ArticleClinical transplantation2025
A Simple One-Item Nursing Falls Assessment Predicts Outcomes for Patients With Stage D Heart Failure Undergoing Surgical Advanced Therapies.
Article in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionFrailty portends worse outcomes for patients with advanced heart failure (HF) undergoing surgical advanced therapies. Falls are characteristic of frailty, but it is unknown if the history of falls predicts post-operative risk. We hypothesized that a one-item fall screening is associated with worse outcomes.
methodsWe conducted a retrospective study of all patients undergoing orthotopic heart transplantation (OHT) or left ventricular assist device (LVAD) implantation at our institution between 2020 and 2023. Our primary exposure of interest was falls, as assessed by a nursing questionnaire within 12 months or less prior to surgery. We tracked hospital- and ICU-length of stay, duration of mechanical ventilator use, renal replacement therapy (RRT), and survival.
resultsHistory of falls was associated with prolonged mechanical support (mean difference: +1.5 days, p = 0.002), prolonged ICU stay (mean difference: +13 days, p = 0.03), and prolonged hospital stay (mean difference: +17 days, p = 0.03). Patients with a history of falls also had a higher rate of needing RRT in the 90 days following surgery (adjusted HR: 4.7, 95% CI 1.1-20, p = 0.035). There were no differences in survival between the two groups.
conclusionAmong patients with advanced HF undergoing OHT or LVAD, a simple one-item nursing falls assessment is associated with clinically relevant worse outcomes.
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