Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients)

To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age years, range 65–101). Falls were defined “accidental” (fall explained by a definite accidental cause), “medical” (fall caused directly by a specific medical disease), “dementia-related” (fall in patients affected by moderate-severe dementia), and “unexplained” (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury. 1. Introduction Falls in older people are a major public health concern in terms of morbidity, mortality, and health and social services costs [1]. Falls are the leading cause of injury-related visits to emergency department in the United States. Trauma is the fifth leading cause of death in people starting from 65 years, and falls are responsible for 70% of accidental death in people starting from 75 years. More than a third of older adults falls each year [2]. About one-third of community-dwelling elderly people and up to 60% of nursing home residents fall each year; one half of these “fallers” have multiple episodes [3]. Nearly all hip fractures occur as a fall result [4]. Fall-related injuries among older adults, especially among older women, are associated with substantial economic costs, mostly because of hip fractures and their subsequent disability [5]. Data regarding fall types in patients admitted to orthopaedic wards because of fall-related injury are lacking: the UFO study (Unexplained Falls in Older Patients) was made to assess the incidence and the clinical characteristics of unexplained falls in this specific group of elderly subjects affected by fall-related fractures. 2. Methods 2.1.