Aizen Efraim, Nixon Hila, Shugaev Inna
Fliman Geriatric Rehabilitation Hospital, Haifa, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Isr Med Assoc J. 2018 Jan;20(1):38-42.
There is little evidence about awareness and functional outcome of hip fracture-related falls among patients with a history of recurrent falling.
To measure the awareness of recurrent falling in patients and to compare their functional outcomes with those who suffered hip fracture after a sporadic isolated fall.
A prospective comparative study of patients after a hip fracture-related fall was conducted. Awareness of falls was measured and functional outcome was assessed by total and motor Functional Independence Measure (FIM) score changes and efficiency and scores at admission and on discharge.
Of 97 eligible participants, 49 (50.5%) were recurrent fallers. Of these recurrent falls, 19 (38.8%) were not reported, 16 (32.7%) were reported but no action was taken, and 7 (14.3%) were reported and a partial assessment performed. A full assessment was performed in only 7 cases (14.3%). FIM scores on admission and discharge were significantly higher in once-fallers. A multiple linear regression analysis showed that being a once-faller was independently associated with higher total FIM at admission (β coefficient = 0.290, P = 0.004), higher motor FIM at admission (β coefficient = 0.295, P = 0.003), higher total FIM at discharge (β Coefficient = 0.264, P = 0.009), and higher motor FIM at discharge (β coefficient = 0.230, P = 0.023).
Awareness of the syndrome of recurrent falling is extremely low. Recurrent falls before a hip fracture-related fall is associated with substantial loss of functional independence. Being a recurrent faller adversely affects rehabilitation outcome of hip fracture patients.
关于有反复跌倒史的患者对髋部骨折相关跌倒的认知及功能结局的证据很少。
测量患者对反复跌倒的认知，并将其功能结局与偶发单次跌倒后发生髋部骨折的患者进行比较。
对髋部骨折相关跌倒后的患者进行前瞻性对照研究。通过测量跌倒认知情况，并根据入院时和出院时的总功能独立性测量（FIM）评分变化、运动功能独立性测量（FIM）评分变化、效率及评分来评估功能结局。
在97名符合条件的参与者中，49名（50.5%）为反复跌倒者。在这些反复跌倒中，19名（38.8%）未被报告，16名（32.7%）被报告但未采取行动，7名（14.3%）被报告并进行了部分评估。仅7例（14.3%）进行了全面评估。单次跌倒者入院时和出院时的FIM评分显著更高。多元线性回归分析显示，作为单次跌倒者与入院时更高的总FIM（β系数 = 0.290，P = 0.004）、入院时更高的运动FIM（β系数 = 0.295，P = 0.003）、出院时更高的总FIM（β系数 = 0.264，P = 0.009）以及出院时更高的运动FIM（β系数 = 0.23 , P = 0.023）独立相关。
对反复跌倒综合征的认知极低。与髋部骨折相关的跌倒前反复跌倒与功能独立性的大量丧失有关。反复跌倒者对髋部骨折患者的康复结局有不利影响。
