Risk Factors for Fall and Fracture

Study Overview
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Brief Summary
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This project aims to improve the global outcome for an aging individual after a traumatic fall, through identifying conditions contributing to a fall and promoting recovery and rehabilitation. Through better understanding 'falling phenotype', the ultimate aim is to prevent future complications, as well as new falls and fractures in the growing older population.

Detailed Description
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Background: The knowledge of risk factors for falls and fractures amongst older individuals are enormous, still identification of fallers and prevention of falls is not part of Swedish standard of care. Some risk factors are more or less overlooked, such as alcohol consumption, orthostatic reactions, as are increased risks related to common medications such as certain antidepressants, opioids and sedatives. Although functional activity and frailty scores have been suggested to be potential predictors of adverse events, length of hospital stay and mortality, the use of standardized questionnaires has not been implemented in routine care in Sweden. Furthermore, outcomes after fragility fractures, a well known consequence of falls among older individuals, are continuously poor, although palpable improvements have been reached regarding surgical treatment. Are there other factors that are equally or more decisive for the global outcome from the patient's point of view? Material & Methods: In this prospective observational cohort study, all in-patients treated due to a fall-related trauma (fracture, dislocation or contusion) at the Department of Orthopaedics, Skane University Hospital Malmö, aged 65 years or older will be invited to participate during a 1-year study period. In all participants, a standard package of blood samples, temperature, measurement of orthostatic blood pressure and grip strength, grading of frailty and activity will be routinely obtained.

Official Title
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Risk Factors for Fall and Fracture - A Cohort Study of Fall-related Factors Obtained in Routine Orthopaedic Fracture Care

Conditions
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Fall Injury, Hip Fractures, Risk Reduction, Osteoporosis, Osteopenia, Frailty

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 65 years or older at the time of admission. Admitted to Orthopaedic ward at due to fall, with or without a fracture. Exclusion Criteria: Younger than 65 years old at the time of admission. Severe head trauma or other severe non-orthopaedic trauma. Other condition requiring ward at other department (CCU, ICU). Moribund individuals with palliative care only.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Fallers without a fracture<br>Individuals who obtain no fracture. | |
| Fallers with a fracture<br>Individuals who obtain one or several fractures through fall. This group can be further subgrouped according to type of fracture. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | The number of deaths during follow-up | One year after admission to hospital | 
| Re-admission | Number of re-admissions to emergency centre or in-patient ward due to a new fall (primarily) or complications related previous fall/fracture | One year after admission to hospital | 
| Other adverse events | Other adverse events that are not included in outcome measure 1 or 2, such as infection, new falls, fractures, or complications from previous fall/fracture, or other medical complications. These can be further grouped by whether the events occur in in-patient or out-patient care. | One year after admission to hospital | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Falls, Fracture, Frailty, Orthogeriatric