Abstract
Background: Most hip fractures are due to falls among frail elderly people. In order to formulate strategies to prevent falls leading to hip fracture, the characteristics of the falls of patients should be clarified in more detail. We investigate the fall situations of hip fracture patients. Methods: The fall conditions of eighty female and seventeen male hip fracture patients with an average age of 82.3 y.o. who were admitted to the hospital of the National Center for Geriatrics and Gerontology, Japan over a two-year period were investigated by questionnaire concerning 1) the time of falling, 2) the place of falling, 3) what they were doing at the moment of falling, and 4) the cause of falling. Their Barthel Index, representing patients’ ADL capability before injuries, was obtained as well, and the relation between falling situations and the Barthel Index score was analyzed. Results: The most frequent time, place, cause of the fall and activities at the time of the fall were in the evening (from 5 to 9 P.M.), in their own room, and involved their loss of balance and walking, respectively. Those who fell in the following situations had lower ADL capacity before injury: occurring at evening and night, either in the toilet or other places indoors and at falling, from losing their balance or slipping. Conclusion: Fall situations causing hip fractures differed considerably with the hip fracture patients’ capacities before injury. These differences must be taken into careful consideration in order to formulate effective strategies in hip fracture prevention.
Highlights
Prevention of hip fractures is a critical issue because it is one of the most common injuries which cause frail old people to become bedridden
We present the results of our investigations of fall situations in hip fracture patients and describe the results of our analysis of the relations between fall states and their capability for Activities of Daily Living (ADL) before injury
Subjects are patients who were admitted to the hospital of the National Center for Geriatrics and Gerontology (Obu, Aichi, Japan) for the treatment of proximal femoral fracture over a two-year period and gave their written informed consent to the investigation of their fall situations
Summary
Prevention of hip fractures is a critical issue because it is one of the most common injuries which cause frail old people to become bedridden. According to recent research reports of the Japanese Orthopedic Association, 70-80% of hip fractures occur by a fall from the standing position, and two-thirds of the falls take place inside the house [2]. This is quite different from the falls of general community dwellers, which occur mainly outside the house [3,4,5]. Considering the differences between the two; fall prevention strategies for healthy (or almost healthy) old people in general may not necessarily be suitable for when targeting hip fractures.
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