Risk factors for fractures due to falls.

A matched case-control study was carried out to identify risk factors for fractures due to falls. All falls that occurred at a rehabilitation hospital from 1981 to 1988 were identified and classified as index falls (falls resulting in fractures) or referent falls (falls not resulting in fractures). For each of the 94 index falls, four referent falls were chosen at random (n = 376) from all other falls occurring in the same four week period. The average age of the individuals sustaining the index fall was 76.8 +/- 10.4 years, and 68% were female; in contrast, the average age of the individuals sustaining the referent fall was 72.0 years (+/- 13.2), and 32% were female. Fractures of the hip predominated (n = 40; 42.6%) and fractures of the ribs were the second most prevalent (n = 20; 21.4%). Fractures most often ensured from a fall from the upright position. Of the 24 variables considered in the conditional logistic regression model, advanced age, being female, being ambulatory, experiencing disorientation, use of vitamin supplements, and use of antiulcer medications were significantly associated with the risk of a fracture. Thus, because fractures are potentially life-threatening, strategies to prevent falls should be targeted especially towards those who are at risk to sustain a fracture from a fall. However, to be compatible with rehabilitation goals, the preventive strategies must strike a balance between the achievement of functional autonomy and patient safety.