injurious falls
Recently Published Documents


TOTAL DOCUMENTS

215
(FIVE YEARS 83)

H-INDEX

31
(FIVE YEARS 5)

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Amy Drahota ◽  
Lambert M. Felix ◽  
James Raftery ◽  
Bethany E. Keenan ◽  
Chantelle C. Lachance ◽  
...  

Abstract Background Shock-absorbing flooring may minimise impact forces incurred from falls to reduce fall-related injuries; however, synthesized evidence is required to inform decision-making in hospitals and care homes. Methods This is a Health Technology Assessment mixed methods systematic review of flooring interventions targeting older adults and staff in care settings. Our search incorporated the findings from a previous scoping review, MEDLINE, AgeLine, and Scopus (to September 2019) and other sources. Two independent reviewers selected, assessed, and extracted data from studies. We assessed risk of bias using Cochrane and Joanna Briggs Institute tools, undertook meta-analyses, and meta-aggregation. Results 20 of 22 included studies assessed our outcomes (3 Randomised Controlled Trials (RCTs); 7 observational; 5 qualitative; 5 economic), on novel floors (N = 12), sports floors (N = 5), carpet (N = 5), and wooden sub-floors (N = 1). Quantitative data related to 11,857 patient falls (9 studies), and 163 staff injuries (1 study). One care home-based RCT found a novel underlay produced similar injurious falls rates (high-quality evidence) and falls rates (moderate-quality evidence) to a plywood underlay with vinyl overlay and concrete sub-floors. Very low-quality evidence suggested that shock-absorbing flooring may reduce injuries in hospitals (Rate Ratio 0.55, 95% CI 0.36 to 0.84, 2 studies; 27.1% vs. 42.4%; Risk Ratio (RR) = 0.64, 95% CI 0.44 to 0.93, 2 studies) and care homes (26.4% vs. 33.0%; RR 0.80, 95% CI 0.70 to 0.91, 3 studies), without increasing falls. Economic evidence indicated that if injuries are fewer and falls not increased, then shock-absorbing flooring would be a dominant strategy. Fracture outcomes were imprecise; however, hip fractures reduced from 30 in 1000 falls on concrete to 18 in 1000 falls on wooden sub-floors (OR 0.59, 95% CI 0.45 to 0.78; one study; very low-quality evidence). Staff found moving wheeled equipment harder on shock-absorbing floors leading to workplace adaptations. Very low-quality evidence suggests staff injuries were no less frequent on rigid floors. Conclusion Evidence favouring shock-absorbing flooring is uncertain and of very low quality. Robust research following a core outcome set is required, with attention to wider staff workplace implications. Trial registration PROSPERO CRD42019118834.


Author(s):  
Iris C. Levine ◽  
Roger E. Montgomery ◽  
Alison C. Novak

Objective This study evaluated the hazard (risk of unrecovered balance loss and hazardous fall) and strategies associated with grab bar use, compared to no grab bar use, during unexpected balance loss initiated whilst exiting a bathtub. Background While independent bathing is critical for maintaining self-sufficiency, injurious falls during bathing transfer tasks are common. Grab bars are recommended to support bathing tasks, but no evidence exists regarding fall prevention efficacy. Method Sixty-three adults completed a hazardous bathtub transfer task, experiencing an unpredictable external balance perturbation while stepping from a slippery bathtub to a dry surface. Thirty-two were provided a grab bar, while 31 had no grab bar available. Slips and grab bar use were recorded via four video cameras. Slip occurrence and strategy were identified by two independent video coders. Results Participants who had a grab bar were 75.8% more likely to recover their balance during the task than those who did not have a grab bar. Successful grab bar grasp was associated with balance recovery in all cases. Attempts to stabilize using other environmental elements, or using internal strategies only, were less successful balance recovery strategies. Grab bar presence appeared to cue use of the environment for stability. Proactive grasp and other strategies modified grasping success. Conclusion Grab bars appear to provide effective support for recovery from unexpected balance loss. Grab bar presence may instigate development of fall prevention strategies prior to loss of balance. Application Bathroom designs with grab bars may reduce frequency of fall-related injuries during bathing transfer tasks.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 703-703
Author(s):  
Megan Jones ◽  
Sally Paulson ◽  
Joshua Gills ◽  
Anthony Campitelli ◽  
Jordan Glenn ◽  
...  

