Berggren M, Stenvall M, Olofsson B, Gustafson Y
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, 901 87 Umeå, Sweden.
Osteoporos Int. 2008 Jun;19(6):801-9. doi: 10.1007/s00198-007-0507-9.
A randomized, controlled fall-prevention study including 199 patients operated on for femoral neck fracture reduced inpatient falls and injuries. No statistically significant effects of the intervention program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone old people.
This study evaluates whether a postoperative multidisciplinary, multifactorial fall-prevention program performed by a geriatric team that reduced inpatient falls and injuries had any continuing effect after discharge. The intervention consisted of staff education, systematic assessment and treatment of fall risk factors and vitamin D and calcium supplementation.
The randomized, controlled trial with a one-year follow-up at Umeå University Hospital, Sweden, included 199 patients operated on for femoral neck fracture, aged > or = 70 years.
After one year 44 participants had fallen 138 times in the intervention group compared with 55 participants and 191 falls in the control group. The crude postoperative fall incidence was 4.16/1,000 days in the intervention group vs. 6.43/1,000 days in the control group. The incidence rate ratio was 0.64 (95% CI: 0.40-1.02, p = 0.063). Seven new fractures occurred in the intervention group and 11 in the control group.
A team applying comprehensive geriatric assessment and rehabilitation, including prevention and treatment of fall-risk factors, reduced inpatient falls and injuries, but no statistically significant effects of the program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone elderly.
一项纳入199例接受股骨颈骨折手术患者的随机对照防跌倒研究降低了住院患者的跌倒及损伤发生率。出院后未检测到干预方案有统计学显著效果。对于易跌倒的老年人而言，预防跌倒似乎必须成为日常生活的一部分。
本研究评估由老年医学团队实施的术后多学科、多因素防跌倒方案在降低住院患者跌倒及损伤发生率方面，出院后是否有持续效果。干预措施包括工作人员培训、对跌倒风险因素进行系统评估与治疗以及补充维生素D和钙。
在瑞典于默奥大学医院进行的这项随机对照试验，随访一年，纳入199例年龄≥70岁、接受股骨颈骨折手术的患者。
一年后，干预组44名参与者跌倒138次，而对照组有55名参与者跌倒191次。干预组术后跌倒粗发生率为4.16/1000天，对照组为6.43/1000天。发病率比为0.64（95%可信区间：0.40 - 1.02，p = 0.063）。干预组发生7例新发骨折，对照组发生11例。
一个应用综合老年医学评估与康复措施（包括预防和治疗跌倒风险因素）的团队降低了住院患者的跌倒及损伤发生率，但出院后未检测到该方案有统计学显著效果。对于易跌倒的老年人而言，预防跌倒似乎必须成为日常生活的一部分。
