June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Predicting the likelihood of an inpatient fall as a function of visual pathology, visual acuity, and constitutive health.
Author Affiliations & Notes
  • Giovanni Campagna
    School of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • Sumitra Khandelwal
    School of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • Kristin Biggerstaff
    School of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • Silvia Orengo-Nania
    School of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • Footnotes
    Commercial Relationships   Giovanni Campagna, None; Sumitra Khandelwal, None; Kristin Biggerstaff, None; Silvia Orengo-Nania, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1336. doi:
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      Giovanni Campagna, Sumitra Khandelwal, Kristin Biggerstaff, Silvia Orengo-Nania; Predicting the likelihood of an inpatient fall as a function of visual pathology, visual acuity, and constitutive health.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1336.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Adult falls result in significant morbidity with associated healthcare costs approaching 20 billion dollars annually. Identifying patients at high risk for a fall and instituting fall prevention strategies would reduce suffering and expense. This study seeks to determine the correlation between visual pathology and risk of an inpatient fall.

Methods : This retrospective analysis studied the medical records of patients admitted to the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) in January 2014 who had also been examined in the Eye Clinic within 1 year of their admission date. Fall patients had at least one fall during their inpatient stay, and controls had none. The patients’ eye examinations, including presenting best corrected visual acuity (BCVA), spherical equivalent (SEQ), and ophthalmic diagnoses as well as other indicators of constitutive health, were compared between the groups. Homoscedastic t-test was used for statistical analysis.

Results : Of the 400 patients admitted during the study period, 34 (8.5%) had documented inpatient falls. Baseline demographics were similar in the fall (test) group and the non-fall (control) group including age, race, and gender. Age-related macular degeneration (AMD) was a statistically significant predictor of a fall (p<0.01, OR 4.06, CI 1.50–11.01). A history of myocardial infarction was also predictive (p<0.01, OR 7.22, CI 1.65–31.69). Additionally, a difference of 2 or more lines on the Snellen chart between the BCVA of each eye was predictive (p<0.05, OR 2.37, CI 1.01–5.58). A comparison of the mean logmar of BCVA in the better seeing eye between the groups was not statistically significant (p=0.46). A comparison of the mean SEQ in the better seeing eye between the groups was not statistically significant (p=0.40). BCVA of 20/40 or worse in the patient’s best eye was not predictive of a fall (p=0.29, OR 1.57, CI 0.68–3.64).

Conclusions : Disease states like AMD predispose patients to a greater risk of a fall, likely due to acquired loss of central vision and its impact on depth perception. It also stands to reason that a difference of 2 or more Snellen chart lines between the BCVA of each eye would yield similar difficulties. The analysis will be augmented upon review of the remaining annual charts.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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