Fall, Fracture and Frailty (FFF)

Risk Factors for Fall and Fracture - A Cohort Study of Fall-related Factors Obtained in Routine Orthopaedic Fracture Care

This project aims to improve the global outcome for an aging individual after a traumatic fall, through identifying conditions contributing to a fall and promoting recovery and rehabilitation. Through better understanding 'falling phenotype', the ultimate aim is to prevent future complications, as well as new falls and fractures in the growing older population.

Study Overview

• Status: Active, not recruiting
• Conditions: Frailty; Hip Fractures; Risk Reduction; Fall Injury; Osteoporosis, Osteopenia

Detailed Description

Background: The knowledge of risk factors for falls and fractures amongst older individuals are enormous, still identification of fallers and prevention of falls is not part of Swedish standard of care. Some risk factors are more or less overlooked, such as alcohol consumption, orthostatic reactions, as are increased risks related to common medications such as certain antidepressants, opioids and sedatives. Although functional activity and frailty scores have been suggested to be potential predictors of adverse events, length of hospital stay and mortality, the use of standardized questionnaires has not been implemented in routine care in Sweden. Furthermore, outcomes after fragility fractures, a well known consequence of falls among older individuals, are continuously poor, although palpable improvements have been reached regarding surgical treatment. Are there other factors that are equally or more decisive for the global outcome from the patient's point of view?

Material & Methods: In this prospective observational cohort study, all in-patients treated due to a fall-related trauma (fracture, dislocation or contusion) at the Department of Orthopaedics, Skane University Hospital Malmö, aged 65 years or older will be invited to participate during a 1-year study period. In all participants, a standard package of blood samples, temperature, measurement of orthostatic blood pressure and grip strength, grading of frailty and activity will be routinely obtained.

• Study Type: Observational
• Enrollment (Actual): 1200

Contacts and Locations

Study Locations

• Sweden
  • Skåne
    • Malmö, Skåne, Sweden, 20502
      • Department of Orthopaedics

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Individuals aged 65 years or older who are admitted to Orthopaedic ward at Skåne University Hospital in Malmö, due to a fall or fall-related trauma.

Description

Inclusion Criteria:

• 65 years or older at the time of admission.
• Admitted to Orthopaedic ward at due to fall, with or without a fracture.

Exclusion Criteria:

• Severe head trauma or other severe non-orthopaedic trauma.
• Other condition requiring ward at other department (CCU, ICU) >24 hours.
• Moribund individuals with palliative care only.
• Declined to participate
• Fall > 7 days before admission
• Residence outside the region (lack of follow-up)

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Fallers without a fracture; Individuals who obtain no fracture.
Fallers with a fracture; Individuals who obtain one or several fractures through fall. This group can be further subgrouped according to type of fracture.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mortality	The number of deaths during follow-up	One year after admission to hospital
Re-admission	Number of re-admissions to emergency centre or in-patient ward due to a new fall (primarily) or complications related previous fall/fracture	One year after admission to hospital
Other adverse events	Other adverse events that are not included in outcome measure 1 or 2, such as infection, new falls, fractures, or complications from previous fall/fracture, or other medical complications. These can be further grouped by whether the events occur in in-patient or out-patient care.	One year after admission to hospital

Collaborators and Investigators

• Sponsor: Region Skane
• Investigators: Principal Investigator: Cecilia Rogmark, MD, PhD, Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2023
• Primary Completion (Actual): October 6, 2024
• Study Completion (Estimated): September 6, 2027

Study Registration Dates

• First Submitted: January 11, 2023
• First Submitted That Met QC Criteria: January 25, 2023
• First Posted (Actual): February 3, 2023

Study Record Updates

• Last Update Posted (Actual): July 16, 2025
• Last Update Submitted That Met QC Criteria: July 13, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Keywords: Frailty; Fracture; Falls; Orthogeriatric
• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Wounds and Injuries; Pathologic Processes; Metabolic Diseases; Leg Injuries; Femoral Fractures; Hip Injuries; Frailty; Fractures, Bone; Osteoporosis; Hip Fractures; Bone Diseases, Metabolic
• Other Study ID Numbers: 2022-01997-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data are not publicly available because of patient integrity but anonymized, supplementary data supporting the findings of individual studies are available upon reasonable request to the corresponding author.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No