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 Researchers examined data on 2,456 people hospitalized for heart
attacks, heart failure, or a heart rhythm disorder known as atrial
fibrillation. Within one year of the hospitalizations, 362 patients
died, for a one-year mortality rate of 15 percent.
Based on assessments of overall health and functioning, 22 percent
of the patients had a high risk of falls and another 38 percent had
a moderate risk. Compared with people at low risk for falls,
individuals with moderate risk were 51 percent more likely to die
within one year, and patients at high risk for falls were more than
three times as likely to die.
"Increased risk of falling can be conceptualized as a proxy for
frailty, or increased vulnerability to stressors," said senior study
author Dr. Veronique Roger of the Mayo Clinic College of Medicine in
Rochester, Minnesota.
"The most important factor in reducing the risk of falls is to
preserve muscle mass and equilibrium," Roger said by email. "This
can be achieved by regular physical activity in a safe environment."
Patients in the study were 71 years old on average and many of them
had high blood pressure, elevated cholesterol, a history of smoking
and were overweight or obese.
Overall, 18 percent had at least one repeat hospitalization within
30 days of discharge. Within one year, 1,177 patients had a total of
2,325 readmissions.
Most of the repeat hospitalizations and deaths in the study were not
related to cardiovascular conditions, researchers report in
Circulation: Cardiovascular Quality Outcomes. Overall, 59 percent of
deaths, 57 percent of readmissions within 30 days and 65 percent of
repeat hospitalizations within one year were not for heart problems.
People with a higher risk of falling were much older - 81 years old,
on average, compared with 71 years old for individuals with a
moderate risk of falling and 65 for people with a low risk.
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The study wasn't a controlled experiment designed to prove whether
or how cardiovascular problems might contribute to falls or how an
elevated risk of falling might make people more likely to have
serious complications or deaths from cardiovascular disease.
Even so, the results underscore the importance of maintaining
mobility after a heart attack or hospitalization for other serious
heart problems, said Dr. Sharon Straus, director of the division of
geriatric medicine at the University of Toronto.
"When patients are admitted to the hospital with cardiac events,
they are usually put to bed and older adults can become
deconditioned in a hospital as a result - which means they get weak
and lose muscle strength," Straus, who wasn't involved in the study,
said by email.
"And, if they had cardiac problems prior to admission, this may have
impacted their mobility and functional status prior to admission,"
Straus added. "We need to assess functional status of older adults
and optimize their mobility, which will impact fall risk."
Poor mobility and functioning not only increases the risk of falls,
it can also lead to more severe injuries, said Saija Karinkanta of
the UKK Institute for Health Promotion Research in Tampere, Finland.
Falls that result in hip fractures or head injuries may lead to more
fatalities, Karinkanta, who wasn't involved in the study, said by
email.
"A good way for everybody to avoid falls is to improve mobility by
training gait, lower limb muscle strength, and balance," Karinkanta
said. "Starting exercise with an expert like a physical therapist,
is the safest way for cardiovascular disease patients."
SOURCE: https://bit.ly/2NruuZp Circulation: Cardiovascular Quality
Outcomes, online August 3, 2018.
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