ISSN: 2640-2734
Authors: Daus D* and Srinivasan J
Background: Recent publications by the American Occupational Therapy Association (AOTA) and the American Physical Therapy Association (APTA) aim at guiding families and therapies in strategies that make movement in the home and the community safer for patients with HD. Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder resulting in deficits in motor, cognitive and psychiatric function. Hospitalizations due to HD and its complications are common during some stage of the illness. Falls, multiple medical conditions, poor ability to breathe or swallow and acute psychiatric distress have been noted as some of causes leading to hospitalization. Objectives: Determination of correlations between falls, severity levels, admitting diagnosis and number of ICD-10 codes for psychiatric comorbidities was reviewed in the Healthcare cost and Utilization Project (HCUP) data for the 2016 National Inpatient Sample (NIS) for inpatients with HD. Methods: Patient cases in the 4th quarter of the NIS were searched for inpatients with HD as their admitting, 2nd, 3rd and 4th diagnosis until N=230. Secondary data analysis compared variables in the NIS. Results: Level of severity was consistently higher for hospitalization within patient severity levels 2 and 3 in the sample at 72%. Severity of HD diagnosis when admitting diagnosis was HD, was statistically significant differences with the majority of inpatients injuries or fall HD severity was reported as level 2. Falls were most significantly correlated when compared to the number of psychiatric diagnosis on record (p <.001). Discussion: The most significant mild predictor of falls (33.4%) was the presence of multiple additional inpatient psychiatric diagnoses including dementia, anxiety, depression, bipolar disorder and schizophrenia. Chi-Squared analysis results indicated the greatest difference between expected falls and actual falls occurred in the presence of multiple psychiatric diagnosis’s (p<.001). Researchers in occupational and physical therapy investigating falls in the HD population could benefit from proposing psychiatric frames of reference for treatments for falls in addition to organized strategies of exercise and improvement of motor control.
Keywords: Huntington’s Disease; Falls; Psychiatric Diagnosis; Occupational Therapy; Physical Therapy
