Recurrent and injurious falls in the year following hip fracture: a prospective study of incidence and risk factors from the Sarcopenia and Hip Fracture study.
BACKGROUND
The incidence and etiology of falls in patients following hip fracture remains poorly understood.


METHODS
We prospectively investigated the incidence of, and risk factors for, recurrent and injurious falls in community-dwelling persons admitted for surgical repair of minimal-trauma hip fracture. Fall surveillance methods included phone calls, medical records, and fall calendars. Potential predictors of falls included health status, quality of life, nutritional status, body composition, muscle strength, range of motion, gait velocity, balance, walking endurance, disability, cognition, depression, fear of falling, self-efficacy, social support, physical activity level, and vision.


RESULTS
193 participants enrolled in the study (81 +/- 8 years, 72% women, gait velocity 0.3 +/- 0.2 m/s). We identified 227 falls in the year after hip fracture for the 178 participants with fall surveillance data. Fifty-six percent of participants fell at least once, 28% had recurrent falls, 30% were injured, 12% sustained a new fracture, and 5% sustained a new hip fracture. Age-adjusted risk factors for recurrent and injurious falls included lower strength, balance, range of motion, physical activity level, quality of life, depth perception, vitamin D, and nutritional status, and greater polypharmacy, comorbidity, and disability. Multivariate analyses identified older age, congestive heart failure, poorer quality of life, and nutritional status as independent risk factors for recurrent and injurious falls.


CONCLUSIONS
Recurrent and injurious falls are common after hip fracture and are associated with multiple risk factors, many of which are treatable. Interventions should therefore be tailored to alleviating or reversing any nutritional, physiological, and psychosocial risk factors of individual patients.
Lloyd
Bradley D
BD
Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, New South Wales, Australia.
Williamson
Dominique A
DA
Singh
Nalin A
NA
Hansen
Ross D
RD
Diamond
Terrence H
TH
Finnegan
Terence P
TP
Allen
Barry J
BJ
Grady
Jodie N
JN
Stavrinos
Theodora M
TM
Smith
Emma U R
EU
Diwan
Ashish D
AD
Fiatarone Singh
Maria A
MA
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000150:complications*; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D012008:Recurrence; D012307:Risk Factors