Choi Kyung-A, Ha Yong-Chan, Lee Kyung-Hag
National Institute of Medical Welfare, Kangnam University, Yongin, Korea.
Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul, Korea.
J Bone Metab. 2023 Feb;30(1):103-114. doi: 10.11005/jbm.2023.30.1.103. Epub 2023 Feb 28.
Fall prevention is important for reducing hip fractures. The aim of this study was to determine the relationship between variables related to hip fractures according to sex and season.
This study included patients admitted for fragility hip fractures between 2012 and 2021. Patients were interviewed by a junior resident before discharge. Data on sex, age, diagnosis, osteoporosis treatment, direction, voiding problems, ambulatory function, seasons, weather, time of day, place, location, floor condition, activity during fall, and perceived reason for fall were collected and analyzed.
A total of 1,118 patients were included (279 males and 839 females). In both sexes, indoor falls were prevalent throughout all seasons, but males showed a higher proportion of outdoor falls, especially in winter during cloudy or snowy weather. Rooms and walking were the most common locations and activities during falls. The poor ambulatory function was associated with a higher prevalence of indoor falls. Osteoporosis treatment rates were low and did not differ according to Koval stage. Winter was associated with higher osteoporosis non-treatment group. Urgency/incontinence in female patients caused a higher proportion of falls during the evening time.
Strategies for indoor fall prevention and vigilant osteoporosis diagnosis and treatment are important for all seasons, especially for frail elderly patients. Outdoor fall prevention emphasized for male patients, and education around nighttime falls should be provided for female patients with voiding dysfunction.
预防跌倒对于减少髋部骨折至关重要。本研究的目的是确定按性别和季节划分的与髋部骨折相关变量之间的关系。
本研究纳入了2012年至2021年间因脆性髋部骨折入院的患者。患者在出院前由一名住院医师进行访谈。收集并分析了有关性别、年龄、诊断、骨质疏松症治疗、方向、排尿问题、行走功能、季节、天气、一天中的时间、地点、位置、地面状况、跌倒时的活动以及跌倒的感知原因等数据。
共纳入1118例患者（男性279例，女性839例）。在男女两性中，室内跌倒在所有季节都很普遍，但男性户外跌倒的比例更高，尤其是在冬季多云或下雪天气时。房间和行走是跌倒时最常见的地点和活动。行走功能差与室内跌倒的患病率较高有关。骨质疏松症治疗率较低，且根据科瓦尔分期没有差异。冬季与骨质疏松症未治疗组比例较高有关。女性患者的尿急/尿失禁导致晚上跌倒的比例更高。
预防室内跌倒的策略以及警惕的骨质疏松症诊断和治疗对所有季节都很重要，尤其是对体弱的老年患者。应强调男性患者的户外跌倒预防，对于有排尿功能障碍的女性患者应提供夜间跌倒方面的教育。
