Luukinen H, Herala M, Koski K, Honkanen R, Laippala P, Kivelä S L
Department of Public Health Science and General Practice, Oulu University Hospital, Finland.
Osteoporos Int. 2000;11(7):631-4. doi: 10.1007/s001980070086.
The kinetic energy and direction of a fall contribute to the occurrence of fracture. However, the fracture risk associated with different types of fall, different amounts of energy and different landing directions is poorly understood. We recorded all falls and fall-related fractures over 7 years in an aged semi-rural home-dwelling population (n = 980), using intensive fall recording. The falls were classified according to type and place of occurrence into slip falls (SLFs), trip falls (TRFs), other extrinsic falls on the level (OEFs), intrinsic falls on the level (IFs), stair falls (STFs), falls from an upper level (ULFs) and nondefined falls (NDFs) occurring indoors or outdoors. Incidences of falls and fractures were calculated for the whole follow-up period. The population was clinically examined to assess general risk factors of fracture, after which the risk of fracture was determined in the first fall according to the different fall types. Comparison was made with intrinsic falling on the level. The overall incidences of indoor and outdoor falls were 328 (95% CI 314-345) and 198 (186 210) per 1000 person-years (PY), respectively, and those of fractures 23 (19-27) and 11 (8-4) per 1000 PY, respectively. Indoor SLFs, TRFs, OEFs, IFs, STFs, ULFs and NDFs occurred relatively evenly throughout the study period. The crude and adjusted relative fracture risks were greater in SLFs, OEFs and STFs compared with IFs. Indoor falls and fractures are more common than those occurring outdoors in aged home-dwelling persons. The kinetic energies produced in SLFs, OEFs and STFs may be higher than those generated in IFs, leading to increased risk of fracture.
跌倒的动能和方向会导致骨折的发生。然而，人们对不同类型的跌倒、不同能量水平以及不同着地方向所关联的骨折风险了解甚少。我们通过密集的跌倒记录，对一个半乡村居家老年人群（n = 980）在7年期间的所有跌倒及与跌倒相关的骨折情况进行了记录。跌倒根据类型和发生地点分为滑倒（SLF）、绊倒（TRF）、其他平地外部跌倒（OEF）、平地内在跌倒（IF）、楼梯跌倒（STF）、高处跌倒（ULF）以及室内或室外发生的未定义跌倒（NDF）。计算了整个随访期间的跌倒和骨折发生率。对该人群进行临床检查以评估骨折的一般风险因素，之后根据不同的跌倒类型确定首次跌倒时的骨折风险。与平地内在跌倒进行了比较。室内和室外跌倒的总体发生率分别为每1000人年328次（95%可信区间314 - 345）和198次（186 - 210），骨折发生率分别为每1000人年23次（19 - 27）和11次（8 - 14）。在整个研究期间，室内的SLF、TRF、OEF、IF、STF、ULF和NDF发生情况相对较为均匀。与IF相比，SLF、OEF和STF的粗相对骨折风险和调整后相对骨折风险更高。在居家老年人中，室内跌倒和骨折比室外更为常见。SLF、OEF和STF产生的动能可能高于IF产生的动能，从而导致骨折风险增加。 （注：原文中“11 (8 - 4)”可能有误，根据上下文推测应为“11 (8 - 14)”，译文已按此修正）
