Kannus Pekka, Palvanen Mika, Niemi Seppo, Parkkari Jari
Accident & Trauma Research Center, UKK Institute for Health Promotion Research, P.O. Box 30, FIN-33501 Tampere, Finland.
J Gerontol A Biol Sci Med Sci. 2007 Feb;62(2):180-3. doi: 10.1093/gerona/62.2.180.
Although fall-induced injuries among older adults are said to be a major public health concern in modern societies with aging populations, reliable epidemiologic information on their secular trends is limited.
We determined the current trend in the number and incidence (per 100,000 persons) of fall-induced severe cervical spine injuries (fracture, cord injury, or both) of older adults in Finland, a European Union country with a well-defined white population of 5.2 million, by taking into account all persons aged 50 years or older who were admitted to all Finnish hospitals for primary treatment of such injury in 1970-2004. Similar patients aged 20-49 years served as a reference group.
The number and raw incidence of fall-induced cervical spine injury among Finns aged 50 years or older rose considerably between the years 1970 and 2004, from 59 (number) and 5.2 (incidence) in 1970 to 228 and 12.0 in 2004. The relative increases were 286% and 131%, respectively. Throughout the study period, the age-standardized incidence of injury was higher in men than women, and showed a clear increase in both sexes in 1970-2004 from 8.5 to 17.4 in men (105% increase), and from 2.8 to 6.4 in women (129% increase). A similar finding was observed in the age-specific incidences of the study group. In the reference group, the annual number and incidence of injury decreased slightly over time. Assuming that the observed increase in the age-standardized or age-specific injury incidence continues in Finns aged 50 years or older and the size of this population increases as predicted, the annual number of fall-induced cervical spine injuries in this population will be about 100% higher in the year 2030 (about 400 injuries annually) than it was during 2000-2004 (about 200 injuries annually).
In Finnish persons aged 50 years or older, the number of fall-induced severe cervical spine injuries seems to show an alarming rise with a rate that cannot be explained merely by demographic changes. The finding underscores an increasing influence of falls on health and well-being of our older adults; therefore, wide-scale fall-prevention measures should be urgently adopted to control this development.
尽管在人口老龄化的现代社会中,老年人因跌倒导致的伤害被认为是一个主要的公共卫生问题,但关于其长期趋势的可靠流行病学信息有限。
我们通过纳入1970 - 2004年期间因此类损伤在芬兰所有医院接受初次治疗的所有50岁及以上的患者,确定了芬兰(一个拥有520万明确白种人口的欧盟国家)老年人因跌倒导致的严重颈椎损伤(骨折、脊髓损伤或两者皆有)的数量和发病率(每10万人)的当前趋势。年龄在20 - 49岁的类似患者作为参照组。
1970年至2004年期间,芬兰50岁及以上人群中因跌倒导致的颈椎损伤的数量和粗发病率大幅上升,从1970年的59例(数量)和5.2(发病率)增至2004年的228例和12.0。相对增幅分别为286%和131%。在整个研究期间,男性的年龄标准化损伤发病率高于女性,并且在1970 - 2004年期间,男女发病率均明显上升,男性从8.5升至17.4(增幅105%),女性从2.8升至6.4(增幅129%)。在研究组的年龄特异性发病率中也观察到类似的发现。在参照组中,损伤的年度数量和发病率随时间略有下降。假设在50岁及以上的芬兰人中,观察到的年龄标准化或年龄特异性损伤发病率的上升继续存在,且该人群规模如预期那样增加,那么到2030年,该人群中因跌倒导致的颈椎损伤的年度数量将比2000 - 2004年期间(每年约200例损伤)高出约100%(每年约400例损伤)。
在芬兰50岁及以上的人群中,因跌倒导致的严重颈椎损伤的数量似乎呈惊人的上升趋势,其速率不能仅由人口结构变化来解释。这一发现强调了跌倒对老年人健康和福祉的影响日益增加;因此,应紧急采取广泛的预防跌倒措施来控制这一发展趋势。