Michael S
authors.initials: MS
authors.lastname: Avidan
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D057234:Preoperative Period; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult