Gribbin J, Hubbard R, Smith C, Gladman J, Lewis S
Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
QJM. 2009 Jul;102(7):477-83. doi: 10.1093/qjmed/hcp064. Epub 2009 Jun 5.
Despite the role of primary care in the falls care pathway, there are almost no data on the extent of falls seen in general practices.
To quantify the incidence and mortality of falls amongst older people in primary care in the UK.
Cohort study of people aged >or=60 years and registered in a UK practice contributing data to The Health Improvement Network primary care database (THIN) throughout 2003-06. Analysis of crude incidence and estimation of incidence rate ratios using negative binomial regression, and survival using Cox regression. Sensitivity analysis of criteria for distinguishing discrete fall events from follow-up appointments.
Amongst people aged >or=60 years the overall crude incidence rate of recorded falls was 3.58/100 person-years (95% CI 3.56-3.61). The rate of recurrent falls was 0.67/100 person-years (95% CI 0.66-0.68). The incidence rate of recorded falls and recurrent falls was higher in older age groups, in women and least advantaged social groups. Incidence of recorded falls was constant through the time period 2003-06. Mortality for recurrent fallers was about twice that of general population controls.
These data suggest that more than 475,000 fall events in older people are recorded in general practice each year in the UK, and are associated with increased mortality and relative deprivation. The underlying incidence rate has remained stable in recent years.
尽管初级保健在跌倒护理路径中发挥着作用，但关于全科医疗中所见跌倒情况的程度几乎没有数据。
量化英国初级保健中老年人跌倒的发生率和死亡率。
对年龄≥60岁且在2003年至2006年期间向健康改善网络初级保健数据库（THIN）提供数据的英国医疗机构注册人员进行队列研究。使用负二项回归分析粗发病率并估计发病率比，使用Cox回归分析生存率。对区分离散跌倒事件与随访预约标准的敏感性分析。
在年龄≥60岁的人群中，记录的跌倒总体粗发病率为3.58/100人年（95%可信区间3.56 - 3.61）。反复跌倒率为0.67/100人年（95%可信区间0.66 - 0.68）。记录的跌倒和反复跌倒的发病率在老年人群、女性和最弱势群体中较高。2003年至2006年期间记录的跌倒发病率保持稳定。反复跌倒者的死亡率约为一般人群对照的两倍。
这些数据表明，英国每年在全科医疗中记录的老年人跌倒事件超过47.5万起，且与死亡率增加和相对贫困相关。近年来潜在发病率一直保持稳定。
