Abstract
Introduction: Fragility fractures are a major cause of morbidity in older adults and are often preceded by falls. Identifying patients at greatest risk of refracture is vital for optimising secondary prevention strategies within Fracture Liaison Service (FLS). This study measures impact of history of single or recurrent (2 or more) falls on the incidence of re-fracture and mortality among patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS).
Methods: This study included fragility fracture patients (n= 2,176) reviewed by AB-FLS between January and December 2023. Complete data on both frequency of falls was only available in 1093 patients (50.2%), which is a limitation of this study. Clinical outcomes included re-fracture rates and mortality over a 27-months follow-up until 31st March, 2025 was completed retrospectively.
Results: The mean age was 79.4±9.6 years (range = 50-100). Women were 77.7% (n=849). Only 5.5% (n=60) patients were admitted from care homes.
Previous history of single and recurrent falls was reported in 58.2% (n=636) and 41.8% (n=457) of patients respectively. The mean age (SD, range) for patents with single falls and recurrent falls were 79.1±9.5 (50-100) and 79.8±9.7 (53-100) respectively.
The one-year mortality rate in patients with history of single falls and recurrent falls was 12.6% (n=80) and 15.1% (n=69) respectively, and this was not statistically significant (p=0.24).
The re-fracture rate in patients with history of single falls and recurrent falls was 11.3% (n=72) and 15.1% (n=69) respectively, and this was not statistically significant (p=0.64). However, over 27 months, the overall re-fracture rate in patients with previous recurrent falls was 22.1% (n=101) and in comparison, patients with previous single falls were 15.1% (n=96), which was statistically different (p=0.003).
Conclusion: This study demonstrates a strong association between history of recurrent falls and risk of re-fracture after 2 years. Enhanced fall prevention and tailored follow up for fragility fracture patients, particularly those with history of recurrent falls needs to be explored further to minimise re-fracture risks and improve long-term outcomes.
Comments
This is an excellent…
This is an excellent addressing a key issue in osteoporosis care. Inequalities in access to DXA scanning can delay diagnosis and treatment, leading to preventable fractures and poorer outcomes. The multi-dimensional quality improvement approach outlined here is highly relevant, as it focuses on tackling barriers from multiple angles—clinical, logistical, and educational. This kind of comprehensive strategy is essential to ensure equitable access and improve overall bone health management. Keep up the good work.
This is very relevant information
Thank you for this interesting poster. This research effectively draws attention to a growing public health concern and the need for improved screening and preventive strategies..
The impact is knowledgeable
The study conclusion is genuine and authentic, the impact is knowledgeable.
Thanks for taking time to visit our poster
Thanks for your kind comments
This is a good reminder that…
This is a good reminder that a bone health assessment is incomplete without a falls assessment. Just out of interest, how did you define a single fall in your study? For instance, if a patient experienced multiple falls that did not result in hospital attendance, would those community falls be captured in your data? Thank you
Excellent comment and question
We agree that we must do falls assessment and assess for psychological fears associated with falls.
All patients are assessed via FLS and falls question is asked to all we are able to contact and our aim to reach maximum patients
Single falls is marked when a patient report one fall in the last 12 months and 2 or more falls defined as recurrent falls.
So, it is all patient reported most of the time but if we do see falls related admission on system, we mark as recurrent falls.
Happy to link with you further.
Thanks
Inder Singh, Wales