Kendrick Denise, Watson Michael C, Mulvaney Caroline A, Smith Sherie J, Sutton Alex J, Coupland Carol A C, Mason-Jones Amanda J
Division of Primary Care, School of Nursing, University of Nottingham, Hucknall Primary Care Trust, Hucknall Health Centre, Nottingham, England, UK.
Am J Prev Med. 2008 Oct;35(4):370-379. doi: 10.1016/j.amepre.2008.06.038.
Childhood falls are an important global public health problem, but evidence on their prevention has not been quantitatively synthesized. Despite social inequalities in childhood injury rates, there is a lack of evidence examining the effect of fall-prevention practices by social group.
A systematic review of literature was conducted up to June 2004 and meta-analysis using individual patient data to evaluate the effect of home-safety interventions on fall-prevention practices and fall-injury rates. Meta-regression examined the effect of interventions by child age, gender, and social variables. Included were 21 studies, 13 of which contributed to meta-analyses.
Home-safety interventions increased stair-gate use (OR=1.26; 95% CI=1.05, 1.51), and there was some evidence of reduced baby-walker use (OR=0.66; 95% CI=0.43, 1.00), but little evidence of increased possession of window locks, screens, or windows with limited opening (OR=1.16, 95% CI=0.84, 1.59) or of nonslip bath mats or decals (OR=1.15; 95% CI=0.51, 2.62). Two studies reported nonsignificant effects on falls (baby-walker-related falls on flat ground [OR=1.35; 95% CI=0.64, 2.83] or down steps or stairs [OR=0.70; 95% CI=0.14, 3.49]) and medically attended falls (OR=0.78; 95% CI=0.61, 1.00).
Home-safety education and the provision of safety equipment improved some fall-prevention practices, but the impact on fall-injury rates is unclear. There was some evidence that the effect of home-safety interventions varied by social group.
儿童跌倒在全球范围内是一个重要的公共卫生问题，但关于预防跌倒的证据尚未进行定量综合分析。尽管儿童伤害发生率存在社会不平等现象，但缺乏关于不同社会群体预防跌倒措施效果的证据。
截至2004年6月进行了一项文献系统综述，并使用个体患者数据进行荟萃分析，以评估家庭安全干预措施对预防跌倒措施和跌倒伤害率的影响。荟萃回归分析了儿童年龄、性别和社会变量对干预效果的影响。纳入了21项研究，其中13项有助于荟萃分析。
家庭安全干预措施增加了楼梯门的使用（比值比=1.26；95%置信区间=1.05，1.51），有一些证据表明婴儿学步车的使用有所减少（比值比=0.66；95%置信区间=0.43，1.00），但几乎没有证据表明窗户锁、纱窗或开口受限窗户的拥有量增加（比值比=1.16，95%置信区间=0.84，1.59），也没有证据表明防滑浴垫或贴纸的拥有量增加（比值比=1.15；95%置信区间=0.51，2.62）。两项研究报告了对跌倒（与婴儿学步车相关的平地跌倒[比值比=1.35；95%置信区间=0.64，2.83]或下台阶或楼梯跌倒[比值比=0.70；95%置信区间=0.14，3.49]）和需要就医的跌倒（比值比=0.78；95%置信区间=0.61，1.00）的影响不显著。
家庭安全教育和安全设备的提供改善了一些预防跌倒的措施，但对跌倒伤害率的影响尚不清楚。有一些证据表明家庭安全干预措施的效果因社会群体而异。
