Summary of best evidence for fall prevention after total hip arthroplasty in elderly patients_West China Medical Journal

Authors：

MA Yanfei ,  NING Ning , ZHOU Zongke , CHEN Jiali , HOU Ailin , LI Peifang , HU Rong

Department of Orthopedic Surgery, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

NING Ning, Email: gkningning@126.com

Keywords：

Total hip arthroplasty; fall; elderly; evidence summary; evidence-based nursing

DOI：

10.7507/1002-0179.202305061

Video：

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Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.

Citation： MA Yanfei, NING Ning, ZHOU Zongke, CHEN Jiali, HOU Ailin, LI Peifang, HU Rong. Summary of best evidence for fall prevention after total hip arthroplasty in elderly patients. West China Medical Journal, 2024, 39(10): 1585-1591. doi: 10.7507/1002-0179.202305061 Copy

1.	谷斌. 漸進式平衡訓練在全髖關節置換術后康復早期的應用研究. 南京: 南京中醫藥大學, 2020.
2.	許夢瑤. 八卦掌鍛煉對老年人跌倒風險的影響研究. 北京: 首都體育學院, 2022.
3.	張雪梅. 積極老齡化視角下社區老年健康教育供給研究——以柳州 L 社區為例. 南寧: 廣西大學, 2021.
4.	Ikutomo H, Nagai K, Tagomori K, et al. Incidences and circumstances of falls among women following total hip arthroplasty on long-term follow-up. J Orthop Sci, 2023, 28(3): 577-582.
5.	施小明. 應加強老年健康關鍵因素與相關機制研究. 中華醫學雜志, 2022, 102(2): 85-89.
6.	Hill AM, Ross-Adjie G, McPhail SM, et al. Incidence and associated risk factors for falls in older adults after elective total knee replacement surgery: a prospective cohort study. Am J Phys Med Rehabil, 2022, 101(5): 454-459.
7.	Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
8.	胡雁, 郝玉芳. 循證護理學. 北京: 人民衛生出版社, 2018: 56-67.
9.	汪洋. Cochrane 偏倚風險評估工具簡介. 中國全科醫學, 2019, 22(11): 1322.
10.	王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015(11): 964-967.
11.	北京醫院, 國家老年醫學中心, 中國老年保健醫學研究會老齡健康服務與標準化分會, 等. 居家(養護)老年人跌倒干預指南. 中國老年保健醫學, 2018, 16(3): 32-34.
12.	Crandall M, Duncan T, Mallat A, et al. Prevention of fall-related injuries in the elderly: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg, 2016, 81(1): 196-206.
13.	Kim KI, Jung HK, Kim CO, et al. Evidence-based guidelines for fall prevention in Korea. Korean J Intern Med, 2017, 32(1): 199-210.
14.	National Institute for Health and Care Excellence. Falls: assessment and prevention of falls in older people. London: National Institute for Health and Care Excellence, 2013.
15.	Tseng MY, Liang J, Shyu YI, et al. Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: a prospective randomized controlled trial. BMC Musculoskelet Disord, 2016, 17: 114.
