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Susan J Leat, Aleksandra Zecevic, Alexis Keeling, Dylan Brennan, Denise Hileeto, Tammy Labreche, Chris Brymer; Is Vision Loss Linked to Falls among Hospital Inpatients?. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Falls of hospitalized patients are a serious and costly problem in healthcare. Although reduction in vision is a known risk factor for falls, current hospital policies and practices do not include an assessment of vision at patient admission or post-falls. Nor is vision included in the hospital’s reporting system of adverse events. This study’s purpose was to explore the prevalence of vision loss among adult hospitalized patients and the possible link between vision loss and falls that occur during hospitalization.
This was a cross sectional study of vision among adult hospital patients in the medicine units of an acute care hospital. The study also included a case-control component of those who fell during their hospital stay. Exclusion criteria were patients who had a legal substitute decision-maker for medical decisions and those who were wheelchair bound. The following parameters were measured; ETDRS visual acuity (monocularly and binocularly) with by-letter scoring, binocular contrast sensitivity with the Mars chart, stereoacuity with the Randot circles, screening for field loss by confrontation, and neglect. Data on medications, health diagnoses, ocular history, age and sex were recorded. Each faller was matched with a non-faller for age, sex, a weighted multi-morbidity score and a weighted medication score.
There were 115 participants, average age 67±17.5 (range 24-95), 48% female. Overall, 88.7% of participants had a visual impairment (outside the age-norms for one or more vision measure), 61.7% had low vision, and 35.6% had vision loss equivalent to legal blindness (VA≤6/60 or ≥ 1 log unit [10x] loss compared to age-norms). There was a discrepancy between the prevalence of low vision (61.7%) and the percentage of patients who reported an ocular diagnosis that would result in visual loss (38.3%). Ten patients fell during their hospital stay. Significantly more fallers had visual impairment based on VA or reduced stereopsis than the matched non-fallers (Barnard’s test, p<0.05).
Vision loss has a high prevalence in this hospital population and it is notably higher than in community dwelling older adults. Vision appears to be one of many contributing factors for falls that occur in hospitals. Since patients are often unaware of their vision loss, implementing an actual measure of vision at admission would be more useful than a patient questionnaire.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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