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Investigating the Relationship between Factors Affecting Hip Fracture and Its Consequences in Imam Khomeini Hospital Complex during 2017-2020
Mahya Jafarnejad, Esmaeil Mohammadnejad, Leila Sayadi, Shima Haghani, Reza Ghanei Gheshlagh, Afzal Shamsi,
Volume 16, Issue 3 (8-2022)
Abstract
Background and Aim: Fractures and dislocations of the femur are a common and disruptive public health problem worldwide. One of the most common ways is to identify the factors associated with common outcomes that increase mortality, length of hospital stay, and postoperative complications. By identifying these factors, the adverse outcomes of elderly hip fractures can be prevented. Therefore, the aim of this study was to determine the relationship between factors affecting hip fracture and its consequences. 
Materials and Methods: The present study was a descriptive cross-sectional observational study. The study population in this study included patients with hip fractures. Patients’ information was examined between 2017-2020 years. Data were analyzed by SPSS applying descriptive statistics, Fisher Exact test, chi-square, independent t-tests, and analytical regression.
Results: The results showed that in this study, the majority of patients with hip fracture had an underlying disease (73.9%). The most common underlying diseases in patients included high blood pressure (20.7%), diabetes (13.2%) and heart diseases (10.5%). The most common causes of death was include old age (40.4%), prevalence of covid-19 (20.2%), heart attack (11.7%), pulmonary embolism (10.6%) and surgical wound infection (10.6%). The most common cause of hip fracture was osteoporosis (26.3%) and falling from a height (24.7%). Also level of education (P=0.0001), causes of fracture (P=0.001), type of anesthesia (P=0.001), history of hospitalization in special wards (P=0.001), readmission (P=0.0001), age (P=0.001) and level of self-care (P=0.001) were significantly associated with elderly mortality. There was a significant relation between type of surgery (P=0.038), history of hospitalization in intensive care units (P=0.001), history of blood transfusion (P=0.021) and level of self-care (P=0.001) with length of hospital stay of fractured elderly hip.
Conclusion: It can be concluded that by identifying the factors affecting the length of hospital stay, surgical wound infection and mortality of the patients with hip fractures, witness better surgery results, shorter hospital stay, less postoperative complications and reduced death. Some factors such as osteoporosis are preventable, which can be prevented with timely education.

Solutions for Preventing Patient Falls in Hospitals: A Scoping Review
Marziyeh Najafi, Roya Rajaee, Hojjat Rahmani, Behrooz Pouragha, Nazanin Sheikh Mohammadi, Ghasem Rajabi Vasokolaei,
Volume 18, Issue 1 (3-2024)
Abstract
Background and Aim: Patient falls are common in hospitals, leading to financial loss and potential harm to patients, staff, and the organization. They can often be prevented with proper planning. This study aims to identify strategies to prevent patient falls and provide evidence to develop safety initiatives.
Materials and Methods: Our review used the Arksey and O’Malley scoping review model to identify strategies for preventing patient falls. We conducted searches with relevant keywords in the PubMed and Web of Science databases until May 25, 2024. In the final stage, we consulted with 18 experts using the Delphi method to gather their opinions. The data were analyzed using the thematic analysis method.
Results: Out of the 4202 studies initially found, 19 articles were chosen. The solutions to prevent patient falls can be grouped into six general categories: planning (which includes quality improvement programs, establishment of patient safety culture, patient fall prevention guidelines and programs), physical space (involving patient room design and the location of treatment staff), equipment (such as monitoring and alarms, pressure sensors, and standard beds), human resources (including communication networks between nurses and other treatment staff, as well as factors like self-efficacy and responsiveness of nurses, and their motivation and job satisfaction), training (covering education and patient participation, training of nurses and treatment staff, and electronic training), and control of executive processes (involving evaluation of risk factors and process control). The highest level of agreement among the members was on the equipment dimension (9.76), and the lowest was on the human resources dimension (8.65).
Conclusion: Patient falls are a common safety concern in hospitals and can be prevented with proper planning. Each hospital should use a combination of prevention methods tailored to its specific conditions.

Smart Health Ecosystem of Osteoporotic Fracture Prevention: A Qualitative Systematic Review
Ayoub Mohamadian, Ali Moeini, Mahnaz Sanjari, Zahra Abdullahzade,
Volume 18, Issue 6 (2-2025)
Abstract
Background and Aim: Smart health, due to its capacity in disease prevention, is a suitable solution for providing osteoporosis fracture prevention services. Also, the existence of close relationships between active organizations for the prevention of this disease requires this area to be examined from the perspective of the ecosystem. Therefore, the purpose of this study is to identify the factors and players of the ecosystem of preventing fractures caused by osteoporosis in smart health.
Materials and Methods: A qualitative systematic review of meta-synthesis was conducted to find resources related to the prevention of osteoporosis-related fractures. For this purpose, scientific databases of Web of Science, Scopus and PubMed were examined and 155 were selected from 10344 sources found. At the end, by using the Shannon entropy method, the categories of each dimension were ranked.
Results: This systematic review demonstrated that the ecosystem for preventing fractures caused by osteoporosis comprises four main categories of factors: lifestyle (nutrition, exercise, fall prevention, cessation of tobacco, alcohol, and caffeine consumption), clinical (screening, diagnosis, and drug therapy), technological (infrastructure, platform, and application), and contextual (cultural, social participation, policy, economic, and education). The application and infrastructure secured the first and second positions in the ranking, while the platform and education collectively ranked third. Ecosystem participants were also categorized into three core layers: the fracture prevention and treatment team members, firms related to fracture prevention and treatment, and other health stakeholders; the extended layer, which includes affected or at-risk individuals, education stakeholders, cultural stakeholders, social stakeholders, and health stakeholders; and the external layer, comprising international organizations and national ministries. In the ranking, affected or at-risk individuals, other health stakeholders, and fracture prevention and treatment team members earned first to third positions, respectively.
Conclusion: The research results showed that “technological”, “contextual”, “lifestyle change” and “clinical” factors are in the first to fourth places, respectively. Also, among the players, the first place was assigned to the extended layer, the main core took the second place, and the external layer took the third place.

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