Abstract

To investigate the relationship between performance at discharge and falls within the following year among older people who underwent hip fracture surgery and were discharged from the convalescent rehabilitation ward (CRW) to their homes. Enrolled in this retrospective study were 235 people, of whom 117 responded to a questionnaire regarding falls. Of these 117, the fall group included 31 participants and the non-fall group included 86 participants. The primary outcome was a fall within one year after discharge from CRW. The secondary outcomes were age, sex, length of CRW stay, standing test for imbalance and disequilibrium, preferred gait speed, Functional Independence Measure (FIM) and Mini-Mental State Examination (MMSE) at discharge.

Logistic regression analysis adjusted for potential confounders showed that only preferred gait speed remained statistically significant in influencing the odds ratio of falls (OR=19.70, 95% confidence interval [CI] 1.50–259.10). There were significant differences in FIM score and MMSE score between falls inside and outside the home (p<0.05). A high preferred gait speed was associated with falls within one year after discharge among older people who underwent hip fracture surgery. Falls inside the home were associated with lower functional outcomes and cognitive function compared to falls outside the home. Tailoring fall prevention interventions based on the location of falls and considering additional risk factors is crucial for effective fall prevention in this population.

Keywords:Future fall; Hip fracture surgery; Preferred gait speed; Older people; Rehabilitation

Abbreviations:ADL: Activities of Daily Living; AUG: Area Under the Curve; cFIM: 5-item Cognition Subscale of FIM; CI: Confidence Interval; CRW: Convalescent Rehabilitation Ward; CRWs: Convalescent Rehabilitation Wards; FIM: Functional Independence Measure; mFIM: 13-item Motor Subscale of FIM; MMSE: Mini-Mental State Examination; NCGG: National Center for Geriatrics and Gerontology; OR: Odds Ratio; QOL: Quality of Life; ROC: Receiver-Operation Characteristic; SIDE: Standing Test for Imbalance and Disequilibrium; TUG: Timed “Up & Go”