Falls are a leading cause of injury-related death, especially in those over 65 [1] and account for 87% of all fractures in this age group [2]. Fractures are among the most serious health outcomes associated with falls and of these, hip fractures cause the greatest number of deaths (one in five die within first year of fracture) and lead to the most severe health problems [3,4].Studies have suggested that patients who have had one fracture whether related or not to osteoporosis are at higher risk of sustaining a further fracture. These patients represent a group that could benefit from interventional strategies. Identifying the predictive factors for falls, and therefore susceptibility to a further fracture is thus important. These processes should ascertain who is at high risk and therefore justify further treatment [1].Both intrinsic and environmental risk factors contribute to falls and the presence of multiple risk factors increases the likelihood of a fall [5]. The factors that correlate most with recurrent falls include a history of falls in the past year, visual impairment, urinary incontinence and functional limitations defined as difficulties with at least two of: climbing stairs, using transport and cutting toenails [6,7]. Stride-to-stride gait variability and balance are also implicated and these are also associated with predicting morbidity and the likelihood of nursing home admission [8,9]. There are many other established risks for falls including medications, other forms of impaired sensory input, locomotor disorders, decreased cerebral perfusion, epilepsy, general frailty and psychiatric disorders [10]. All these factors need to be addressed in order to apply an interventional strategy to prevent recurrence of falls, fracture, morbidity and mortality in the elderly.This aim of this study is to identify common predictive factors that will predispose an elderly patient who has had one fracture following a fall, to fall in future and sustain a neck of femur fracture. Patients and methodsThis study was performed in the hospital environment and a retrospective approach to data collection was utilized in the study design. Eligible patients were identified on the basis of (1) age greater than 65 and (2) those sustaining a fracture of the neck of the femur and also sustaining another fracture of any type in the preceding 3 years (ICD-10 criteria for fractures). A form was developed for each patient. The information entered per form included patient identification, fall history, concurrent disorders, socio-demographic details and other identifiable risk factors. All entered information was correct at the time of admission for the neck of femur fracture. These data were then entered into a database and collated into percentage values to see which factors were most predictive. A full list of risk factors can be seen in Table 1. ResultsA total of 67 patients were identified as being eligible based on the inclusion criteria. Of these, 51 patients had clinical notes available for data collection to form the subs...
There is great managerial hierarchy within the NHS. Doctors play a key role in this although it may not be stated as such. This article examines the history of management in the NHS and key management skills that can be adopted by doctors to deliver effective health care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.