Seasonal Variations and Common Places of Hip Fractures in Elderly Patients: Nine Year Consecutive Survey

BACKGROUND: Fall prevention is important for reducing hip fractures. The aim of this study was to determine the relationship between variables related to hip fractures according to sex and season. METHODS: This study included patients admitted for fragility hip fractures between 2012 and 2021. Patients were interviewed by a junior resident before discharge. Data on sex, age, diagnosis, osteoporosis treatment, direction, voiding problems, ambulatory function, seasons, weather, time of day, place, location, floor condition, activity during fall, and perceived reason for fall were collected and analyzed. RESULTS: A total of 1,118 patients were included (279 males and 839 females). In both sexes, indoor falls were prevalent throughout all seasons, but males showed a higher proportion of outdoor falls, especially in winter during cloudy or snowy weather. Rooms and walking were the most common locations and activities during falls. The poor ambulatory function was associated with a higher prevalence of indoor falls. Osteoporosis treatment rates were low and did not differ according to Koval stage. Winter was associated with higher osteoporosis non-treatment group. Urgency/incontinence in female patients caused a higher proportion of falls during the evening time. CONCLUSIONS: Strategies for indoor fall prevention and vigilant osteoporosis diagnosis and treatment are important for all seasons, especially for frail elderly patients. Outdoor fall prevention emphasized for male patients, and education around nighttime falls should be provided for female patients with voiding dysfunction.