65 - Preissitzung
16. Mai 2019, 13:45 - 15:15, Sopra 3, 4. OG
Fear of falling, recurrence of falls and quality of life in elderly patients with a minor trauma fracture – An observational study.
P. C. van der Vet, J. Q. Kusen, B. C. Link, R. Babst, L. Schmid, C. Henzen, F. J. Beeres, Presenter: M. Rohner-Spengler (Lucerne)
The primary purpose of this study was to evaluate Fear of Falling (FoF) and the amount of subsequent falls in elderly patients one year after a Minor Trauma Fracture (MTF). Secondary aim was to examine how FoF affects patients’ lives in terms of their Quality of Life (QoL), mobility and activity level. Furthermore, participation in a voluntary fall prevention program (FPP) was evaluated.
Prospective cohort study of elderly trauma patients in a single, level I trauma centre. Patients with a MTF, defined as a fracture resulting from a fall from standing height or less, who were treated in the hospital between May 2012 and December 2015 were analyzed one year after injury. The primary outcomes were FoF (assessed through both the Falls-Efficacy Score-International (FES-I) and a binary patient-reported outcome), and amount of subsequent falls and fractures. Secondary outcomes were QoL (measured by the EuroQol-5-Dimensions-3-Levels (EQ5D-3L)), mobility, hours of outside activity and participation rate in the FPP.
A total of 411 patients were included for analysis. Mean age was 72±9.3 years and mean FoF in all patients was 21.1±7.7. In the sixty patients with a subsequent fall (15.1%), mean FoF was 23.7±9.8 and in the 15 patients with a subsequent fracture (4.2%) it was 25.3±9.2. FoF scores were moderate to high in 39.6% of all patients. The mean QoL score in all patients was 0.86±0.20. In patients without a subsequent fall it was 0.90±0.20, whereas it was 0.77±0.24 in patients with a fall (P=0.003). In patients with high FoF (FES > 27) QOL was significantly lower than in patients with low to moderate FoF scores (0.53±0.25 versus 0.9±0.13, P=0.000). Overall, there was a significant correlation between FoF and QOL at a moderate level (R=-0.64; P=0.000). Twenty-one patients (6%) attended the FPP.
One year after MTF, 40% of the patients suffered from FoF which seems to negatively affect patients’ quality of life. Nevertheless, participation in a voluntary fall prevention program was very low. Simply informing the patients about their susceptibility to falls and recommending participation in a FPP does not seem to be sufficient to encourage patients to attend such a program. We strongly suggest the implementation of repeated fall risk and FoF screenings as standard procedures in the follow-up period of patients with MTF.