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Diabetes Res Clin Pract. 2015 Aug;109(2):233-7. doi: 10.1016/j.diabres.2015.05.050. Epub 2015 Jun 4.

Clinical evidence of diabetes mellitus end-organ damage as risk factor for falls complicated by hip fracture: A multi-center study of 1225 patients.

Author information

1
Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: fformiga@bellvitgehospital.cat.
2
Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
3
Geriatric Unit, Internal Medicine Service, Hospital Sant Pau, IDIBAPS, Barcelona, Spain.
4
Geriatric Unit, Internal Medicine Service, Hospital Clinic, IDIBAPS, Barcelona, Spain.
5
Geriatric Unit, Hospital Sociosanitari Isabel Roig (Centres Blauclinic), Barcelona, Spain.
6
Geriatric Service, Hospital d'Igualada, Consorci Santiàri de l'Anoia, Barcelona, Spain.
7
Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Albert Jovell Institute for Public Health and Patients, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.

Abstract

AIMS:

To identify the differential characteristics of patients with type 2 diabetes mellitus (T2DM) complicated by end-organ damage who experience a fall-related hip fracture.

METHODS:

We analyzed the socio-demographic data and index fall clinical characteristics of a group of patients with nephropathy, neuropathy or retinopathy related to T2DM consecutively admitted to six hospitals in Barcelona, Spain because of a fall-related hip fracture.

RESULTS:

Out of 1225 patients admitted because of a fall-related hip fracture, 107 (8.7%) had clinical evidence of end-organ damage related to T2DM. Among this cohort the mean number of falls during the year prior to the index admission was 2.6±3.2; and 29 of them (27.1%) had already experienced three or more falls. Most falls leading to the index admission took place at the patients' home, from a standing position, and during daylight time. An intrinsic cause of falling was identified in all but one of these patients. Multiple stepwise logistic regression analysis showed that, compared to patients without this diagnosis, patients with complicated T2DM were younger (odds ratio 0.762), had less prevalence of dementia (odds ratio 0.078), but had experienced a higher number of falls in the previous year (odds 1.183).

CONCLUSIONS:

A significant amount of patients with clinical evidence of end-organ damage due to T2DM who experience a fall-related hip fracture have a history of recurrent falling in the previous year. These patients should be identified and offered preventive actions aimed at reducing their risk of falling.

KEYWORDS:

Diabetes; Elderly; End-organ damage; Fall; Hip fracture

PMID:
26070216
DOI:
10.1016/j.diabres.2015.05.050
[Indexed for MEDLINE]

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