The Relationship Between the Time and Location Distribution of Falls in Elderly Hip Fracture Patients and Clinical Characteristics

Background Falls can be detrimental for older adults, causing hip fracture that result in disability and increased risk of mortality. This study aimed to investigate the temporal distribution of falls among the geriatric patents with hip fractures and compare the characteristics of falls occurring at different times and locations. Methods This study recruited older with hip fractures resulting from accidental falls. The participants were categorized into two groups based on the timing and location of their falls. Information regarding fall times, locations, and causes was obtained through interviews. Additionally, demographic data, handgrip strength, Charlson Comorbidity Index (CCI), and responses to quality of life, activities of daily living (ADL), and dementia screening questionnaires using the Portable Mental Status Questionnaire (SPMSQ) were collected. Results This study encompassed 801 hip fracture patients, with 560 women (70%) and 241 men (30%), and a median age of 81 years. Among these patients, 546 (68.3%) experienced falls during the daytime, while 255 (31.7%) fell at night. Furthermore, 577 (74.9%) hip fractures occurred indoors, with 193 (25.1%) falls taking place outdoors. The analysis revealed that patients with lower handgrip strength and BMI were significantly more susceptible to daytime falls compared to nighttime falls. Furthermore, patients who fell indoors exhibited notably higher CCI and SPMSQ error scores, along with lower BMI, handgrip strength, and pre-fracture ADL, in comparison to those who fell outdoors. Conclusions Our findings indicate that falls during the daytime were more prevalent among geriatric hip fracture patients in Taiwan compared to nighttime falls. Moreover, we observed that more fragile patients were relatively susceptible to falling indoors and at night, emphasizing the potential clinical value for clinicians to take proactive measures in fall prevention.