title: Four-wheeled walker related injuries in older adults in the Netherlands.
abstract: BACKGROUND
  With ageing populations worldwide, mobility devices are used more than ever. In the current literature there is no consensus whether the available mobility devices safely improve the mobility of their users. Also, evidence is lacking concerning the risks and types of injuries sustained while using a four-wheeled walker.
  
  
  OBJECTIVE
  To assess injury risks and injury patterns in older adults (≥65 years) who presented at Emergency Departments (ED) in the Netherlands with an injury due to using a four-wheeled walker.
  
  
  METHODS
  In this study, the Dutch Injury Surveillance System was used to obtain a national representative sample of annual ED visits in the Netherlands in the adult population (≥65 years) sustaining an injury while using a four-wheeled walker. The numbers of four-wheeled walker users in the Netherlands were obtained from the national insurance board. The numbers of ED visits were divided by the numbers of four-wheeled walker users to calculate age- and sex-specific injury risks.
  
  
  RESULTS
  Annually 1869 older adults visited an ED after sustaining an injury while using a four-wheeled walker. Falls were the main cause of injury (96%). The injury risk was 3.1 per 100 users of four-wheeled walkers. Women (3.5 per 100 users) had a higher risk than men (2.0 per 100 users). Injury risk was the highest in women aged 85 years and older (6.2 per 100 users). The majority of injuries were fractures (60%) with hip fracture (25%) being the most common injury. Nearly half of all four-wheeled walker related injuries required hospitalisation, mostly due to hip fractures. Healthcare costs per injury were approximately €12 000.
  
  
  CONCLUSIONS
  This study presents evidence that older adults experiencing a fall while using a four-wheeled walker are at high risk to suffer severe injuries.
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, , Rotterdam, The Netherlands.
authors.forename: K M M
authors.initials: KM
authors.lastname: van Riel
authors.forename: K A
authors.initials: KA
authors.lastname: Hartholt
authors.forename: M J M
authors.initials: MJ
authors.lastname: Panneman
authors.forename: P
authors.initials: P
authors.lastname: Patka
authors.forename: E F
authors.initials: EF
authors.lastname: van Beeck
authors.forename: T J M
authors.initials: TJ
authors.lastname: van der Cammen
mesh_terms: D000058:Accidental Falls / Q000191:economics / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D017678:Sex Distribution; D014853:Walkers / Q000009:adverse effects*; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology / Q000209:etiology*