Kirchhoff Marianne, Bregnbak Michael J, Backe Hanne, Hendriksen Carsten, Obel Kirsten
Den Rehabiliterende Klinik, Geriatrisk Afsnit, Frederiksberg Hospital, DK-2000 Frederiksberg.
Ugeskr Laeger. 2008 Nov 3;170(45):3667-70.
The aim of this retrospective study was to quantify and characterize contacts to the acute emergency department due to fall accidents among elderly aged 65 years and above at H:S Hvidovre hospital in Copenhagen during a three-month period. Data on demographics, injuries and admission rates were collected along with follow-up data during the six months after the index contact.
Case records from patients aged 65 years and above seen in the emergency department from July 1st to September 30th 2001 were examined. Patients with documented falls as primary cause of contact were included. Via a central database the use of emergency department, admissions to hospital and mortality during the next six months were monitored.
During the three-month period, 535 elderly persons (582 visits) were seen in the acute emergency department because of a fall. Of these 186 (32%) had a fracture. A total of 39% of the patients were admitted to hospital. Among the elderly who returned directly to their home from the emergency department, 37% had no planned appointment for follow-up in the social or health care system. The next six months saw 215 contacts to acute emergency departments and 444 hospital admissions (including the first admission). The contacts and admissions generated 8,310 bed-days. The six-month mortality was 13%.
The results document the frailty of a considerable proportion of the elderly who contact the acute emergency department because of a fall. About half of the elderly returning home directly from hospital have no planned follow-up. A more structured assessment and collaboration between hospital and primary health care is needed in order to prevent further falls among the elderly.
这项回顾性研究的目的是对哥本哈根市H:S维德奥医院65岁及以上老年人在三个月内因跌倒事故前往急诊部的情况进行量化和特征描述。收集了人口统计学、损伤情况和入院率数据以及首次就诊后六个月的随访数据。
对2001年7月1日至9月30日在急诊部就诊的65岁及以上患者的病历进行检查。纳入以跌倒为主要就诊原因且有记录的患者。通过中央数据库监测急诊部的使用情况、接下来六个月的住院情况和死亡率。
在这三个月期间,有535名老年人(共就诊582次)因跌倒前往急诊部。其中186人(32%)发生了骨折。共有39%的患者入院。在从急诊部直接回家的老年人中,37%在社会或医疗保健系统中没有安排后续随访预约。在接下来的六个月里,有215人次前往急诊部,444人次住院(包括首次住院)。这些就诊和住院产生了8310个住院日。六个月的死亡率为13%。
结果表明,相当一部分因跌倒前往急诊部的老年人身体虚弱。约一半直接从医院回家的老年人没有安排后续随访。为防止老年人再次跌倒,需要在医院和初级卫生保健之间进行更有条理的评估和协作。