Abstract Falls affect more than 30% of older adults and are one of the leading causes of injury, hospitalization, and mortality in this populations. Mild cognitive impairment (MCI) is one of the risk factors for falls in older adults. The purpose of this study is to determine if older adults with MCI have increased fall severity than older adults without MCI. Participants (n: 81: age: 79 ± 6) completed a Montreal Cognitive Assessment (MoCA) and a Hopkins Falls Grading Scale, a tool used to grade the severity of falls on a scale of 1-4 (1 = loss of balance without fall; 4 = fall requiring hospital admission). Participants were categorized as having MCI (score <26: N: 44: age: 81 ± 6.4) or non-MCI (score ≥26: n: 37: age: 77 ± 6). Groups were analyzed using a one-way ANOVA in SPSS to compare the severity of falls within the previous 12 months. There were no differences between groups for fall grade 1 (p =.22) or fall grade 2 (p =.45). There was a significant difference between groups for fall grade 3 (p =.04) and fall grade 4 (p =.05) with the MCI group having more of these falls compared to the non-MCI group. Older adults with MCI had a higher number of falls requiring medical attention than older adults without MCI. Although falls are a risk in all older adults, those with MCI may be at higher risk of more injurious falls than older adults without MCI.


2021 ◽  
Author(s):  
Manonita Ghosh ◽  
Beverly O’Connell ◽  
Eben Afrifa-Yamoah ◽  
Sue Kitchen ◽  
Linda Coventry

Abstract Background: Injurious falls in hospital patients are threat to patient safety which can result in a financial burden on the patient’s family and health care services. Both patient specific and environmental and organisational factors are associated with injurious hospital falls. It is important to continuously analyse the factors associated with the severity of falls which can inform the implementation of any fall preventive strategies. This study aims to identify risk factors associated with the severity of falls in hospitalised adult patients in Western Australia.Methods: This study involved a retrospective analysis of hospital inpatient falls records extracted from the hospital’s Clinical Incident Database. Falls clinical incidents were reviewed and analysed from May 2014 to April 2019.Results: There were 3705 complete reported cases of falls with the average age of the patients was 68.5±17.0 years, with 40.2% identified as female. Gender, activity at time of fall and height of fall were associated with the level of severity of the fall. The risk of falling at a higher level of severity increased by approximately 20% (65-74 years), 29% (75-84 years) and 39% (>84 years) respectively compared with patients age <50 years. Females were 15.1% more likely to fall at higher severity condition compared to males (AOR = 1.151, 95% CI: 1.063, 1.247, p < 0.001). Toileting and showering activities were 14.5% more likely to cause falling in higher level of severity (AOR = 1.145, 95% CI: 1.022, 1.284, p = 0.020) compared with attempting to sit or stand. A fall in a communal area was approximately 26% more likely to resulted in higher level of severity (AOR = 1.257, 95% CI: 1.003, 1.576, p = 0.047).Conclusions: Identification of underlying risk factors associated with the severity of falls provides information which can inform the implementation of fall prevention strategies that mitigate the risk of injurious falls.


2021 ◽  
Vol 5 (1) ◽  
pp. e001125
Author(s):  
Jennifer Smith ◽  
Harpreet Chhina ◽  
Pardeep Sidhu ◽  
Mariana Brussoni ◽  
Ian Pike ◽  
...  

BackgroundSupracondylar humerus fractures (SCHF) are the most common fractures sustained following a fall onto an outstretched hand among healthy children, and one of the leading causes of hospital admission and surgical intervention. The aim of this study was to examine SCHF occurring at public play spaces—particularly to determine whether or not the playground equipment implicated in injurious falls aligned with Canadian playground safety standards.MethodsCases of children who attended the provincial paediatric orthopaedic clinic following SCHF at a public playground between April 2017 and October 2019 were included in the study. A research assistant visited each playground to measure the play structure type and dimensions, height of the equipment at the point from which the child fell and the type and depth of the surface material, and compare measurements to the 2016 safety standards. Child demographics and injury classification were also noted. Descriptive statistics were calculated and a scatterplot of fall height and surface depth was generated.ResultsForty-three sites, representing 47 SCHF cases (18 female, 29 male), were included in the final analysis. Fourteen children sustained type 1 fracture, 23 had type 2 fracture and the remaining 10 had type 3 fracture. Five children with type 2 fracture and all 10 children with type 3 fracture required surgery. The majority of sites had engineered wood fibre surfacing, with surfacing at 35 sites being less than 300 mm deep. Twenty-six play structures were upper body equipment (ie, monkey bars or similar), seven were track rides, five were rotating structures and the rest comprised a variety of classified and unclassified structures. Twenty-seven children fell from a height exceeding 2 m.ConclusionsThe majority of SCHF cases occurred at playgrounds with insufficient surface depth and/or non-compliant equipment. Upper body equipment, track rides and rotating play structures were of particular concern, as the children fell from heights exceeding the recommended standard, likely reflecting the degradation and compaction of the surfacing material over time.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253374
Author(s):  
Roel H. A. Weijer ◽  
Marco J. M. Hoozemans ◽  
Onno G. Meijer ◽  
Jaap H. van Dieën ◽  
Mirjam Pijnappels

