Grisso J A, Schwarz D F, Wolfson V, Polansky M, LaPann K
Clinical Epidemiology Unit, University of Pennsylvania 19104.
J Am Geriatr Soc. 1992 Jul;40(7):673-8. doi: 10.1111/j.1532-5415.1992.tb01958.x.
To describe the impact of falls in an elderly African-American urban community and to identify predictors of poor recovery from falls.
Prospective cohort study.
Emergency departments of 11 hospitals in western Philadelphia.
Interviews were conducted with 197 African-American persons 65 years and older residing in West Philadelphia who were treated at an emergency department because of a fall. Second interviews were conducted a median of 7 months after the fall with a sample of 70 patients who had not recovered at the time of the first interview.
Information abstracted from emergency department medical records and information on recovery obtained from two subsequent interviews.
A median of 8 weeks after the fall occurred, 43% of persons reported continued pain or restriction in their usual activities as a result of the fall. Predictors of poor recovery included the presence of grandchildren in the household, hearing impairment, severity of the injury, and injury to the lower extremities. Having someone present at the time of the fall was associated with a lower risk of poor recovery. Forty-one percent of the 70 persons interviewed a second time reported continued pain or restriction in usual activities a median of 7 months after the fall occurred. However, only 7% and 39% had received the services of a home health aide or physical therapist, respectively, and only 14% reported that a physician or other health professional had been particularly helpful since the fall had occurred.
A large proportion of elderly African-American persons treated at emergency departments for falls experience continued pain and restriction of activities after the fall. Many individuals have not recovered 7 months or longer after the fall and few persons report that a physician or other health professional has been particularly helpful since the fall occurred. We suggest that follow-up programs be developed for elderly persons in minority communities who come to emergency departments after a fall.
描述美国城市中一个老年非裔社区跌倒的影响，并确定跌倒后恢复不佳的预测因素。
前瞻性队列研究。
费城西部11家医院的急诊科。
对居住在西费城、年龄在65岁及以上、因跌倒在急诊科接受治疗的197名非裔美国人进行访谈。在跌倒后中位数为7个月时，对首次访谈时未恢复的70名患者进行了第二次访谈。
从急诊科病历中提取的信息以及从随后两次访谈中获得的恢复情况信息。
跌倒发生后中位数为8周时，43%的人报告因跌倒导致持续疼痛或日常活动受限。恢复不佳的预测因素包括家中有孙辈、听力障碍、损伤严重程度以及下肢损伤。跌倒时有他人在场与恢复不佳的风险较低相关。在第二次接受访谈的70人中，41%的人报告在跌倒发生后中位数为7个月时仍有持续疼痛或日常活动受限。然而，分别只有7%和39%的人接受过家庭健康助理或物理治疗师的服务，只有14%的人报告自跌倒发生以来医生或其他健康专业人员特别有帮助。
在急诊科接受治疗的老年非裔美国人中，很大一部分人跌倒后会持续疼痛并活动受限。许多人在跌倒后7个月或更长时间仍未恢复，很少有人报告自跌倒发生以来医生或其他健康专业人员特别有帮助。我们建议为跌倒后前往急诊科的少数族裔社区老年人制定随访计划。
