Chronic Venous Insufficiency and Fall Risk

Purpose: Chronic venous insufficiency (CVI) damages the legs and negatively affects mobility. Critical variables examined in both the fall risk and CVI literature include balance, gait, mobility, and pain; yet, research is lacking about CVI as a risk factor for falls. We examined the association between CVI and fall risk for persons in methadone treatment.

Methodology: We used a cross-sectional, comparative design with stratification for type of drug use, sex, age, and race. Demographic, health, ankle goniometry for ankle mobility, activity level, and pain data were collected. The Clinical CEAP scale was used to assess CVI (e.g., none to current ulcers). Fall risk was calculated from the Tinetti Balance and Gait tests with a score of 24 or less indicating a risk of falls.

Statistics: We used descriptive and correlation statistics.

Results: The 713 participants included men (46.9%) and African Americans (61.7%). They had a mean age of 46 years and a mean of 2.91 co-morbidities. Worsening CVI was significantly (p<.001) associated with increased fall risk (r=.32), poor ankle mobility (r=-.44), poor balance (r=-.34), poor gait (r=-.33), and increased leg pain (r=.31). Fall risk was negatively (p<.001) associated with slow walking (r=-.43), decreased physical activity (r=-.42), and difficulty performing activities (r=.51).

Conclusions: In a drug treatment population, CVI was associated with increased fall risk. Fall risk was associated with decreased mobility; yet, maintaining mobility is important for those with CVI. Since CVI most commonly occurs in older adults, the effect of CVI on fall risk in both drug use and general populations needs further study. WOC nurses can add to the science of fall risk indicators, quality of care, and patient safety with research about lower extremities changes.

Funding: NINR/NIH, Effect of Drug Use on the Legs: Chronic Venous Insufficiency, Mobility and Pain, R01 NR009264.