Richter M, Becker C, Seifert J, Gebhard F, Pieske O, Holch M, Lob G
Unfallchirurgische Klinik mit Unfallforschung, Medizinische Hochschule Hannover, Hannover.
Unfallchirurg. 2002 Dec;105(12):1076-87. doi: 10.1007/s00113-002-0540-2.
Injuries in the elderly population have more considerable consequences (more difficult treatment, higher costs,worse outcome) than in the younger population. Therefore, the prevention is especially important. The majority of the injuries are caused by traffic accidents and falls. TRAFFIC ACCIDENTS: An analysis of the current injury situation in elderly road users (65 years and older) involved in road traffic accidents was intended to allow conclusions regarding future prophylaxis. FALLS: Falls are mostly caused by numerous factors. The most important predictors for falls are dementia,Parkinson-Syndrome and neurologic deficits after cerebrovascular insults. The most important symptoms, that indicate an increased risk for fall are gait abnormalities, balance lack and underweight. The most important anamnestic indications are more than one falls in the recent 90 days, need for assistance in daily living and prevailing medication. Another important factor is the residential setting (lighting, stairs, floor conditions,bath installations). The most affective protective interventions involve multiple factors. The incidence of falls could be reduced by 30%. The hip protector is an effective protection against proximal femur fractures. which is the most frequent fracture in the elderly population that requires treatment as an inpatient. Injury prevention in the elderly population is an interdisciplinary task as for example shown by the successful fall clinics in the anglo-american area.
与年轻人群相比,老年人群中的损伤会带来更严重的后果(治疗更困难、费用更高、预后更差)。因此,预防尤为重要。大多数损伤是由交通事故和跌倒引起的。交通事故:对涉及道路交通事故的老年道路使用者(65岁及以上)当前的损伤情况进行分析,旨在得出有关未来预防措施的结论。跌倒:跌倒大多由多种因素引起。跌倒的最重要预测因素是痴呆、帕金森综合征和脑血管损伤后的神经功能缺损。表明跌倒风险增加的最重要症状是步态异常、平衡能力差和体重过轻。最重要的既往史指标是最近90天内发生不止一次跌倒、日常生活需要协助以及正在服用的药物。另一个重要因素是居住环境(照明、楼梯、地面状况、浴室设施)。最有效的防护干预措施涉及多个因素。跌倒发生率可降低30%。髋部保护器对预防股骨近端骨折有效,股骨近端骨折是老年人群中最常见的需要住院治疗的骨折。老年人群的损伤预防是一项跨学科任务,例如英美地区成功的跌倒诊所就证明了这一点。