Pliannuom Suphawita, Phinyo Phichayut, Buawangpong Nida, Nantsupawat Nopakoon, Atthakomol Pichitchai, Vaseenon Tanawat, Kitcharanant Nitchanant, Lerttrakarnnon Peerasak, Pinyopornpanish Kanokporn
Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Road, Sri Phum, Muang, Chiang Mai, 50200, Thailand.
Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Eur Geriatr Med. 2025 Mar 25. doi: 10.1007/s41999-025-01188-x.
Concern about falling [CaF] is common among older adults, particularly after fragility hip fracture. This condition is associated with adverse health outcomes and a reduced quality of life. The aim of this study is to explore predictors of CaF among older patients with fragility hip fractures 2 weeks after hospital discharge.
A prospective observational cohort study was conducted at a Tertiary Care Hospital in Thailand. Participants were patients aged 60 years and above who had fragility hip fractures and were admitted to the hospital from March 2023 to March 2024. CaF was assessed using the short Falls Efficacy Scale-International 2 weeks after hospital discharge. Predictors examined pre-fall characteristics, fall-related data, surgery-related data, and postoperative data. In the full model approach, the multivariable Gaussian regression was employed to identify predictive factors.
Of the 165 patients included in the study (mean age 78.76 ± 8.72 years), 79.39% were female. In the full model approach, pre-fracture activities of daily living (ADL) < 20 (adjusted mean difference [aMD] 3.44, 95% CI 1.04-5.85, p = 0.005) and shorter in-hospital duration of walking training (aMD - 0.66, 95% CI - 1.10 to - 0.22, p = 0.004) were identified as predictors of CaF at 2 weeks after hospital discharge.
The findings of this study emphasize the importance of assessing pre-fracture functional status and the shorter duration of in-hospital walking training as key predictors of CaF in older adults with fragility hip fractures. Enhancing functional capacity and extending the duration of walking training during hospitalization are crucial steps in reducing CaF in this population.
老年人群，尤其是脆性髋部骨折后，对跌倒恐惧（[CaF]）的担忧很常见。这种情况与不良健康结局及生活质量下降有关。本研究旨在探讨老年脆性髋部骨折患者出院2周后跌倒恐惧的预测因素。
在泰国一家三级护理医院进行了一项前瞻性观察队列研究。参与者为60岁及以上脆性髋部骨折患者，于2023年3月至2024年3月入院。出院2周后使用简短国际跌倒效能量表评估跌倒恐惧。所检查的预测因素包括跌倒前特征、跌倒相关数据、手术相关数据及术后数据。在全模型方法中，采用多变量高斯回归来识别预测因素。
该研究纳入的165例患者（平均年龄78.76±8.72岁）中，79.39%为女性。在全模型方法中，骨折前日常生活活动能力（ADL）<20（调整后均值差[aMD] 3.44，95%置信区间1.04 - 5.85，p = 0.005）及住院期间步行训练时间较短（aMD -0.66，95%置信区间 -1.10至 -0.22，p = 0.004）被确定为出院2周后跌倒恐惧的预测因素。
本研究结果强调了评估骨折前功能状态以及缩短住院期间步行训练时间作为老年脆性髋部骨折患者跌倒恐惧关键预测因素的重要性。提高功能能力及延长住院期间步行训练时间是减少该人群跌倒恐惧的关键步骤。
