Myers A H, Baker S P, Van Natta M L, Abbey H, Robinson E G
Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
Am J Epidemiol. 1991 Jun 1;133(11):1179-90. doi: 10.1093/oxfordjournals.aje.a115830.
A case-control study among 184 matched pairs of patients 65 years of age and older was undertaken to identify risk factors associated with falls and injuries in a long-term care facility in Baltimore, Maryland, in 1984-1985. Patients were matched on length of stay. Variables of interest included sociodemography, functional status, medications, and diagnoses. For all levels of care combined, the following factors were associated (p less than or equal to 0.01) with increased falls: being able to walk (relative odds (RO) = 4.0), age 90 years and older (RO = 3.8), a history of falling (RO = 5.0), and taking a vasodilator (RO = 3.0). Among the 184 fallers, the diagnosis of dementia (RO = 7.5) or taking a diuretic (RO = 7.2) was positively associated with injury (p less than or equal to 0.01). In each of the analyses, medications were associated with falls or injuries, suggesting a feasible intervention. The combination of a history of falling, being able to walk, and being 90 years of age or older increased the relative odds to 51.9 and could alert clinicians to identify and monitor high-risk elderly persons in need of preventive measures.
1984年至1985年期间，在马里兰州巴尔的摩的一家长期护理机构中，对184对年龄在65岁及以上的匹配患者进行了一项病例对照研究，以确定与跌倒和受伤相关的风险因素。患者按住院时间进行匹配。感兴趣的变量包括社会人口统计学、功能状态、药物治疗和诊断。对于所有护理级别合并分析，以下因素与跌倒增加相关（p≤0.01）：能够行走（相对比值（RO）=4.0）、90岁及以上（RO = 3.8）、有跌倒史（RO = 5.0）以及服用血管扩张剂（RO = 3.0）。在184名跌倒患者中，痴呆诊断（RO = 7.5）或服用利尿剂（RO = 7.2）与受伤呈正相关（p≤0.01）。在每项分析中，药物治疗都与跌倒或受伤相关，提示有可行的干预措施。有跌倒史、能够行走且年龄在90岁及以上这几个因素相结合，使相对比值增加到51.9，这可以提醒临床医生识别和监测需要采取预防措施的高危老年人。
