Causes and course of falls resulting in hip fracture among elderly Thai patients

Abstract

© 2015, Medical Association of Thailand. All rights reserved. To investigate causes and course of fall-related hip fractures in elderly individuals admitted to a hospital. Material and Method: The authors collected data from older patients admitted with fall-related hip fractures. The cause and the clinical course of falls were evaluated by consultants in geriatric medicine. All patients were followed-up until discharge from the hospital. Results: Falls usually occurred indoors (78.6%) during the daytime (67.5%). Only 27.5% of the falls were attributable to purely extrinsic causes. Neurological, musculoskeletal, and visual problems along with orthostatic hypotension were the leading causes of falls in the present study. Women demonstrated more intrinsic causes (41.9% vs. 28.9%), such as musculoskeletal (33.9% vs. 11.1%), and visual impairment (21.0% vs. 11.1%), whereas falls involving men were more likely to be caused by orthostatic hypotension (21.8% vs. 8.1%). Most patients received surgical treatment (92.5%). The most common complications during the hospital stay were delirium (45%). The modified Rankin Scale of 2-5 at discharge was noted in 46.3% of patients, and mortality was 3.8%. The median length of hospital stay was 15 days (7-75 days). The direct costs of in-hospital care were 2,427.2 (761.9-8,348.6) US dollars for general wards, and 3,739.1 (1,333.6-11,871.7) US dollars for special wards. Conclusion: Intrinsic causes (pure and combined with extrinsic) lead to falls with hip fractures more often than purely extrinsic causes. Women and men had different etiologies for falls. Hip fracture leads to a number of in-hospital complications and significant functional impairment. Preventive strategies following the present study would likely lead to more accurate and beneficial outcomes.