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Predictors of postoperative falls in the first and second postoperative years among older hip fracture patients
Author(s) -
Yeh HsiangFen,
Shao JungHua,
Li ChiaLin,
Wu ChiChuan,
Shyu YeaIng L
Publication year - 2017
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13743
Subject(s) - medicine , hip fracture , physical therapy , rehabilitation , activities of daily living , injury prevention , incidence (geometry) , depression (economics) , poison control , physical medicine and rehabilitation , osteoporosis , emergency medicine , physics , optics , economics , macroeconomics
Aims and objectives To explore risk factors for a single fall and multiple falls in the first and second postoperative years among older hip fracture patients. Background Older hip fracture patients have a high probability of falling again after a fall incident. Risk factors for postoperative falls among older hip fracture patients in Taiwan remain to be confirmed. Design Secondary analysis. Methods Data collected from control groups of two clinical trials conducted during 2001–2004 and during 2005–2009 were selected. Overall, 181 older adults who underwent hip fracture surgery were assessed at predischarge and postdischarge. Participant data were collected through home visits. Results Decline in unaffected limb quadriceps muscle endurance was a crucial predictor of a single fall in the first postoperative year for older hip fracture patients. Advanced age and more severe depressive symptoms were the crucial predictor for multiple falls. Engagement in activities of daily living was the crucial predictor for falls during the first to second postoperative years among older hip fracture patients. Conclusion In Taiwan, postoperative falls that occur within 1–2 years of a hip fracture are associated with a high incidence of single and multiple falls in older people. The crucial predictors of falls in the first and second year after a hip fracture include unaffected limb quadriceps endurance, age, depression status and postdischarge activities of daily livings in older people. Relevance to clinical practice The identified factors associated with subsequent falls within one and two years of a hip fracture should be incorporated into clinical strategies and taught in nursing courses. Early postoperative lower extremity muscular endurance rehabilitation must be provided. Furthermore, as part of the healthcare plan before hospital discharge, it must be ensured that the community where the older adults live has nutritional education, cognitive screening and psychological support.