Association of Fall Timing and Location With Clinical Characteristics in Geriatric Hip Fracture Patients: A Cross-Sectional Study

Introduction: Falls can be detrimental for older adults, causing hip fracture that result in disability and increased risk of mortality. This study aimed to investigate the temporal distribution of falls among the geriatric patients with hip fractures and compare the characteristics of falls occurring at different times and locations. Methods: This cross-sectional study analyzed 801 older adults with hip fractures from falls. We collected data on fall timing (day vs night), location (indoor vs outdoor), and patient characteristics, including demographics, handgrip strength, BMI, and the Charlson Comorbidity Index (CCI). The primary analysis investigated the association between these clinical characteristics and the specific circumstances of the fall. Results: This study encompassed 801 hip fracture patients, with 560 women (70%) and 241 men (30%), and a median age of 81 years. Among these patients, 546 (68.3%) experienced falls during the daytime, while 255 (31.7%) fell at night. Furthermore, 577 (74.9%) hip fractures occurred indoors, with 193 (25.1%) falls taking place outdoors. The analysis revealed that patients with lower handgrip strength and BMI were significantly more susceptible to nighttime falls compared to daytime falls. Furthermore, patients who fell indoors exhibited notably higher CCI scores, along with lower BMI, handgrip strength, and pre-fracture ADL, in comparison to those who fell outdoors. Conclusions: Our findings indicate that falls during the daytime were more prevalent among geriatric hip fracture patients in Taiwan compared to nighttime falls. Moreover, we observed that more frail patients were relatively susceptible to falling indoors and at night, emphasizing the potential clinical value for clinicians to take proactive measures in fall prevention.