title: Clinical evidence of diabetes mellitus end-organ damage as risk factor for falls complicated by hip fracture: A multi-center study of 1225 patients.
abstract: OBJECTIVE
  To identify the differential characteristics of patients with type 2 diabetes mellitus (T2DM) complicated by end-organ damage who experience a fall-related hip fracture.
  
  
  METHODS
  We analyzed the socio-demographic data and index fall clinical characteristics of a group of patients with nephropathy, neuropathy or retinopathy related to T2DM consecutively admitted to six hospitals in Barcelona, Spain because of a fall-related hip fracture.
  
  
  RESULTS
  Out of 1225 patients admitted because of a fall-related hip fracture, 107 (8.7%) had clinical evidence of end-organ damage related to T2DM. Among this cohort the mean number of falls during the year prior to the index admission was 2.6±3.2; and 29 of them (27.1%) had already experienced three or more falls. Most falls leading to the index admission took place at the patients' home, from a standing position, and during daylight time. An intrinsic cause of falling was identified in all but one of these patients. Multiple stepwise logistic regression analysis showed that, compared to patients without this diagnosis, patients with complicated T2DM were younger (odds ratio 0.762), had less prevalence of dementia (odds ratio 0.078), but had experienced a higher number of falls in the previous year (odds 1.183).
  
  
  CONCLUSIONS
  A significant amount of patients with clinical evidence of end-organ damage due to T2DM who experience a fall-related hip fracture have a history of recurrent falling in the previous year. These patients should be identified and offered preventive actions aimed at reducing their risk of falling.
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: fformiga@bellvitgehospital.cat.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Chivite
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Sant Pau, IDIBAPS, Barcelona, Spain.
authors.forename: Domingo
authors.initials: D
authors.lastname: Ruiz
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Clinic, IDIBAPS, Barcelona, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Navarro
authors.affiliation: Geriatric Unit, Hospital Sociosanitari Isabel Roig (Centres Blauclinic), Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Perez Castejon
authors.affiliation: Geriatric Service, Hospital d'Igualada, Consorci Santiàri de l'Anoia, Barcelona, Spain.
authors.forename: Enric
authors.initials: E
authors.lastname: Duaso
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Abelardo
authors.initials: A
authors.lastname: Montero
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Clinic, IDIBAPS, Barcelona, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Lopez-Soto
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Albert Jovell Institute for Public Health and Patients, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Corbella
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Diabetes; Elderly; End-organ damage; Fall; Hip fracture