16.	Shyu YI, Liang J, Tseng MY, et al. Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: a randomised controlled trial. Int J Nurs Stud, 2016, 56: 54-62.
17.	Ikutomo H, Nagai K, Tagomori K, et al. Gait abnormality predicts falls in women after total hip arthroplasty. J Arthroplasty, 2018, 33(10): 3215-3219.
18.	Yau DT, Chung RC, Pang MY. Knee muscle strength and visual acuity are the most important modifiable predictors of falls in patients after hip fracture surgery: a prospective study. Calcif Tissue Int, 2013, 92(3): 287-295.
19.	中華中醫藥學會骨傷科分會髖關節功能障礙診療指南制定工作組. 中醫骨傷科臨床診療指南·人工髖關節置換圍手術期康復專家共識. 康復學報, 2017, 27(4): 1-6.
20.	中國康復醫學會老年康復專業委員會專家共識組, 上海市康復醫學會專家共識組. 預防老年人跌倒康復綜合干預專家共識. 老年醫學與保健, 2017, 23(5): 349-352.
21.	廣東省藥學會. 老年人藥物相關性跌倒預防管理專家共識. 今日藥學, 2019, 29(10): 649-659.
22.	US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA, 2018, 319(16): 1696-1704.
23.	Chang CJ, Lin NL, Lee MS, et al. Recovery of posture stability at different foot placements in patients who underwent minimally invasive total hip arthroplasty: a one-year follow-up study. Biomed Res Int, 2015, 2015: 463792.
24.	Di Monaco M, Vallero F, De Toma E, et al. Adherence to recommendations for fall prevention significantly affects the risk of falling after hip fracture: post-hoc analyses of a quasi-randomized controlled trial. Eur J Phys Rehabil Med, 2012, 48(1): 9-15.
25.	中國老年醫學學會. 老年醫學科多學科門診服務模式與規范. 中華老年醫學雜志, 2021, 40(8): 987-990.
26.	毛一晴, 康定鼎, 張博文, 等. 國內外多學科團隊診療模式研究進展. 中國醫院, 2022, 26(3): 18-21.
27.	周洋洋, 倪英杰, 李滎娟, 等. 老年股骨頸骨折治療研究進展. 中國修復重建外科雜志, 2019, 33(8): 1033-1040.
28.	Loizzo M, Gallo F, Caruso D. Reducing complications and overall healthcare costs of hip fracture management: a retrospective study on the application of a diagnostic therapeutic pathway in the Cosenza general hospital. Ann Ig, 2018, 30(3): 191-199.
29.	芮云峰, 邱曉東, 鄒繼紅, 等. 多學科協作診療模式在老年髖部骨折的臨床應用. 中國修復重建外科雜志, 2019, 33(10): 1276-1282.
30.	Bartlett AS, Parton S, Lattuca J. Physical therapy self-management strategies for a patient with a total hip replacement and heart failure: a case report. Home Healthc Now, 2018, 36(5): 304-311.
31.	丁曄, 何曉紅. 多元化健康教育對骨科術后患者深靜脈血栓認知水平及健康行為的影響. 海軍醫學雜志, 2020, 41(3): 343-345.
32.	符美玲, 蘇飛月, 趙慶華, 等. 患者安全文化建設實踐研究. 中國衛生質量管理, 2021, 28(5): 75-78.
33.	趙瑞萍, 李澍, 張鵬, 等. 基于 HFMEA 的醫院公共區域公用設施患者安全流程再造. 中國醫院管理, 2021, 41(11): 57-59.
34.	郭麗敏, 楊思源, 賈媛, 等. 術后跌倒恐懼對髖關節置換患者結局指標的影響. 長春中醫藥大學學報, 2020, 36(6): 1272-1274, 1278.
35.	徐程, 徐姝娟, 陳思仙, 等. 皖南地區三級甲等醫院護士對患者安全態度現狀及影響因素分析. 職業與健康, 2022, 38(4): 488-491, 496.

