A prospective cohort study to predict fall risk in patients with recent hip fracture

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A prospective cohort study to predict fall risk in patients with recent hip fracture

 

Author: Yau, Tsui-yi Dora
Title: A prospective cohort study to predict fall risk in patients with recent hip fracture
Degree: M.Sc.
Year: 2010
Subject: Hong Kong Polytechnic University -- Dissertations
Falls (Accidents) in old age -- Prevention.
Falls (Accidents) in old age -- Risk factors.
Cohort analysis
Hip joint -- Fractures
Department: Dept. of Rehabilitation Sciences
Pages: xi, 104 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2353068
URI: http://theses.lib.polyu.edu.hk/handle/200/5653
Abstract: Introduction: Patients who have sustained a hip fracture may have a higher risk for recurrent falls and hence, further injuries. The aim of this study was to identify the fall risk factors among community-dwelling elderly who had recently received a hip surgery as a result of a hip fracture. Methods: This was a prospective cohort study. Sixty-six older adults (age ≥ 65 years) who had sustained a hip fracture and were referred to Tung Wah Eastern Hospital for rehabilitation post-surgery participated in the study. After completion ofthe inpatient rehabilitation program, fall risk factors were assessed by using the Physiological Profile, and the guidelines on fall prevention adopted by the Hong Kong Hospital Authority. Follow-up infonnation on falls and related injuries was collected on a monthly basis by telephone interview. Mann-Whitney U tests (for continuous and ordinal variables) and Chi-square tests (for nominal variables) were used to compare the variables of interest between fallers and non-fallers. For those variables that showed a significant between-group difference. receiver operating characteristic (ROC) curves were constructed to detennine the optimal cutoff score. Univariate logistic regression analyses were then conducted to identify the odds ratio of each fall-related risk factor. Results: A new fall incident was reported by 8 patients during the follow-up period. Seven of them had one fall and one of them had two falls. Logistic regression analyses revealed that age (OR 5.7;95% CI: 1.05 -30.87), ankle dorsi-flexor muscle strength (OR 7.235; 95% CI: 1.325 -39.497), knee extensor muscle strength (OR 7.88; 95% CI: 1.438 -43.139), visual acuity (OR 8.6; 95% CI: 1.564 -47.303), postural sway while standing on foam with eyes open (OR 10.562; 95% CI: 1.228-92.397). Maximum Balance score (OR 6.67; 95% CI: 1.225 -36.283), were significant predictors of falls. In addition those who had received extended rehabilitation had lower risk of falls than those who had not received any extended rehabilitation (OR 6.36; 95% CI: 1.16 -34.81). Conclusion: Advanced age, lower extremity muscle strength, visual acuity, standing balance were significant intrinsic factors that contributed to falls among those patients who had recently undergone a hip surgery following the first hip fracture. In addition, those extended rehabilitation also had lower risk of falls than those who had not received the same service. The results point to the potential importance of training leg muscle strength and balance in our rehabilitation programs, in order to prevent falls in this patient population.

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