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Characteristics and Risk factors of Fall in Elderly Hip Fracture Patients : 고령 고관절 골절 환자의 낙상 특성 및 요인

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Authors

이훈훈

Advisor
임재영
Major
의과대학 의학과
Issue Date
2018-02
Publisher
서울대학교 대학원
Keywords
Fallhip fractureelderlyfall mechanismfall characteristics (낙상고관절 골절노인낙상 기전낙상 요인)
Description
학위논문 (석사)-- 서울대학교 대학원 : 의과대학 의학과, 2018. 2. 임재영.
Abstract
Introduction: Falls and fall-related injuries are in big concerns as major health issues in elderly as it can cause considerable mortality and deteriorating QOL. To prevent hip fracture after fall, not only the risk factors for hip fracture, but also understanding the fall mechanism need to be investigated in hip fracture patients. This study tried to find out the fall mechanism and the association of risk factors in elderly hip fracture patients in Korea
Methods: Fall-related hip fracture patients who underwent hip surgery in our institute and transferred to our department from January 2014 to February 2017 were retrospectively recruited. Demographic data, fracture type and operation type, fall characteristics and functional evaluations were recorded for analysis.
Results: Most of patients fell to the side and backward on buttock. Age and gender differences were not significant in the direction of falls. The main mechanisms of fall were slip, followed by sudden weakness, more prominent in female. Patients aged 85 or above experienced more slipped down events than below 85. Most of falls happened during walking whereas falling backward on buttock was often seen while standing, especially in male. Seventy one percent of patients fell at home. Roughly half of patients were previously healthy. Most common comorbidity was hypertension, followed by osteoporosis and diabetes mellitus. Prevalent risk factors were gait difficulty followed by balance deficit, multiple medications, impaired functional status, cognitive impairment, postural hypotension. By cross analysis, male and age below 85 with better DEXA score showed more fall down event by blockage of something while walking compared with other activities, and both male and female with postural hypotension fell with sudden weakness, in statistical significance.
Conclusions: Most hip fractures occurred after slip down, to the side, and fall backward on buttock by sudden weakness. By cross analysis, there were two statistically significant association in fall mechanism
male and age below 85 though had better bone mineral density showed more fall down event by blockage of something while walking compared with other activities, and both male and female with postural hypotension are easily fell down with sudden weakness. These findings could provide some clues to make the prevention strategy based on the fall mechanisms.
Language
English
URI
https://hdl.handle.net/10371/142316
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