title: Clinical Risk Factors for Orthostatic Hypotension: Results Among Elderly Fallers in Long-Term Care.
abstract: Patients at greatest risk for fall-related injuries are older adults with orthostatic hypotension (OH), a condition which drops blood pressure. This study sought to determine salient demographic and patient-level factors increasing risk for OH among a sample of elderly fallers.
  
  
  
  Data analysis for this retrospective study sought to assess the relationship between various demographic and clinical risk factors and the likelihood of OH. Because fallers could experience multiple falls, generalized estimating equations were used to account for patient-level correlations.
  
  
  
  One hundred seventeen falls occurred in 47 patients, who were primarily female with a mean age of 90.7 years. Falls resulted in 18 cases of OH. Orthostatic hypotension cases were less likely to have a gait in a steady line (5.6% vs 55.6%, P = 0.001). Patients with decreased muscular coordination were almost 5 times more likely to experience OH than those with no coordination problems (odds ratio = 4.86, P = 0.02). Patients with gait in a steady line were less likely to experience OH after a fall (OR = 0.06, P = 0.006).
  
  
  
  Orthostatic hypotension is potentially modifiable once detected. Evidenced-based protocol for assessment and management of OH among patients with gait and balance impairment is presented.
authors: From the Division of Nursing Science and Institute for Health, Health Care Policy and Aging Research, Rutgers University, School of Nursing and John A. Hartford Post-Doctoral Scholar, Newark, New Jersey.
authors: Deanna
authors: D
authors: Gray-Miceli
authors: Center for Clinical Epidemiology and Biostatistics.
authors: Sarah J
authors: SJ
authors: Ratcliffe
authors: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania.
authors: Arwin
authors: A
authors: Thomasson
authors: VISN 8, Patient Safety Center of Inquiry, Veterans Administration.
authors: Patricia
authors: P
authors: Quigley
authors: Department of Industrial and Systems Engineering.
authors: Kang
authors: K
authors: Li
authors: Biomedical Engineering, Rutgers University, Piscataway, New Jersey.
authors: William
authors: W
authors: Craelius
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology*; D008134:Long-Term Care / Q000592:standards*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors