Falls are the most frequent cause of hip fracture. We aimed to investigate whether specific fall patterns have predictive value for mortality after hip fracture. In this cohort study, data of individuals presented to the Severance Hospital, Seoul, Korea, between 2005 and 2019 due to fragility hip fracture (n = 1986) were analyzed. Fall patterns were defined as causes, activities leading to falls, and a combination of both, based on electronic medical records using pre-specified classification from a prior study on video-captured falls. Mean age of study subjects were 77 years (71% women) and 211 patients (10.6%) died during follow-up (median 544 days). Indoor falls at home had a higher mortality than outdoor falls (11.9 vs. 8.0%, p = 0.009). Among 16 fall patterns, incorrect weight shift while sitting down (adjusted hazard ratio [aHR] 4.03) or getting up (aHR 2.01), collapse during low-risk activity (aHR 2.39), and slipping while walking (aHR 2.90, p < 0.01 for all) were associated with increased mortality compared to outdoor falls, after adjustment for age, sex, and Charlson comorbidity index (CCI), constituting a high-risk pattern. High-risk fall patterns were associated with a higher risk of mortality (aHR 2.56, p < 0.001) than low-risk patterns (aHR 1.37, p = 0.080) and outdoor falls (referent; log rank p < 0.001), which improved mortality prediction when added to a base model including age, sex, and CCI (integrative area under receiver-operating characteristics curve 0.675 to 0.698, p < 0.001). Specific fall patterns were associated with higher mortality in older adults with hip fracture, independent of age, sex, and comorbidities.

跌倒是髋部骨折最常见的原因。我们旨在调查特定的跌倒模式是否对髋部骨折后的死亡率具有预测价值。在这项队列研究中，分析了 2005 年至 2019 年间因脆性髋部骨折 ( n = 1986) 被送往韩国首尔 Severance 医院的个人数据。跌倒模式被定义为原因、导致跌倒的活动以及两者的组合，基于电子病历，使用先前对视频捕获跌倒的研究中预先指定的分类。研究对象的平均年龄为 77 岁（71% 为女性），211 名患者（10.6%）在随访期间（中位数 544 天）死亡。在家中跌倒的死亡率高于室外跌倒（11.9% vs. 8.0%，p= 0.009）。在 16 种跌倒模式中，坐下时（调整后的风险比 [aHR] 4.03）或起床时体重转移不正确（aHR 2.01）、低风险活动时倒地（aHR 2.39）和走路时滑倒（aHR 2.90，p < 0.01在对年龄、性别和 Charlson 合并症指数 (CCI) 进行调整后，与户外跌倒相比，与室外跌倒的死亡率增加相关，构成高风险模式。高风险的下降模式与死亡率的风险较高（AHR 2.56，相关联的p <0.001）比低风险模式（AHR 1.37，p数等级; = 0.080）和室外瀑布（指涉p< 0.001)，当添加到包括年龄、性别和 CCI 在内的基本模型时，它改进了死亡率预测（接收者操作特征曲线下的综合面积 0.675 至 0.698，p < 0.001）。特定的跌倒模式与老年髋部骨折的较高死亡率相关，与年龄、性别和合并症无关。