Lester Paula, Haq Mahenaaz, Vadnerkar Amruta, Feuerman Marty
Winthrop University Hospital, Mineola, NY, USA.
J Am Med Dir Assoc. 2008 Nov;9(9):684-6. doi: 10.1016/j.jamda.2008.06.007. Epub 2008 Sep 25.
Falls increase morbidity and mortality among nursing home residents and have varied causes and risk factors. The purpose of this study was to assess whether falls in nursing home residents were more prevalent at particular times of the day.
DESIGN/PARTICIPANTS: This study was a retrospective chart review for falls in a skilled nursing facility in New York from January to June, 2007.
There were 220 falls during the 6-month period. Most falls (66%) occurred in the resident's room and almost half (48%) resulted in an injury. Falls during the evening were likely to result in a more serious injury than daytime falls (P = .03). A statistically significant higher percentage of falls (27%) occurred between 4 pm and 8 pm (compared with expected number in a 4-hour period, P < .001). Among the 3 nursing shifts, the lowest percentage of falls occurred during the 11 pm to 7 am night shift (16%).
This study reveals a variation in the prevalence of falls in the nursing home based on time of day that is different from the pattern of falls in the hospital setting. More research is needed to evaluate possible causes of this temporal pattern of falls in the nursing home. Perhaps these data can be used to implement specific interventions at times when falls are more common to reduce the risk of falls.
跌倒会增加疗养院居民的发病率和死亡率，且有多种原因和风险因素。本研究的目的是评估疗养院居民跌倒在一天中的特定时间是否更为普遍。
设计/参与者：本研究是对纽约一家专业护理机构2007年1月至6月期间跌倒情况的回顾性病历审查。
在这6个月期间共发生220次跌倒。大多数跌倒（66%）发生在居民房间内，近一半（48%）导致受伤。与白天跌倒相比，晚上跌倒导致更严重伤害的可能性更大（P = 0.03）。在下午4点至晚上8点之间发生跌倒的百分比在统计学上显著更高（27%）（与4小时时间段内的预期数量相比，P < 0.001）。在三个护理班次中，跌倒发生率最低的是晚上11点至早上7点的夜班（16%）。
本研究揭示了疗养院跌倒发生率在一天中的变化，这与医院环境中的跌倒模式不同。需要更多研究来评估疗养院跌倒时间模式的可能原因。或许这些数据可用于在跌倒更常见的时间实施特定干预措施，以降低跌倒风险。
