Falls: descriptive rates and circumstances in age-unspecified patients with locally advanced esophageal cancer
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ORIGINAL ARTICLE
Falls: descriptive rates and circumstances in age-unspecified patients with locally advanced esophageal cancer Daniel S. Childs 1 & Harry H. Yoon 1 & Rachel A. Eiring 1 & Zhaohui Jin 1 & Jacob A. Jochum 1 & Henry C. Pitot 1 & Aminah Jatoi 1 Received: 22 January 2020 / Accepted: 5 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Falls can occur in older cancer patients, but few studies have examined falls in an age-unspecified group of patients with locally advanced esophageal cancer. Because these patients are often administered neuropathy-inducing agents, are weak, and can develop orthostatic symptoms, examining falls appears relevant. Methods Electronic medical records were used to examine falls and their circumstances in locally advanced esophageal cancer patients treated with chemotherapy and radiation and often surgery. Results Among 300 patients, 62 (21%) suffered a fall, yielding 6 falls per 100 patient years. The median age at first fall was 64 years (range 31 to 83). The median time from cancer diagnosis to first fall was 11 months (range 0 to 107). Forty-two patients (68%) who fell had active cancer; 20 (32%) were cancer-free. Fall-related injuries occurred in 42 patients and included fractures, hematomas, and other musculoskeletal events. Eighteen patients (29%) fell repeatedly. Neuropathy, general weakness, and orthostatic symptoms were associated with falls (“He does state his neuropathy is more bothersome…. He did have a fall last week….” “He has been increasingly weak to the point where he fell down last week….” “Upon rising… [he] felt like somebody had put a sheet over his eyes, felt very lightheaded, and fell to the floor….”). At times, falls occurred under commonplace circumstances, such as slipping on ice or tripping on an underfoot pet. Conclusion Regardless of patient age, clinicians should remain vigilant for fall risk in adult patients with locally advanced esophageal cancer. Keywords Falls . Esophageal cancer . Younger patients . Neuropathy . Fracture
Introduction Falls can result in fractures, soft tissue injury, hemorrhage, pain, debility, nursing home placement, fear of falling again, poor quality of life, and sometimes even death. The magnitude of the problem of falls and their negative impact is captured in the statistic that $50 billion healthcare dollars are expended each year in the USA for the management of the trauma and incapacitation that occur from these untoward events [1]. In the setting of cancer, the study of falls has largely focused on geriatric patients. Although reported fall rates vary in the published literature, it appears that approximately 20% of * Aminah Jatoi [email protected] 1
Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
geriatric cancer patients recall having fallen in the preceding 6 months [2]. However, regardless of age, many cancer patients remain at risk for development of chemotherapyinduced numbness, loss of muscle mass and strength, and, at times, ortho
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