Incidence and risk factors of falls in patients undergoing hemodialysis: A multicenter survey in northern China

Introduction

Patients undergoing hemodialysis (HD) are at a higher risk of falls than healthy individuals. Further knowledge regarding the risk of falls could lead to better risk prevention strategies. We designed a multicenter, prospective cohort study according to the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines to investigate the incidence and risk factors of falls in patients undergoing hemodialysis in Northern China.

Methods

Patients undergoing hemodialysis in six hemodialysis units were recruited from January 2019 to January 2020. Data on demographics and disease conditions were collected at baseline. Data on other variables, the incidence of falls, and related conditions were collected every 3 months during a 1-year follow-up. The Generalized Estimating Equation model was used to evaluate factors associated with falls.

Findings

This study included 472 patients. The incidence of falls was 0.31 per patient year. In patients aged 45–64 years (p = 0.01; odds ratio [OR]: 14.801; 95% confidence interval [CI]: 1.897–115.453) and ≥ 65 years (p = 0.007; OR: 16.562; 95% CI: 2.118–129.521), anemia (p = 0.015; OR: 2.122; 95% CI: 1.154–3.902) and moderately (p = 0.003; OR: 5.439; 95% CI: 1.791–16.516) and severely abnormal timed up and go test (TUGT) levels (p = 0.001; OR: 7.032; 95% CI: 2.226–22.216) were identified as independent risk factors of falls.

Discussion

Falls are prevalent among patients undergoing in-center hemodialysis. Advanced age, anemia, and moderately and severely abnormal TUGT levels may be risk factors of falls.