title: Predictors of fracture from falls reported in hospital and residential care facilities: a cross-sectional study.
abstract: OBJECTIVE
  Fall-related fractures are associated with substantial human and economic costs. An improved understanding of the predictors of fall-related fractures in healthcare settings would be useful in developing future interventions. The objective of this study was to identify such predictors by exploring associations between fall-related factors and fracture outcomes through logistic regression analysis of routinely collected fall incident data.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  197 public healthcare facilities in Queensland, Australia.
  
  
  METHODS
  We included data from incident reports completed after falls among admitted adult hospital patients (n=24 218 falls, 229 fractures) and aged-care residents (n=8980 falls, 74 fractures) between January 2007 and November 2009.
  
  
  METHODS
  The outcomes of interest were fall-related predictors of fracture.
  
  
  RESULTS
  Hospital patients who reported to have been screened for their risk of falling at admission were less likely to fracture after a fall (OR: 0.60, 95% CI 0.41 to 0.89) than those who had not been screened. Further, falls from standing (OR: 2.08, 95% CI 1.22 to 3.55) and falls while walking (OR: 1.86, 95% CI 1.32 to 2.62) were associated with higher fracture odds than falls during other activities. In line with these results, falls while reaching in standing (OR: 3.51, 95% CI 1.44 to 8.56) and falls while walking (OR: 2.11, 95% CI 1.24 to 3.58) were also predictive of fracture in the adjusted residential care model.
  
  
  CONCLUSIONS
  Our findings indicate that screening of hospital patients for their risk of falling may contribute towards the prevention of fall-related injury. Falls from upright postures appear to be more likely to result in fractures than other falls in healthcare settings. Further prospective research is warranted.
authors.affiliation: Falls Prevention, Safety and Quality Unit, Royal Brisbane and Women's Hospital, Queensland Health, Australia.
authors.forename: Satyan
authors.initials: S
authors.lastname: Chari
authors.forename: Prue
authors.initials: P
authors.lastname: McRae
authors.forename: Paul
authors.initials: P
authors.lastname: Varghese
authors.forename: Kaye
authors.initials: K
authors.lastname: Ferrar
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
keywords: Geriatric Medicine
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