The impact of treatment of orthostatic hypotension on falls in elderly patients admitted to acute geriatric care in a university hospital centre

Context: Orthostatic hypotension (OH) is at risk of complications in the geriatric population. Aims: Evaluation of the diagnostic and therapeutic approach concerning an OH and their effectiveness in a university geriatric service. Research of risk factor of fall. Method: Quantitative, retrospective, observational, single-centre study, on practices in accordance with standards of care. Results: 352 patients were included, 42% were men with an average age of 87.6±5.4 years. Patients were often taking multiple medications (hypotensive and psychotropic drugs). Most patients lived at home and used a walking help. A search for OH was carried out in 69.9% of cases and found in 36.4%. A therapeutic decision was taken in 92.9% of patients (venous restraint, reduction of therapy or specific therapy). Re-evaluation was rarely carried out. At the end of follow-up: 30.4% of patients were rehospitalised for falls. A protective factor was treatment with ACEI on admission. Conclusion: Although OH is often sought and found in cases of hospital admission for falls in geriatric ward, therapeutic are rarely re-evaluated. Their effectiveness is difficult to assess. The potential consequences of OH mean that we need to better determine the key-elements of the multidimensional answer.