Characteristics of patients with hip fractures and comorbid fall-related injuries in the emergency department.

AIM: Hip fracture is one of the most common fall-related injuries in the elderly population. Although falls may cause multiple types of injuries, no study has investigated the details of fall-related injuries accompanied by hip fractures. This study aimed to characterize the features of such injuries.

METHODS

This is a cross-sectional study using data from four tertiary emergency departments in Japan. We identified patients diagnosed with hip fracture including femoral neck fracture, trochanter fracture, or subtrochanteric fracture from May 12, 2014 to July 12, 2021. Among patients with hip fracture, we included those with fall-related hip fracture. We excluded patients ages <40 years old and whose fall was high energy onset, defined as fall from more than three steps or 1 m.

RESULTS

Among 326 emergency departments patients diagnosed with fall-related hip fracture, 288 patients were eligible for the analysis. Seventeen patients (6%) had injuries in addition to hip fractures. The most frequent injury was upper limb injury (e.g., distal radial fracture; n = 5, 30%), followed by head injury (e.g., subdural hematoma; n = 4, 24%), chest injury (e.g., pneumothorax; n = 2, 12%), and trunk injury (vertebral compression fracture; n = 2, 12%). There were no significantly different clinical characteristics between patients with hip injuries and those without.

CONCLUSION

A total of 6% of patients diagnosed with hip fracture had other fall-related injuries. The most frequent were upper limb injury and head injury. Our findings underscore the importance of whole-body assessment in patients with fall-related hip fracture in the emergency department.