gms | German Medical Science

Objectives: Falls are a major cause of injury-related deaths or permanent loss of independence. Falls have psychological, social and economic consequences rendering Fear of Falling (FoF) a common health problem. FoF is related to activity restriction and increases the risk of falling. To prevent secondary falls and fractures, a tailored intervention was implemented in our hospital.

The primary purpose of this study was to evaluate FoF and subsequent falls in patients following an initial Minor Trauma Fracture (MTF). Secondly, we aimed to examine how FoF affects patients regarding Quality of Life (QoL), mobility and activity levels. A further aim was to evaluate how many patients visited a fall-prevention consultant.

Methods: Prospective cohort study of trauma patients in a level I trauma center. MTF patients older than 50 were eligible for inclusion. Primary outcome was FoF, assessed by both the Falls-Efficacy Score-International (FES-I) and a binary, patient-reported outcome. Secondary outcomes were: subsequent falls, QoL, measured by the EuroQol-5-Dimensions, mobility and outdoor activity. Also, the amount of visits to the fall-prevention consultant was recorded. One year follow-up data was analysed by available data analysis.

Result: A total of 411 patients participated in the study. Mean age was 72±9.3 and mean FES-I score was 21.1±7.6. Sixty patients (15.1 %) suffered from a subsequent fall. FES-I scores were moderate to high in 39.6% of the patients. 152 (40.2%) reported to be afraid of falling again. Mean FoF was significantly higher in patients who experienced 1 or more secondary falls than in patients who did not fall again (23.7±9.8 vs. 20.7±7.1; P=0.001). In patients with low activity level mean FoF was 26.5±11.9, and in patients with a higher level it was 19.3±5.6 (P=0.000). FoF and QoL were negatively correlated (R=-0.64;P=0.000). Twenty-one patients (6%) visited the fall-prevention consultant.

Patients who experienced a secondary fall suffered more from FoF than patients who did not fall again. FoF negatively affects patients’ QoL and their activity level. Though over 40% of the patients reported to be afraid of falling, participation in a fall-prevention program was low. Therefore, a minor intervention as administered in this study does not seem to be sufficient to recruit patients into a fall prevention program. Further efforts are needed to improve patients’ awareness of their susceptibility to falls and their willingness to participate in a fall prevention program.