3801 Impact of history of recurrent falls on risk of re-fracture and mortality: a 27-month follow-up study

Introduction Fragility fractures are a major cause of morbidity in older adults and are often preceded by falls. Identifying patients at greatest risk of refracture is vital for optimising secondary prevention strategies within Fracture Liaison Service (FLS). This study measures impact of history of single or recurrent (2 or more) falls on the incidence of re-fracture and mortality among patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS). Methods This study included fragility fracture patients (n = 2176) reviewed by AB-FLS between January and December 2023. Complete data on both frequency of falls was only available in 1093 patients (50.2%), which is a limitation of this study. Clinical outcomes included re-fracture rates and mortality over a 27-months follow-up until 31st March 2025 was completed retrospectively. Results The mean age was 79.4 ± 9.6 years (range = 50–100). Women were 77.7% (n = 849). Only 5.5% (n = 60) patients were admitted from care homes. Previous history of single and recurrent falls was reported in 58.2% (n = 636) and 41.8% (n = 457) of patients respectively. The mean age (SD, range) for patents with single falls and recurrent falls were 79.1 ± 9.5 (50–100) and 79.8 ± 9.7 (53–100) respectively. The one-year mortality rate in patients with history of single falls and recurrent falls was 12.6% (n = 80) and 15.1% (n = 69) respectively, and this was not statistically significant (p = 0.24). The re-fracture rate in patients with history of single falls and recurrent falls was 11.3% (n = 72) and 15.1% (n = 69) respectively, and this was not statistically significant (p = 0.64). However, over 27 months, the overall re-fracture rate in patients with previous recurrent falls was 22.1% (n = 101) and in comparison, patients with previous single falls were 15.1% (n = 96), which was statistically different (p = 0.003). Conclusion This study demonstrates a strong association between history of recurrent falls and risk of re-fracture after 2 years. Enhanced fall prevention and tailored follow up for fragility fracture patients, particularly those with history of recurrent falls needs to be explored further to minimise re-fracture risks and improve long-term outcomes.