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Four-wheeled walker related injuries in older adults in the Netherlands
  1. K M M van Riel1,
  2. K A Hartholt1,2,3,
  3. M J M Panneman4,
  4. P Patka5,
  5. E F van Beeck6,
  6. T J M van der Cammen1,7,8
  1. 1Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  2. 2Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  3. 3Department of Surgery, Reinier de Graaf Group, Delft, The Netherlands
  4. 4Research Department, Consumer and Safety Institute, Amsterdam, Noord-Holland, The Netherlands
  5. 5Accident and Emergency Department, Erasmus MC, University Medical Center Rotterdam, The Netherlands
  6. 6Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
  7. 7Department of Medicine, Brighton and Sussex Medical School, Brighton, UK
  8. 8Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
  1. Correspondence to Dr Klaas A Hartholt, Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; k.hartholt{at}erasmusmc.nl

Abstract

Background With ageing populations worldwide, mobility devices are used more than ever. In the current literature there is no consensus whether the available mobility devices safely improve the mobility of their users. Also, evidence is lacking concerning the risks and types of injuries sustained while using a four-wheeled walker.

Objective To assess injury risks and injury patterns in older adults (≥65 years) who presented at Emergency Departments (ED) in the Netherlands with an injury due to using a four-wheeled walker.

Design and setting In this study, the Dutch Injury Surveillance System was used to obtain a national representative sample of annual ED visits in the Netherlands in the adult population (≥65 years) sustaining an injury while using a four-wheeled walker. The numbers of four-wheeled walker users in the Netherlands were obtained from the national insurance board. The numbers of ED visits were divided by the numbers of four-wheeled walker users to calculate age- and sex-specific injury risks.

Results Annually 1869 older adults visited an ED after sustaining an injury while using a four-wheeled walker. Falls were the main cause of injury (96%). The injury risk was 3.1 per 100 users of four-wheeled walkers. Women (3.5 per 100 users) had a higher risk than men (2.0 per 100 users). Injury risk was the highest in women aged 85 years and older (6.2 per 100 users). The majority of injuries were fractures (60%) with hip fracture (25%) being the most common injury. Nearly half of all four-wheeled walker related injuries required hospitalisation, mostly due to hip fractures. Healthcare costs per injury were approximately €12 000.

Conclusions This study presents evidence that older adults experiencing a fall while using a four-wheeled walker are at high risk to suffer severe injuries.

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