58 Epidemiology of Falls and HIP Fractures among the Elderly Community Dwellers in Malaysia

Abstract

Introduction Elderly community dweller has a high risk of falls. It has a high incidence of morbidity and mortality if it involves hip fractures. Our aim is to report the incidence of falls presenting with hip fractures to a Malaysian tertiary centre. Method We have collected data from a Malaysian tertiary centre. The incidence of falls involving elderly patients aged 65 and above from January 2018 till December 2018 was examined. The falls were divided based on the time of fall, place and the type of fracture. Time of fall was divided into day (0800 to 1559), evening (1600 to 2359), night (0000 to 0759). The place was either outdoor or indoor. Results There were 114 falls that involved hip fractures recorded over the past 12 months. There were 85 female cases versus 29 male cases. The average age was 77.3 years. There was a higher incidence in the Chinese (n=59) followed by the Malay (n=40) and Indian (n=15). There were no cases of nursing homes falls that involved hip fractures. Most of the falls with hip fractures occurred indoor with only 11 cases that occurred outdoor. The falls tend to occur in the day (n=65) followed by evening (n=31) and night (n=18). October recorded the highest number of falls with 14 cases followed by April (n=13), and December (n=12). The type of fracture in descending order were intertrochanteric fracture (n=61), neck of femur fracture (n=47), subtrochanteric fracture (n=4) and acetabular fracture (n=2). Conclusion Asians generally care for their aging parents in the family home. Although falls were reported to be higher in nursing homes, this differs in the Asian population. Therefore, fall prevention measures should be implemented at home as falls is a significant cause of morbidity and mortality in the elderly especially if it involves hip fractures.

The Current and Future Challenges of Hip Fracture Management in Malaysia

“…These individuals were older, multimorbid, mostly female and were already at risk of falls and fractures. In Malaysia, the average age ranged from 74-79 years 15 - 19 , up to 75% were female 14 - 18 , 20 , 77% had at least one comorbid illness 15 , 16 , 18 and 26% were considered multimorbid 18 . Of the most common comorbid illnesses, the prevalence of diabetes mellitus was reported between 25-46% 15 , 16 , 21 , hypertension between 34-74% 15 , 16 , 21 , ischaemic heart disease between 311% 15 , 16 , and stroke between 6-10% 15 , 16 , 21 .…”

“…The American Society of Anaesthesiologists (ASA) classification was the most common risk assessment tool used pre-operatively 18 , 22 . Most individuals were surgically managed, and this was reported between 67-100% 17 , 19 , 21 , 23 . ASA 1 and 2 made up almost 85% of these patients 18 , 22 .…”