Peel N M, Kassulke D J, McClure R J
School of Population Health, University of Queensland, Herston, Queensland, Australia.
Inj Prev. 2002 Dec;8(4):280-3. doi: 10.1136/ip.8.4.280.
This study aimed to identify the distribution of fall related injury in older people hospitalised for acute treatment of injury, in order to direct priorities for prevention.
A follow up study was conducted in the Brisbane Metropolitan Region of Australia during 1998.
Medical records of patients aged 65 years and over hospitalised with a fall related injury were reviewed. Demographic and injury data were analysed and injury rates calculated using census data as the denominator for the population at risk.
From age 65, hospitalised fall related injury rates increased exponentially for both males and females, with age adjusted incidence rates twice as high in women than men. Fractures accounted for 89% of admissions, with over half being to the hip. Males were significantly more likely than females to have fractured their skull, face, or ribs (p<0.01). While females were significantly more likely than males to have fractured their upper or lower limbs (p<0.01), the difference between proportions of males and females fracturing their hip was not significant. Males were more likely than females (p<0.01) to have fall related head injuries (13% of admissions). Compared with hip fractures, head injuries contributed significantly to the burden of injury in terms of severity, need for intensive care, and excess mortality.
The frequency and impact of hip fractures warrants continued emphasis in falls program interventions for both males and females to prevent this injury. However, interventions that go beyond measures to slow and protect against bone loss are also needed to prevent fall related head injuries.
本研究旨在确定因急性损伤接受治疗的老年人中与跌倒相关损伤的分布情况，以便指导预防工作的重点。
1998年在澳大利亚布里斯班都会区进行了一项随访研究。
回顾了65岁及以上因跌倒相关损伤住院患者的病历。分析了人口统计学和损伤数据，并以人口普查数据作为危险人群的分母计算损伤率。
从65岁起，男性和女性因跌倒住院的损伤率均呈指数增长，年龄调整后的发病率女性是男性的两倍。骨折占入院病例的89%，其中一半以上是髋部骨折。男性颅骨、面部或肋骨骨折的可能性显著高于女性（p<0.01）。虽然女性上肢或下肢骨折的可能性显著高于男性（p<0.01），但男性和女性髋部骨折比例的差异不显著。男性因跌倒导致头部受伤的可能性高于女性（p<0.01）（占入院病例的13%）。与髋部骨折相比，头部受伤在严重程度、重症监护需求和额外死亡率方面对损伤负担的贡献显著。
髋部骨折的发生频率和影响值得在针对男性和女性的跌倒预防项目干预中持续强调，以预防此类损伤。然而，还需要采取超越减缓骨质流失和预防措施的干预措施，以预防与跌倒相关的头部受伤。
