Orthostatic Hypotension and Falls in Hospitalized Older Adults.

Orthostatic vital signs reflected one point in time, so orthostatic hypotension occurring at other times during hospitalization was not captured. The study could not check whether bedside staff measured blood pressure correctly, and the record did not show the time between position changes. Medications, symptoms, fluid intake, and treatments related to orthostatic hypotension were not collected, so their role cannot be judged. The number of patients with valid first orthostatic vital sign readings was 7745, while fall data were available for 7969 patients. Falls were rare, with 99.22% of patients with fall data having no falls, so few fall events were available to compare groups. The sample came from one health system and lacked ethnic diversity, so the results may not generalize. The exploratory models performed poorly, with an AUC of 0.63, and did not predict any patient as having a fall.

The authors declared no potential conflicts of interest, and the publication types indicate N.I.H. extramural research support.

Do not conclude that orthostatic vital signs should be removed from fall prevention because orthostatic hypotension was not significantly associated with falls. The odds ratio was 1.34, the 95% confidence interval was 0.82 to 2.21, and p=0.2494, while orthostatic vital signs were measured at one point in time.