Risk Factors and Characterization of Falls in Patients on Hemodialysis: A Multicenter Study

Background: Hemodialysis (HD) patients have an increased risk of falls, which raises healthcare expenses in addition to morbidity and mortality. The purpose of this study was to assess the risk factors and characterize the features of falls in hemodialysis patients to provide direction for developing prevention strategies. Methods: 820 HD patients from four hemodialysis facilities participated in this multi-center cross-sectional study. Online self-made questionnaires was used to gather general information about HD patients as well as fall characteristics. We analyzed the characteristics of fall patients and employed the multivariate logistic regression model to assess the risk factors of falls. Results: A total of 820 hemodialysis patients were actually included in the statistics, consisting of 60.1% males (493 patients) and 39.9% females (327 patients), with an average age of 58.5±14.3 years old and a median dialysis vintage of 42 months. A total of 187 patients (22.8%) experienced falls, with an average age of 60.5 ± 14.6 years old. The incidence of falls was 19.7% (97 fallers) in males and 27.5% (90 fallers) in females. 358 falls occurred overall, of which 50.8% happened during daytime activity. 78.8% of falls led to varying degrees of injury, with the most common injury being soft tissue contusion. Falls most often occur in the living room or bedroom of the home. The leading symptoms in hemodialysis patients before falling was dizziness (26.3%) or lower limb weakness (34.4%). The results of multivariate logistic regression analysis indicated that age 65 and over (OR=1.699, 95%CI: 1.183-2.439, P=0.004), females (OR=1.505, 95%CI:1.070-2.118, P=0.019), and longer dialysis vintage (OR=1.475, 95%CI:1.224-1.779, P=0.000) were independent risk factors for falls among hemodialysis patients. Conclusion: In summary, our results showed that the incidence of falls was higher in hemodialysis patients (22.8%), with females having a higher incidence than males. Female gender, age older than 65 years, and longer dialysis vintage are critical risk factors for falls among hemodialysis patients. Future research should explore specific interventions to reduce the risk of falls and improve the overall safety and quality of life for hemodialysis patients.