Document Type
Article
Publication Date
4-14-2025
Abstract
Introduction: Frailty 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. Methods: We 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. Results: History 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. Conclusion: Among patients with advanced HF undergoing OHT or LVAD, a simple one-item nursing falls assessment is associated with clinically relevant worse outcomes.
Keywords
dialysis, fall, frailty, heart transplant, LVAD, mortality
Language
English
Publication Title
Clinical Transplantation
Rights
© 2025 The Authors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/), which permits non-commercial copying and redistribution of the material in any medium or format, provided the original work is not changed in any way and is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Salvador, V.D., Perez, J.A., Hudec, P.W., Gorodeski, E.Z. and JosephO'Neill, T., IV (2025), A Simple One-Item Nursing Falls Assessment Predicts Outcomes for Patients With Stage D Heart Failure Undergoing Surgical Advanced Therapies. Clinical Transplantation., 39: e70146. https://doi.org/10.1111/ctr.70146
Manuscript Version
Final Publisher Version