Suppr超能文献

熟练护理机构居民中机械约束的使用与跌倒相关伤害

Mechanical restraint use and fall-related injuries among residents of skilled nursing facilities.

作者信息

Tinetti M E, Liu W L, Ginter S F

机构信息

Department of Medicine, Yale University School of Medicine, New Haven, CT 06510-8056.

出版信息

Ann Intern Med. 1992 Mar 1;116(5):369-74. doi: 10.7326/0003-4819-116-5-369.

Abstract

OBJECTIVE

To evaluate the association between mechanical restraint use and the occurrence of injurious falls among persons residing in skilled nursing facilities.

DESIGN

Prospective observational cohort study.

SETTING

Twelve skilled nursing facilities in southern Connecticut.

PARTICIPANTS

The 397 persons who were mobile and unrestrained at baseline.

MEASUREMENTS

Restraint use was defined both as the number of days restrained and as "never," "intermittently," or "continually" restrained. The primary outcome measure was the occurrence of a serious fall-related injury. Analyses were done on the entire cohort as well as on a subgroup hypothesized as having a high risk for falls.

MAIN RESULTS

During one year of follow-up, 122 subjects (31%) became restrained, 83 intermittently and 39 continually. A serious fall-related injury was experienced by 5% (15 of 275) of unrestrained, compared with 17% (21 of 122) of restrained, subjects (chi-square = 12.478; P less than 0.001). Restraint use remained independently associated with serious injury after adjusting for other factors, both in the entire cohort (adjusted odds ratio, 10.2; 95% CI, 2.8 to 36.9) and in the high-risk subgroup (adjusted odds ratio, 6.2; CI, 1.7 to 22.2). Among the 305 subjects who experienced two or fewer falls, the proportion having a serious injury was 15% for restrained subjects compared with 4% for unrestrained subjects (difference in proportions 11%, CI, 4% to 17%), whereas the comparable proportions for the 92 subjects who experienced more than two falls were 20% and 16%, respectively. Results were similar in the high-risk subgroup.

CONCLUSIONS

Mechanical restraints were associated with continued, and perhaps increased, occurrence of serious fall-related injuries after controlling for other injury risk factors. Study results suggest the need to consider whether restraints provide adequate, if any, protection.

摘要

目的

评估在专业护理机构中使用机械约束与发生伤害性跌倒之间的关联。

设计

前瞻性观察队列研究。

地点

康涅狄格州南部的12家专业护理机构。

参与者

397名在基线时可移动且未受约束的人员。

测量

约束使用情况定义为受约束的天数以及“从未”、“间歇性”或“持续”受约束。主要结局指标是发生严重的与跌倒相关的损伤。对整个队列以及假设为跌倒高风险的亚组进行了分析。

主要结果

在一年的随访期间,122名受试者(31%)受到约束,83名间歇性受约束,39名持续受约束。未受约束的受试者中有5%(275名中的15名)经历了严重的与跌倒相关的损伤,而受约束的受试者中有17%(122名中的21名)经历了此类损伤(卡方 = 12.478;P < 0.001)。在调整其他因素后,约束使用在整个队列(调整后的优势比,10.2;95%可信区间,2.8至36.9)和高风险亚组(调整后的优势比,6.2;可信区间,1.7至22.2)中仍与严重损伤独立相关。在经历两次或更少跌倒的305名受试者中,受约束受试者发生严重损伤的比例为15%,而未受约束受试者为4%(比例差异为11%,可信区间,4%至17%),而在经历两次以上跌倒的92名受试者中,相应比例分别为20%和16%。高风险亚组的结果相似。

结论

在控制其他损伤风险因素后,机械约束与严重的与跌倒相关的损伤持续发生且可能增加有关。研究结果表明需要考虑约束是否提供了充分的保护(如果有的话)。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验