Fuller G F
White House Medical Clinic, Washington, DC 20502-0041, USA.
Am Fam Physician. 2000 Apr 1;61(7):2159-68, 2173-4.
Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can be markers of poor health and declining function, and they are often associated with significant morbidity. More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age. One third of community-dwelling elderly persons and 60 percent of nursing home residents fall each year. Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications, a directed physical examination and simple tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall and can return the patient to baseline function.
跌倒是美国急诊室受伤相关就诊的主要原因，也是65岁以上人群意外死亡的主要病因。跌倒的死亡率在所有性别、种族和族裔群体中均随年龄急剧上升，75岁及以上人群中70%的意外死亡是由跌倒所致。跌倒可能是健康状况不佳和功能衰退的标志，且常伴有严重的发病情况。超过90%的髋部骨折是跌倒所致，其中大多数骨折发生在70岁以上的人群中。每年有三分之一居住在社区的老年人和60%的养老院居民会跌倒。老年人跌倒的风险因素包括年龄增长、药物使用、认知障碍和感觉缺陷。对跌倒患者的门诊评估包括重点询问用药情况的病史、有针对性的体格检查以及姿势控制和整体身体功能的简单测试。治疗针对跌倒的根本原因，可使患者恢复到基线功能。
