3724 An audit of inpatient falls—are we adequately addressing bone health?
Abstract
Falls in older adults frequently result in osteoporotic fractures, leading to longer stays, greater dependency, and long-term morbidity. Fragility fractures are estimated to cost the UK around £4.5 billion annually. Despite these serious implications, tools like FRAX, and routine assessments such as calcium and vitamin D levels, are still underused in the inpatient setting, especially following a fall. The National Osteoporosis Guideline Group (NOGG) recommends using the FRAX tool to estimate 10-year fracture risk and guide bone protection.
To evaluate: • Was a FRAX score calculated for patients who fell while in hospital? • Was bone protection initiated appropriately based on FRAX risk? • Was a vitamin D level checked within one year of the fall?
A retrospective case review of 35 in-patients falls during April–May 2023 across the Trust was done. Patients identified via DATIX and then randomly selected. A custom-designed proforma was used to assess completion of post-fall assessment form, FRAX score, risk stratification and bone health management decisions.
Most falls occurred in patients aged 70–90, consistent with NICE data indicating that 30% of people over 65 and 50% over 80 fall annually. Falls assessment sheet was completed in over 80% of cases. FRAX score was calculated in only 33.3% of cases. Among those, 60% of the patients were at intermediate risk, 20% at high risk and 10% at very high risk of future fractures. Among high-risk patients only 50% received oral…
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