Analysis of latent profiles and influencing factors of fall risk perception in elderly patients with hip fracture

Abstract Background Fall risk perception (FRP) plays a crucial role in preventing secondary falls in elderly patients undergoing hip fracture surgery. Different patient groups may perceive environmental fall risk differently, but current research on this is relatively limited. Analyzing the differences in environmental fall risk perception and influencing factors among different types of elderly patients undergoing hip fracture surgery can contribute to a deeper understanding of fall risk awareness. Methods Using convenience sampling, 255 elderly patients hospitalized for hip fractures in the orthopedics department of a Grade A, Class II hospital in Hangzhou from April to July 2025 were selected as participants. Data were collected using a general information questionnaire, the FRP Questionnaire, the Dizziness Handicap Inventory, the Barthel Index, and the Physical Status Scale. Latent profile analysis was conducted using Mplus 8.3. Univariate analysis and multivariate logistic regression were performed using SPSS 26.0. Results This study included a total of 255 elderly patients who were hospitalized due to hip fracture surgery. The three-category model was determined to be the optimal solution (entropy = 0.802) with good classification accuracy and discrimination ability. The elderly patients with hip fractures in the three categories showed the most pronounced differences in environmental factors, while differences in personal activities and physical conditions were relatively small in comparison. Therefore, the three categories were named Low Environmental FRP group (n = 81, 31.76%), Medium Environmental FRP’ group (n = 96, 37.65%) and High Environmental FRP group (n = 78, 30.59%)。The average scores for the three types in terms of environmental factors were 15.51, 24.58 and 34.54. And statistically significant differences were found among the three patient groups in self-reported health status, fear of falling, environmental factor scores, overall fall risk perception score, vertigo handicap score, Barthel Index and physical function performance (P < 0.05). Using the Moderate Environmental FRP Type as the reference group, multinomial logistic regression revealed that poorer self-rated health (OR = 0.243, 95% CI: 0.123–0.481) and fear of falling (OR = 0.209, 95% CI: 0.100–0.438) were associated with a higher likelihood of belonging to the Low Environmental FRP Type. Conversely, better self-rated health (OR = 3.342, 95% CI: 1.578–7.075) and stronger fear of falling (OR = 5.090, 95% CI: 2.230–11.617) significantly increased the likelihood of being classified into the High Environmental FRP Type. Dizziness handicap, Barthel Index and physical performance were not independently associated with profile membership. Conclusion The level of fall risk perception among elderly hip fracture patients was moderate overall and could be classified into distinct latent profiles with clear categorical characteristics. Clinical nursing staff can tailor interventions based on these heterogeneous profiles, providing precise targets to enhance the accuracy of patients’ fall risk perception and ultimately reduce the actual risk of falls. Clinical trial number not applicable.