Hip Fracture and Injurious Falls Among Older Persons in Nursing Homes

¶ … Epidemiological Study on Falls

This is a matched cohort study of 754 volunteer elders who live together in a community in New Haven, Connecticut in determining damaging effects of injurious falls among the disabled ones (Gill et al., 2013). It sought to discover the connection between hip fractures and the damaging effects. Of this total number of participants, 122 were hospitalized patients for injurious falls, 59 of whom were hip-fractured and 63 were injured for other causes. They were compared or matched with 241 patients who were hospitalized for other causes not related to falls. Their mean age was 85.7 and they were evaluated every month for disability. They were admitted in nursing homes from 1998 to 2010 for injuries caused by hip fractures and other causes. It was found that their disability substantially increased in the first 6 months of hospitalization as compared to those who were hospitalized for non-fall causes (Gill et al.).

This also meant that those who became more disabled for falls were more likely to remain in nursing homes for a longer time than those who were hospitalized for other causes (Gill et al., 2013). This points to an association between hip fracture and other fall-related injuries as contributing to greater disability and likelihood of long-term stay in nursing homes (Gill et al.).

The study found that exposure to hip fracture increases the risk of injury among the participants (Gordis, 2015). Their group is compared to the risk of injury among other elders in the same community and admitted to nursing homes who did not suffer from hip fracture. The home-based assessment lasted for 108 months with 18 months of interval from June 30, 2010. A proxy informant was used for patients who died during the conduct of the study. In this period, both groups were monitored using different variables, such as the difference in falls in the first group, economic status and health status. Researchers noted any significant increase in falls in this first group as compared to the second group to extract evidence in favor or against the connection between the injury, its cause and length of stay in nursing homes (Gordis).

The damaging effects of injuries falls were, however, not limited to hip fracture as a cause

(Gill et al., 2013; Gordis, 2015). There were other causes of fall-related injuries, which lengthen stay in nursing homes. These findings strongly suggest and call for more stringent prevention and treatment measures for injurious falls and to consider these high-priority measures. Raising their level of priority will triggen the allocation of the necessary resources at addressing this specific need of elder persons (Gordis, Gill et al.).

This cohort, prospective study was not preceded by a similar investigation, as far as the authors know, which evaluated the link among injurious falls, disabling conditions such as hip fractures, and their length of stay in nursing homes (Gill et al., 2013). Those hospitalized for injurious falls were matched with those who were not exposed to these falls according to age, sex and disability. The second group were hospitalized for a wide range of medical and surgical causes, which were just as serious as injurious falls. The large increase in the level of disability during the first month after hospitalization and the strong likelihood of death within months from causes relating to falls provided evidence for the finding. They also had slower or reduced complete recovery chances of bodily and mental function prior to hospitalization in the succeeding five months than the other group. The findings were consistent across three different domains of functioning, namely basic, instrumental, and mobility activities (Gill et al.).

Those in the first group had, as a whole, worse disability outcomes in the six months following hospitalization as well as a longer stay in nursing home following admission than those in the second group, i.e., those who were hospitalized for non-injurious fall causes. Another overall finding is that hip fracture was not the only cause of injurious falls. Overall, these findings point to the need for greater attention to the prevention and treatment of injurious falls as a high priority in among decision=-makers in the health sector (Gill et al.).