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Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review

DOI: 10.1186/1471-2288-12-50

Keywords: Systematic review, Injurious falls, Elderly, Fall-related outcomes, Fall prevention trials

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Abstract:

An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls".The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes.No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review.At least 30% of persons aged over 65 years experience one or more falls each year [1,2] and this proportion increases to 40% after age of 75 [3]. Both the incidence of falls and the severity of complications stemming from a fall increase with age, level of disability, and extent of functional impairment [4,5]. Falls are a major health problem in older adults, causing fall-related sequelae such as fractures, head injuries, and post-fall anxiety [6-11]. Older adults are hospitalised for fall-related injuries five times more often than they are for injuries from other causes [6]. The costs of injurious falls substantially burden health care systems [12].The prevention of falls in older people is an important health target in many countries [13,14] and numerous studies have been published to identify appropriate int

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