The relationship of fall-related fractures to social deprivation

Court-Brown, Charles M.; Aitken, Stuart A.; Ralston, Stuart H.; McQueen, M. M.

doi:10.1007/s00198-010-1315-1

Cited by 31 publications

(17 citation statements)

References 28 publications

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“…In a recent study, Court-Brown et al [7] demonstrated the influence of social deprivation on the incidence of fractures from simple falls, and our results confirm that this influence also extends to fractures related to falls on stairs. Notably the greatest difference between patient groups was seen between Quintiles 4 and 5, with far less variation identified between the Quintiles 1, 2, and 3.…”

Section: Isrn Epidemiologysupporting

confidence: 86%

“…The Carstairs score is a -score based on overcrowding, male unemployment, social class, and car ownership. It has been extensively used to examine social deprivation in orthopaedic surgery [7,8,12] and other branches of medicine [9,13]. The Carstairs score can be used to divide the population of Scotland into five equal quintiles, with Quintile 1 (Q1) being the most affluent and Quintile 5 (Q5) being the most deprived.…”

Section: Methodsmentioning

confidence: 99%

“…Socioeconomic deprivation is known to have an influence on the incidence of fractures from falls from standing height [7], the outcome of joint replacement surgery [8], and the prevalence of chronic medical conditions such as heart disease [9]. As yet, the influence of deprivation on fractures caused by falls down stairs has not been examined.…”

Section: Introductionmentioning

confidence: 99%

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The Epidemiology of Fractures Caused by Falls Down Stairs

2013

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Fractures sustained from a fall down stairs have received little attention in the orthopaedic literature. We have undertaken a study of these fractures to determine their epidemiology and to compare it to that of fractures caused by a standing fall. All new patients presenting with a fracture between July 2007 and June 2008 were prospectively identified. Falls down stairs caused 261 fractures and were the fifth commonest mode of injury in all ages but the second commonest in those aged 65 years or over. Patients in this category were significantly younger than those with a fracture from a standing fall (54.6 yrs versus 64.9 yrs, < 0.001). Fractures of the ankle (odds ratio (OR) 1.9, < 0.001), talus (OR 3.0, = 0.04), calcaneus (OR 9.7, < 0.001), midfoot (OR 6.9, < 0.001), toe phalanges (OR 12.0, < 0.001), scapula (OR 4.6, = 0.002), and proximal ulna (OR 2.4, = 0.04) were significantly more likely to result from a fall involving stairs. When grouped together, the odds of any foot or ankle fracture resulting from a fall down stairs were approximately double when compared with a fall from standing (OR 2.1, < 0.001). There was a trend towards increased fracture incidence from falls down stairs with worsening social deprivation ( = 0.63, = 0.05). A fall down stairs poses a substantial risk of fractures of the foot, ankle, and scapula. When examining patients with this mechanism of injury, these fracture types should be excluded.

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Section: Isrn Epidemiologysupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Epidemiology of Fractures Caused by Falls Down Stairs

2013

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“…In contrast, the reverse relationship has been reported in Spain where hip fracture risk was higher in the least deprived compared to most deprived areas, possibly explained by the protective effects of obesity for the hip (12). In the UK, a number of studies have identified an association between worsening deprivation and higher hip fracture incidence (13)(14)(15)(16); but this has not been consistently demonstrated albeit by studies of varying lengths (17,18). In addition, recent evidence suggests the relationship between deprivation and hip fracture risk may be stronger in men than women (16), potentially explained by differing predispositions in men and women towards lifestyle habits that increase fracture risk, such as tobacco and heavy alcohol consumption (19,20).…”

Section: Introductionmentioning

confidence: 98%

The effect of social deprivation on hip fracture incidence in England has not changed over 14 years: an analysis of the English Hospital Episodes Statistics (2001–2015)

et al. 2017

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“…Previous studies have also identified the occurrence of ‘post-fall syndrome’ in fallers. Individuals who have a fear of falling appear to enter a debilitating spiral of loss of confidence, functional decline and social deprivation, physical frailty, falls, and loss of independence [11,12]. Hypothermia, pressure-related injuries and infections may also result from falls [13].…”

Section: Introductionmentioning

confidence: 99%

An individually-tailored multifactorial intervention program for older fallers in a middle-income developing country: Malaysian Falls Assessment and Intervention Trial (MyFAIT)

et al. 2014

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BackgroundIn line with a rapidly ageing global population, the rise in the frequency of falls will lead to increased healthcare and social care costs. This study will be one of the few randomized controlled trials evaluating a multifaceted falls intervention in a low-middle income, culturally-diverse older Asian community. The primary objective of our paper is to evaluate whether individually tailored multifactorial interventions will successfully reduce the number of falls among older adults.MethodsThree hundred community-dwelling older Malaysian adults with a history of (i) two or more falls, or (ii) one injurious fall in the past 12 months will be recruited. Baseline assessment will include cardiovascular, frailty, fracture risk, psychological factors, gait and balance, activities of daily living and visual assessments. Fallers will be randomized into 2 groups: to receive tailored multifactorial interventions (intervention group); or given lifestyle advice with continued conventional care (control group). Multifactorial interventions will target 6 specific risk factors. All participants will be re-assessed after 12 months. The primary outcome measure will be fall recurrence, measured with monthly falls diaries. Secondary outcomes include falls risk factors; and psychological measures including fear of falling, and quality of life.DiscussionPrevious studies evaluating multifactorial interventions in falls have reported variable outcomes. Given likely cultural, personal, lifestyle and health service differences in Asian countries, it is vital that individually-tailored multifaceted interventions are evaluated in an Asian population to determine applicability of these interventions in our setting. If successful, these approaches have the potential for widespread application in geriatric healthcare services, will reduce the projected escalation of falls and fall-related injuries, and improve the quality of life of our older community.Trial registrationISRCTN11674947

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The relationship of fall-related fractures to social deprivation

Cited by 31 publications

References 28 publications

The Epidemiology of Fractures Caused by Falls Down Stairs

The Epidemiology of Fractures Caused by Falls Down Stairs

The effect of social deprivation on hip fracture incidence in England has not changed over 14 years: an analysis of the English Hospital Episodes Statistics (2001–2015)

An individually-tailored multifactorial intervention program for older fallers in a middle-income developing country: Malaysian Falls Assessment and Intervention Trial (MyFAIT)

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