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Open Access Highly Accessed Research article

Relationship between location and activity in injurious falls: an exploratory study

Michel HC Bleijlevens12*, Joseph PM Diederiks3, Marike RC Hendriks245, Jolanda CM van Haastregt12, Harry FJM Crebolder26 and Jacques ThM van Eijk27

Author Affiliations

1 Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands

2 School for Public Health and Primary Care (Caphri), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands

3 Department of Healthcare studies, Faculty of Health, Medicine and Life Sciences Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands

4 Department of Movement Science, Faculty of Health, Medicine and Life Sciences Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands

5 Department of Health Organization Economics and Policy, Faculty of Health, Medicine and Life Sciences Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands

6 Department of General Practice, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

7 Department of Social Medicine, Faculty of Health, Medicine and Life Sciences Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands

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BMC Geriatrics 2010, 10:40  doi:10.1186/1471-2318-10-40

Published: 18 June 2010

Abstract

Background

Knowledge about the circumstances under which injurious falls occur could provide healthcare workers with better tools to prevent falls and fall-related injuries. Therefore, we assessed whether older persons who sustain an injurious fall can be classified into specific fall types, based on a combination of fall location and activity up to the moment of the fall. In addition, we assessed whether specific injurious fall types are related to causes of the fall, consequences of the fall, socio-demographic characteristics, and health-related characteristics.

Methods

An exploratory, cross-sectional study design was used to identify injurious fall types. The study population comprised 333 community-dwelling Dutch elderly people aged 65 years or over who attended an accident and emergency department after a fall. All participants received a self-administered questionnaire after being discharged home. The questionnaire comprised items concerning circumstances of the injurious fall, causes of the fall, consequences of the fall, socio-demographic characteristics and health-related characteristics. Injurious fall types were distinguished by analyzing data by means of HOMALS (homogeneity analysis by means of alternating least squares).

Results

We identified 4 injurious fall types: 1) Indoor falls related to lavatory visits (hall and bathroom); 2) Indoor falls during other activities of daily living; 3) Outdoor falls near the home during instrumental activities of daily living; 4) Outdoor falls away from home, occurring during walking, cycling, and shopping for groceries. These injurious fall types were significantly related to age, cause of the fall, activity avoidance and daily functioning.

Conclusion

The face validity of the injurious fall typology is obvious. However, we found no relationship between the injurious fall types and severity of the consequences of the fall. Nevertheless, there appears to be a difference between the prevalence of fractures and the cause of the fall between the injurious fall types. Our data suggests that with regard to prevention of serious injuries, we should pay special attention to outdoor fallers and indoor fallers during lavatory visits. In addition, we should have special attention for causes of the fall. However, the conclusions reached in this exploratory analysis are tentative and need to be validated in a separate dataset.