Managing Geriatric Patients with Falls and Fractures

Williams, Carla T.; Whyman, Jeremy D.; Loewenthal, Julia; Chahal, Khushminder

doi:10.1016/j.ocl.2023.04.001

Cited by 7 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Physically, falls are often associated with severe complications that can lead to extended hospitalizations [ 9 ]. These hospitalizations are usually due to serious injuries, often cranioencephalic trauma, fractures, or soft tissue injuries [ 10 , 11 ]. Psychologically, falls among the older adult population tend to result in self-imposed limitations due to the fear of falling again [ 10 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Applications of Artificial Intelligence for Assessing Fall Risk: Systematic Review

González-Castro,

Leirós-Rodríguez,

Prada-García

et al. 2024

J Med Internet Res

View full text Add to dashboard Cite

Background Falls and their consequences are a serious public health problem worldwide. Each year, 37.3 million falls requiring medical attention occur. Therefore, the analysis of fall risk is of great importance for prevention. Artificial intelligence (AI) represents an innovative tool for creating predictive statistical models of fall risk through data analysis. Objective The aim of this review was to analyze the available evidence on the applications of AI in the analysis of data related to postural control and fall risk. Methods A literature search was conducted in 6 databases with the following inclusion criteria: the articles had to be published within the last 5 years (from 2018 to 2024), they had to apply some method of AI, AI analyses had to be applied to data from samples consisting of humans, and the analyzed sample had to consist of individuals with independent walking with or without the assistance of external orthopedic devices. Results We obtained a total of 3858 articles, of which 22 were finally selected. Data extraction for subsequent analysis varied in the different studies: 82% (18/22) of them extracted data through tests or functional assessments, and the remaining 18% (4/22) of them extracted through existing medical records. Different AI techniques were used throughout the articles. All the research included in the review obtained accuracy values of >70% in the predictive models obtained through AI. Conclusions The use of AI proves to be a valuable tool for creating predictive models of fall risk. The use of this tool could have a significant socioeconomic impact as it enables the development of low-cost predictive models with a high level of accuracy. Trial Registration PROSPERO CRD42023443277; https://tinyurl.com/4sb72ssv

show abstract

Section: Introductionmentioning

confidence: 99%

The Applications of Artificial Intelligence for Assessing Fall Risk: Systematic Review

González-Castro,

Leirós-Rodríguez,

Prada-García

et al. 2024

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…This is an important case as it occurred approximately 3000 years ago and appears to be the oldest case of a healed intertrochanteric hip fracture in the archaeological literature. Today, intertrochanteric hip fractures typically occur in the elderly from simple falls [ 1 , 2 ], while in younger adults (those whose femora have minimal osteopenia), they are due to higher energy events (motor vehicle crashes, falls from large height) [ 3 ]. Hip fractures in children are extremely rare [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

A Healed Intertrochanteric Femur Fracture, Shoulder, and Rib Fractures in an Ancient Nubian Female: An Osteoarchaeological Perspective

Loder,

Buzon,

Sanders

2024

The Scientific World Journal

View full text Add to dashboard Cite

This report is a case of a healed proximal intertrochanteric femur fracture nonunion in an ancient Nubian adult female, approximately 58 years old at the time of death, from the Tombos archaeological site in present day northern Sudan. Tombos was founded as an Egyptian colonial town during the New Kingdom Period (14001070 BC). The individual was radiocarbon dated to 1114-910 BC and also exhibited healed fractures of the left proximal humerus and ribs. There was shortening and mild atrophy of the right femur compared to the left; radiographs demonstrated a varus deformity of the proximal femur with associated retroversion. Bone density analysis revealed that the tissue mineral density z-score for this individual was −0.798, with the z-score for Tombos females 15–24 years old being 0.396, or a total difference of 1.194. This indicates that the individual was osteopenic but not osteoporotic prior to demise. This is an important case as it occurred approximately 3000 years ago and is the oldest known reported case of a healed intertrochanteric hip fracture in the archaeological literature. Archaeological cases of intertrochanteric hip fractures are rare, with none previously reported from the BC era. The timing of these multiple fractures is unknown, but all healed before the demise of the individual. Thus, there must have been considerable care afforded to such an individual to minimize the morbidities associated with nonoperative care of such a fracture. If all these fractures occurred at the same time due to a traumatic, accidental injury, the Modified Injury Severity Score (MISS) would be 25. Modern day trauma resuscitation and orthopaedic care gives an estimated mortality for such a MISS score of 28% for those <50 years old. It is likely that this individual’s high socioeconomic status allowed for intensive nursing care which likely decreased the morality risk.