Background and aim The reciprocal relation between falling and concern about falling is complex and not well understood. We aimed to determine whether concern about falling increases after a fall and whether concern about falling increases the odds of future falls in community-dwelling older adults without a recent fall history. Methods We selected 118 community-dwelling older adults (mean age: 71.4 (SD: 5.3) years) without a self-reported history of falling, one year prior to baseline assessment, from the one-year VIBE cohort for analyses. On a monthly basis, we recorded concern about falling (using the Falls Efficacy Scale-International, FES-I), as well as the occurrence of falls (through questionnaires and telephone calls). We determined 1) whether falling predicts an increase in concern about falling and 2) whether a high concern about falling is predictive of falling. Standard linear (fixed-effects) regression and mixed effects regression analyses were performed over long-term, i.e. one year, and short-term, i.e. one-month, intervals, respectively and were adjusted for gender, age and physical activity (quantified as the average total walking duration per day). Analyses were performed separately for all reported falls and for injurious falls only. Results High concern about falling at baseline did not predict falls over the course of one year, nor over the course of one month. Furthermore, falls in between baseline assessment and one year thereafter did not predict increased concern about falling from baseline to one year later, independent of whether all falls or only injurious falls were considered. However, falls, either all or injurious only, happening somewhere over the course of a one-month interval, significantly predicted small increases in concern about falling (1.49 FES-I points, 95% CI [0.74, 2.25], p<0.001 for all falls; 2.60 FES-I points, 95% CI [1.55, 3.64], p<0.001 for injurious falls) from the start to the end of that one-month interval. Conclusion Older adults without a recent history of falling seem to be resilient against developing concern about falling after having fallen, resulting in a short-term temporary effect of falling on concern about falling. Furthermore, we found no evidence that a high concern about falling predicts future falls over a one-month or a one-year follow-up period, suggesting that concern is not a primary cause for falls in older adults without a recent history of falling.


Author(s):  
Jennifer S Brach ◽  
Gardenia Juarez ◽  
Subashan Perera ◽  
Kathleen Cameron ◽  
Jennifer L Vincenzo ◽  
...  

Abstract Background Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, we describe the implementation of evidence-based falls prevention programs by Administrative for Community Living grantees during 2014-2019. Methods Forty-four grantees contributed to the national data repository. Data components include workshop information, participant information, attendance records, and organizational data. Data were collected before and after implementation of the evidence-based fall prevention programs. Results Ten different programs were offered in 35 states with the most common settings being senior centers (25.3%), residential facilities (16.8%), health care organizations (12.5%), and faith-based organizations (11.1%). Individuals who participated in the programs (n=85,848) had an age of 75.5±9.7 years, were primarily female (79.7%) and the majority (86.2%) reported at least some fear of falling. At the post-program assessment, 31.8% reported less fear of falling, 21.6% reported fewer falls, and 10.1% reported fewer injurious falls (all p&lt;0.0001). Conclusions Evidence-based fall prevention programs implemented by Administration for Community Living grantees reached over 85,000 older adults. Participation in the evidence-based fall prevention programs resulted in improved confidence, decreased fear of falling, and fewer falls and injurious falls. Future efforts should focus on reaching specific underserved minorities and examining the effectiveness of individual programs.


Author(s):  
Christian Hentschke ◽  
Martin Halle ◽  
Barbara Geilhof ◽  
Peter Landendoerfer ◽  
Wolfgang Blank ◽  
...  

Abstract Background Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Objective Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. Design and Setting In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). Intervention and Measurements Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. Results After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). Conclusions In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.


Sign in / Sign up

Export Citation Format

Share Document