1. 谷斌. 漸進式平衡訓練在全髖關節置換術后康復早期的應用研究. 南京: 南京中醫藥大學, 2020.
2. 許夢瑤. 八卦掌鍛煉對老年人跌倒風險的影響研究. 北京: 首都體育學院, 2022.
3. 張雪梅. 積極老齡化視角下社區老年健康教育供給研究——以柳州 L 社區為例. 南寧: 廣西大學, 2021.
4. Ikutomo H, Nagai K, Tagomori K, et al. Incidences and circumstances of falls among women following total hip arthroplasty on long-term follow-up. J Orthop Sci, 2023, 28(3): 577-582.
5. 施小明. 應加強老年健康關鍵因素與相關機制研究. 中華醫學雜志, 2022, 102(2): 85-89.
6. Hill AM, Ross-Adjie G, McPhail SM, et al. Incidence and associated risk factors for falls in older adults after elective total knee replacement surgery: a prospective cohort study. Am J Phys Med Rehabil, 2022, 101(5): 454-459.
7. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
8. 胡雁, 郝玉芳. 循證護理學. 北京: 人民衛生出版社, 2018: 56-67.
9. 汪洋. Cochrane 偏倚風險評估工具簡介. 中國全科醫學, 2019, 22(11): 1322.
10. 王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015(11): 964-967.
11. 北京醫院, 國家老年醫學中心, 中國老年保健醫學研究會老齡健康服務與標準化分會, 等. 居家(養護)老年人跌倒干預指南. 中國老年保健醫學, 2018, 16(3): 32-34.
12. Crandall M, Duncan T, Mallat A, et al. Prevention of fall-related injuries in the elderly: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg, 2016, 81(1): 196-206.
13. Kim KI, Jung HK, Kim CO, et al. Evidence-based guidelines for fall prevention in Korea. Korean J Intern Med, 2017, 32(1): 199-210.
14. National Institute for Health and Care Excellence. Falls: assessment and prevention of falls in older people. London: National Institute for Health and Care Excellence, 2013.
15. Tseng MY, Liang J, Shyu YI, et al. Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: a prospective randomized controlled trial. BMC Musculoskelet Disord, 2016, 17: 114.
16. Shyu YI, Liang J, Tseng MY, et al. Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: a randomised controlled trial. Int J Nurs Stud, 2016, 56: 54-62.
17. Ikutomo H, Nagai K, Tagomori K, et al. Gait abnormality predicts falls in women after total hip arthroplasty. J Arthroplasty, 2018, 33(10): 3215-3219.
18. Yau DT, Chung RC, Pang MY. Knee muscle strength and visual acuity are the most important modifiable predictors of falls in patients after hip fracture surgery: a prospective study. Calcif Tissue Int, 2013, 92(3): 287-295.
19. 中華中醫藥學會骨傷科分會髖關節功能障礙診療指南制定工作組. 中醫骨傷科臨床診療指南·人工髖關節置換圍手術期康復專家共識. 康復學報, 2017, 27(4): 1-6.
20. 中國康復醫學會老年康復專業委員會專家共識組, 上海市康復醫學會專家共識組. 預防老年人跌倒康復綜合干預專家共識. 老年醫學與保健, 2017, 23(5): 349-352.
21. 廣東省藥學會. 老年人藥物相關性跌倒預防管理專家共識. 今日藥學, 2019, 29(10): 649-659.
22. US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA, 2018, 319(16): 1696-1704.
23. Chang CJ, Lin NL, Lee MS, et al. Recovery of posture stability at different foot placements in patients who underwent minimally invasive total hip arthroplasty: a one-year follow-up study. Biomed Res Int, 2015, 2015: 463792.
24. Di Monaco M, Vallero F, De Toma E, et al. Adherence to recommendations for fall prevention significantly affects the risk of falling after hip fracture: post-hoc analyses of a quasi-randomized controlled trial. Eur J Phys Rehabil Med, 2012, 48(1): 9-15.
25. 中國老年醫學學會. 老年醫學科多學科門診服務模式與規范. 中華老年醫學雜志, 2021, 40(8): 987-990.
26. 毛一晴, 康定鼎, 張博文, 等. 國內外多學科團隊診療模式研究進展. 中國醫院, 2022, 26(3): 18-21.
27. 周洋洋, 倪英杰, 李滎娟, 等. 老年股骨頸骨折治療研究進展. 中國修復重建外科雜志, 2019, 33(8): 1033-1040.
28. Loizzo M, Gallo F, Caruso D. Reducing complications and overall healthcare costs of hip fracture management: a retrospective study on the application of a diagnostic therapeutic pathway in the Cosenza general hospital. Ann Ig, 2018, 30(3): 191-199.
29. 芮云峰, 邱曉東, 鄒繼紅, 等. 多學科協作診療模式在老年髖部骨折的臨床應用. 中國修復重建外科雜志, 2019, 33(10): 1276-1282.
30. Bartlett AS, Parton S, Lattuca J. Physical therapy self-management strategies for a patient with a total hip replacement and heart failure: a case report. Home Healthc Now, 2018, 36(5): 304-311.
31. 丁曄, 何曉紅. 多元化健康教育對骨科術后患者深靜脈血栓認知水平及健康行為的影響. 海軍醫學雜志, 2020, 41(3): 343-345.
32. 符美玲, 蘇飛月, 趙慶華, 等. 患者安全文化建設實踐研究. 中國衛生質量管理, 2021, 28(5): 75-78.
33. 趙瑞萍, 李澍, 張鵬, 等. 基于 HFMEA 的醫院公共區域公用設施患者安全流程再造. 中國醫院管理, 2021, 41(11): 57-59.
34. 郭麗敏, 楊思源, 賈媛, 等. 術后跌倒恐懼對髖關節置換患者結局指標的影響. 長春中醫藥大學學報, 2020, 36(6): 1272-1274, 1278.
35. 徐程, 徐姝娟, 陳思仙, 等. 皖南地區三級甲等醫院護士對患者安全態度現狀及影響因素分析. 職業與健康, 2022, 38(4): 488-491, 496.

West China Medical Journal

Summary of best evidence for fall prevention after total hip arthroplasty in elderly patients

Abstract Full text Figures/Tables Video References Cited by

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