Background: Falls are a significant health problem and major burden on healthcare services. Falls are typically associated with ageing-related frailty, but diabetic peripheral neuropathy, postural hypotension and hyponatraemia are recognised risk factors for falling that might be independent of ageing-related factors. We undertook a study to assess the prevalence of these independent risk factors in patients admitted to hospital following a fall.
Methods: This study (n=102, 72 females, mean age 77.7 years) included a retrospective sample (RS) of 78 patients and prospective sample (PS) of 24 patients who presented to a district general hospital in the UK following a fall. Paper and electronic notes for all patients were analysed and the prospective patients were assessed for peripheral neuropathy.
Results: Of the102 patients none were assessed for peripheral neuropathy on admission despite a diabetes prevalence of 23%. In the PS group, 11 patients were identified (using touch the toe test and 10 g monofilament) as having peripheral neuropathy (n=5 with diabetes). Less than 10% of patients were assessed for postural hypotension despite 24% reporting associated symptoms. Hyponatraemia was identified in 36%.
Conclusion: This study has identified that after admission to hospital following a fall screening for some key risk factors is not routinely performed. From the PS, prevalence of peripheral neuropathy was 46%. Patients experiencing a fall need to be screened for postural hypotension and peripheral neuropathy, with quick bedside tests available. Hyponatraemia is common in elderly patients and needs greater attention in the community setting. Correctly identifying the presence of risk factors following a fall allows clinicians to make adjustments to a patients care and reduce the risk of further falls.