show abstract

“…Of the fall prevention interventions studied, some results have been favorable, such as those with well-developed educational programs [11]. However, others have been inconclusive [12][13][14], prompting our center to include head injury prevention, and therefore, we investigated a head protection device (HPD), similar to a helmet. In many fields, such as construction and sports, helmets have shown efficacy in preventing head injury risks, especially moderate to severe head injury [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Head Protection Device for Individuals at Risk for Head Injury due to Ground-Level Falls: Single Trauma Center User Experience Investigation

Haag,

Kepros

2024

JMIR Hum Factors

View full text Add to dashboard Cite

Background Falls represent a large percentage of hospitalized patients with trauma as they may result in head injuries. Brain injury from ground-level falls (GLFs) in patients is common and has substantial mortality. As fall prevention initiatives have been inconclusive, we changed our strategy to injury prevention. We identified a head protection device (HPD) with impact-resistant technology, which meets head impact criteria sustained in a GLF. HPDs such as helmets are ubiquitous in preventing head injuries in sports and industrial activities; yet, they have not been studied for daily activities. Objective We investigated the usability of a novel HPD on patients with head injury in acute care and home contexts to predict future compliance. Methods A total of 26 individuals who sustained head injuries, wore an HPD in the hospital, while ambulatory and were evaluated at baseline and 2 months post discharge. Clinical and demographic data were collected; a usability survey captured HPD domains. This user experience design revealed patient perceptions, satisfaction, and compliance. Nonparametric tests were used for intragroup comparisons (Wilcoxon signed rank test). Differences between categorical variables including sex, race, and age (age group 1: 55-77 years; age group 2: 78+ years) and compliance were tested using the chi-square test. Results Of the 26 patients enrolled, 12 (46%) were female, 18 (69%) were on anticoagulants, and 25 (96%) were admitted with a head injury due to a GLF. The median age was 77 (IQR 55-92) years. After 2 months, 22 (85%) wore the device with 0 falls and no GLF hospital readmissions. Usability assessment with 26 patients revealed positive scores for the HPD post discharge regarding satisfaction (mean 4.8, SD 0.89), usability (mean 4.23, SD 0.86), effectiveness (mean 4.69, SD 0.54), and relevance (mean 4.12, SD 1.10). Nonparametric tests showed positive results with no significant differences between 2 observations. One issue emerged in the domain of aesthetics; post discharge, 8 (30%) patients had a concern about device weight. Analysis showed differences in patient compliance regarding age (χ12=4.27; P=.04) but not sex (χ12=1.58; P=.23) or race (χ12=0.75; P=.60). Age group 1 was more likely to wear the device for normal daily activities. Patients most often wore the device ambulating, and protection was identified as the primary benefit. Conclusions The HPD intervention is likely to have reasonably high compliance in a population at risk for GLFs as it was considered usable, protective, and relevant. The feasibility and wearability of the device in patients who are at risk for GLFs will inform future directions, which includes a multicenter study to evaluate device compliance and effectiveness. Our work will guide other institutions in pursuing technologies and interventions that are effective in mitigating injury in the event of a fall in this high-risk population.

show abstract

Managing Geriatric Patients with Falls and Fractures

Cited by 7 publications

References 29 publications

The Applications of Artificial Intelligence for Assessing Fall Risk: Systematic Review

The Applications of Artificial Intelligence for Assessing Fall Risk: Systematic Review

A Healed Intertrochanteric Femur Fracture, Shoulder, and Rib Fractures in an Ancient Nubian Female: An Osteoarchaeological Perspective

Head Protection Device for Individuals at Risk for Head Injury due to Ground-Level Falls: Single Trauma Center User Experience Investigation

Contact Info

Product

Resources

About