Vassallo Michael, Sharma Jagdish C, Allen Stephen C
Kings Mill Hospital, Mansfield Road, Sutton-in-Ashfield, Notts NG17 4JL, UK.
Gerontology. 2002 May-Jun;48(3):147-50. doi: 10.1159/000052833.
Recurrent fallers constitute a minority of patients who fall but contribute considerably to the total number of falls recorded.
To study the characteristics of recurrent fallers in a hospital setting.
In a prospective observational study we investigated the characteristics of 1,025 patients admitted to a geriatric non-acute hospital. Patients were followed until discharge and were classified as non-fallers, single fallers or recurrent fallers.
We identified 824 non-fallers, 136 single fallers and 65 recurrent fallers contributing 175 falls. Compared to non-fallers, recurrent fallers were more likely to have pre-admission falls (p = 0.004), confusion (p < 0.0001), an unsafe gait (p = 0.0001) and be on tranquillisers (p = 0.018) and antidepressants (p = 0.006). They had longer stays in hospital (p < 0.0001) and more nursing home discharges (p = 0.0001). There was considerable overlap with risk factors for single fallers but compared to this group they were more likely to be confused (p = 0.027), and on antidepressant medication (p = 0.009). They also had a longer length of stay (p < 0.001) and more nursing home discharges (p = 0.03). Confusion (p = 0.0001), unsafe gait (p = 0.0006) and antidepressants (p = 0.018) were independently associated with recurrent falls.
It is important to recognise the risk factors that prospectively identify a recurrent faller because of the significant contribution to total falls by a relatively small number of patients. This may be useful not only in trying to reduce total falls but also in trying to reduce injury.
反复跌倒者在跌倒患者中占少数，但对记录的跌倒总数有相当大的影响。
研究医院环境中反复跌倒者的特征。
在一项前瞻性观察研究中，我们调查了1025名入住老年非急症医院的患者的特征。对患者进行随访直至出院，并将其分为非跌倒者、单次跌倒者或反复跌倒者。
我们确定了824名非跌倒者、136名单次跌倒者和65名反复跌倒者，后者导致了175次跌倒。与非跌倒者相比，反复跌倒者更有可能在入院前就有跌倒经历（p = 0.004）、出现意识混乱（p < 0.0001）、步态不安全（p = 0.0001），并且正在服用镇静剂（p = 0.018）和抗抑郁药（p = 0.006）。他们住院时间更长（p < 0.0001），从疗养院出院的次数更多（p = 0.0001）。反复跌倒者与单次跌倒者的风险因素有相当大的重叠，但与该组相比，他们更有可能出现意识混乱（p = 0.027），并且正在服用抗抑郁药物（p = 0.009）。他们的住院时间也更长（p < 0.001），从疗养院出院的次数更多（p = 0.03）。意识混乱（p = 0.0001）、步态不安全（p = 0.0006）和抗抑郁药（p = 0.018）与反复跌倒独立相关。
认识到前瞻性识别反复跌倒者的风险因素很重要，因为相对少数的患者对跌倒总数有重大影响。这不仅可能有助于减少跌倒总数，还可能有助于减少伤害。
