title: Ability of preoperative falls to predict postsurgical outcomes in non-selected patients undergoing elective surgery at an academic medical centre: protocol for a prospective cohort study.
abstract: BACKGROUND
  Falls are increasingly recognised for their ability to herald impending health decline. Despite the likely susceptibility of postsurgical patients to falls, a detailed description of postoperative falls in an unselected surgical population has never been performed. One study suggests that preoperative falls may forecast postoperative complications. However, a larger study with non-selected surgical patients and patient-centred outcomes is needed to provide the generalisability and justification necessary to implement preoperative falls assessment into routine clinical practice. The aims of this study are therefore twofold. First, we aim to describe the main features of postoperative falls in a population of unselected surgical patients. Second, we aim to test the hypothesis that a history of falls in the 6 months prior to surgery predicts postoperative falls, poor quality of life, functional dependence, complications and readmission.
  
  
  METHODS
  To achieve these goals, we study adult patients who underwent elective surgery at our academic medical centre and were recruited to participate in a prospective, survey-based cohort study called Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) (NCT02032030). Patients who reported falling in the 6 months prior to surgery will be considered 'exposed.' The primary outcome of interest is postoperative falls within 30 days of surgery. Secondary outcomes include postoperative functional dependence, quality of life (both physical and mental), in-hospital complications and readmission. Regression models will permit controlling for important confounders.
  
  
  BACKGROUND
  The home institution's Institutional Review Board approved this study (IRB ID number 201505035). The authors will publish the findings, regardless of the results.
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Vanessa L
authors.identifier: http://orcid.org/0000-0002-7489-3134
authors.initials: VL
authors.lastname: Kronzer
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Arbi
authors.initials: A
authors.lastname: Ben Abdallah
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Sherry L
authors.initials: SL
authors.lastname: McKinnon
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Troy S
authors.initials: TS
authors.lastname: Wildes
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Avidan
keywords: falls; functional dependence; patient-reported outcomes; postoperative; preoperative; quality of life