title: Subclinical Peroneal Neuropathy: A Common, Unrecognized, and Preventable Finding Associated With a Recent History of Falling in Hospitalized Patients.
abstract: Identification of modifiable risk factors for falling is paramount in reducing the incidence and morbidity of falling. Peroneal neuropathy with an overt foot drop is a known risk factor for falling, but research into subclinical peroneal neuropathy (SCPN) resulting from compression at the fibular head is lacking. The purpose of our study was to determine the prevalence of SCPN in hospitalized patients and establish whether it is associated with a recent history of falling.
  
  
  
  We conducted a cross-sectional study of 100 medical inpatients at a large academic tertiary care hospital in St Louis, Missouri. General medical inpatients deemed at moderate to high risk for falling were enrolled in the summer of 2013. Patients were examined for findings that suggest peroneal neuropathy, fall risk, and a history of falling. Multivariate logistic regression was used to correlate SCPN with fall risk and a history of falls in the past year.
  
  
  
  The mean patient age was 53 years (SD = 13 years), and 59 patients (59%) were female. Thirty-one patients had examination findings consistent with SCPN. After accounting for various confounding variables within a multivariate logistic regression model, patients with SCPN were 4.7 times (95% CI, 1.4-15.9) more likely to report having fallen 1 or more times in the past year.
  
  
  
  Subclinical peroneal neuropathy is common in medical inpatients and is associated with a recent history of falling. Preventing or identifying SCPN in hospitalized patients provides an opportunity to modify activity and therapy, potentially reducing risk.
authors.affiliation: Division of Plastic & Reconstructive Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri.
authors.forename: Louis H
authors.initials: LH
authors.lastname: Poppler
authors.affiliation: Washington University in St Louis School of Medicine, St Louis, Missouri.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Groves
authors.affiliation: Washington University in St Louis School of Medicine, St Louis, Missouri.
authors.forename: Gina
authors.initials: G
authors.lastname: Sacks
authors.affiliation: Washington University in St Louis School of Medicine, St Louis, Missouri.
authors.forename: Anchal
authors.initials: A
authors.lastname: Bansal
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Davidge
authors.affiliation: BJC HealthCare, St Louis, Missouri.
authors.forename: Jenifer A
authors.initials: JA
authors.lastname: Sledge
authors.affiliation: BJC HealthCare, St Louis, Missouri.
authors.forename: Heidi
authors.initials: H
authors.lastname: Tymkew
authors.affiliation: Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Hasak
authors.affiliation: BJC HealthCare, St Louis, Missouri.
authors.forename: Patricia
authors.initials: P
authors.lastname: Potter
authors.affiliation: Division of Plastic & Reconstructive Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri mackinnon@wudosis.wustl.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Mackinnon
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D015999:Multivariate Analysis; D020427:Peroneal Neuropathies / Q000453:epidemiology* / Q000503:physiopathology*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: accidental; common peroneal; falls; nerve compression syndromes; neuropathy; peroneal nerve diseases; peroneal nerve paralysis; preventive medicine