Fall risk assessment by QTUG device in geriatric cancer patients on chemotherapy at a tertiary care hospital.

Abstract

1533 Background: Age-related changes, such as declines in muscle strength, balance, and coordination, are exacerbated by cancer and its treatments elevating the risk of falls. Cancer chemotherapy often lead to adverse effects which can increase fall risk. The consequences of falls in older cancer patients can be severe impacting the recovery process. The aim of the study was to estimate the baseline fall risk and frailty in geriatric patients and comparing the same after 03 cycles of chemotherapy and correlate the factors contributing to the increased risk. Methods: A prospective observational study enrolling elderly cancer patients, who are not bed-bound or using a limb prosthesis were enrolled. Patients with brain/spinal cord tumours were excluded. Fall risk assessment was done using the Kinesis Q-TUG device. Based on the scores the patients were classified into low-risk, moderate-risk and high-risk of falls. The fall risk assessment was repeated after three cycles of chemotherapy. Results: A total of 94 males and 122 females (n = 216) patients, 25% of whom were more than 70 yrs of age were enrolled. Overall the females were associated with higher fall risk and frailty compared to males. The combined fall risk estimates at baseline and post 3 cycles did not reveal a significant fall risk increase, however the timed-up-and-go (TUG) times were significantly lower post 3 cycles [Table-1]. The average stride length, stride velocity did not show any significant difference but the number of steps to turn increased post 3 cycles. Though the frailty did not show a significant difference, the correlation between fall risk and frailty showed a significant positive correlation (r = -0.91). Conclusions: While there was a slight increase in fall risk and frailty among geriatric cancer patients undergoing chemotherapy, these changes were not statistically significant. However, the decline in mobility underscores the adverse effects of chemotherapy on functional performance. The strong correlation between fall risk and frailty emphasizes the need for assessments and targeted interventions to mitigate fall risks. With increasing number of older adults with cancer, the findings advocate for enhanced monitoring and early management strategies to improve safety and outcomes for elderly cancer patients. Characteristics of QTUG device in elderly cancer patients. Parameter Category Median IQR Min Max P value Combined Fall Risk (%) Pre 49.18 73.44 - 31.53 11.78 79.46 0.098 Post 47.75 60.28 – 36.15 13.96 84.64 Combined Frailty Risk (%) Pre 63.48 74.98 – 47.27 12.33 93.15 0.743 Post 60.25 75.29 – 39.98 11.31 94.41 TUG (s) Pre 12 17 – 9.69 6.5 28.29 0.002 Post 13.44 15.8 – 11.19 7.19 274.29 Average Stride Velocity (cm/s) Pre 93.73 105.67 – 73.37 48.31 135.67 0.062 Post 95.73 115.23 – 77.29 54.22 132.66 Time taken to turn (s) Pre 2.78 3.4-2.24 1.10 36.32 <0.001 Post 6.18 7.2-5.3 3.66 56.48 Number of steps to turn Pre 2.5 3-2 1 9 <0.001 Post 3.5 4-3 2 10