Can side predict the fall after discharge for the patients after surgery for proximal femoral fracture?

• Published in: Annals of physical and rehabilitation medicine Vol. 61; p. e334
• Main Authors: Kondo, I., Ito, K., Takano, E., Morioka, N., Sato, K., Mizuno, Y., Itoh, N.
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01-07-2018
• Subjects: Fall prevention; Predictive measure; SIDE; SIDE; Fall prevention; Predictive measure
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2018.05.782

Standing balance test for imbalance and disequilibrium (SIDE) was developed as a predictive measure for the fall prevention of the patients in hospital. Excellent predictive validity of SIDE was defined with the patients who admitted to reminiscence rehabilitation ward. On the other hand, the prevention of fall after discharge for the patients with fracture is essential to avoid recurrence of fracture. In this study, we use SIDE to predict fall event after the discharge for the patients after the surgery for proximal femoral fracture.
Participants of this study were the patients who discharged and returned to home from reminiscence rehabilitation ward after the surgery for proximal femoral fracture during the period from April, 2014 to September 2016. They were 10 male and 35 female patients and their average age was 78.3 (SD: 8.9). We sent questionnaire about the fall event and recurrence of fracture. Multiple logistic regression analysis was performed with age, duration of admission, the result of Mini Mental State Examination, FIM, SIDE and comfortable gait velocity at discharge as the independent factor according to the fall event occurrence.
The fall event was occurred for seven patients (15.6%). Two of them (4.4%) experienced recurrence of fracture at femoral neck and vertebral body. SIDE (P=0.049) and comfortable gait velocity (P=0.027) had the significant effect on fall event and their odds ratio and 90% confidential interval were 0.32 (0.11−0.99) and 1119.47 (2.18−574866.87), respectively.
In addition to comfortable gait velocity, SIDE was the significant factor to predict the fall event for the one year after discharge. Cutting point of comfortable gait velocity would be warranted to use it as predictive measure. Discreet selection of walking aids and modification of home environment are necessary for the patients with high fall risk detected by SIDE.