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Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up

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Abstract

Summary

A randomized, controlled fall-prevention study including 199 patients operated on for femoral neck fracture reduced inpatient falls and injuries. No statistically significant effects of the intervention program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone old people.

Introduction

This study evaluates whether a postoperative multidisciplinary, multifactorial fall-prevention program performed by a geriatric team that reduced inpatient falls and injuries had any continuing effect after discharge. The intervention consisted of staff education, systematic assessment and treatment of fall risk factors and vitamin D and calcium supplementation.

Methods

The randomized, controlled trial with a one-year follow-up at Umeå University Hospital, Sweden, included 199 patients operated on for femoral neck fracture, aged ≥70 years.

Results

After one year 44 participants had fallen 138 times in the intervention group compared with 55 participants and 191 falls in the control group. The crude postoperative fall incidence was 4.16/1,000 days in the intervention group vs. 6.43/1,000 days in the control group. The incidence rate ratio was 0.64 (95% CI: 0.40–1.02, p = 0.063). Seven new fractures occurred in the intervention group and 11 in the control group.

Conclusion

A team applying comprehensive geriatric assessment and rehabilitation, including prevention and treatment of fall-risk factors, reduced inpatient falls and injuries, but no statistically significant effects of the program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone elderly.

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Acknowledgement

The authors wish to thank all the participants and the staff at the orthopedic and geriatric departments at the University Hospital in Umeå. The authors also wish to thank Maria Lundström RN, Eva Elinge OT and Undis Englund MD, for their cooperation and useful opinions.

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Authors and Affiliations

  1. Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden

    M. Berggren, M. Stenvall & Y. Gustafson

  2. Department of Surgical and Perioperative Sciences, Orthopedics, Umeå University, Umeå, Sweden

    B. Olofsson

Authors
  1. M. Berggren
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  2. M. Stenvall
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  3. B. Olofsson
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  4. Y. Gustafson
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Corresponding author

Correspondence to M. Berggren.

Additional information

The study was supported by the Vårdal Foundation, the Joint Committee of the Northern Health Region of Sweden (Visare Norr), the JC Kempe Memorial Foundation, the Foundation of the Medical Faculty, the Borgerskapet of Umeå Research Foundation, the Arneska Foundation, University of Umeå and the County Council of Västerbotten (“Dagmar”, “FoU” , and “Äldre Centrum Västerbotten”) and the Swedish Research Council, Grant 2005/D1255-V.

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Berggren, M., Stenvall, M., Olofsson, B. et al. Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up. Osteoporos Int 19, 801–809 (2008). https://doi.org/10.1007/s00198-007-0507-9

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  • DOI: https://doi.org/10.1007/s00198-007-0507-9

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