Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands.
BMC Geriatr. 2010 Jun 18;10:40. doi: 10.1186/1471-2318-10-40.
Knowledge about the circumstances under which injurious falls occur could provide healthcare workers with better tools to prevent falls and fall-related injuries. Therefore, we assessed whether older persons who sustain an injurious fall can be classified into specific fall types, based on a combination of fall location and activity up to the moment of the fall. In addition, we assessed whether specific injurious fall types are related to causes of the fall, consequences of the fall, socio-demographic characteristics, and health-related characteristics.
An exploratory, cross-sectional study design was used to identify injurious fall types. The study population comprised 333 community-dwelling Dutch elderly people aged 65 years or over who attended an accident and emergency department after a fall. All participants received a self-administered questionnaire after being discharged home. The questionnaire comprised items concerning circumstances of the injurious fall, causes of the fall, consequences of the fall, socio-demographic characteristics and health-related characteristics. Injurious fall types were distinguished by analyzing data by means of HOMALS (homogeneity analysis by means of alternating least squares).
We identified 4 injurious fall types: 1) Indoor falls related to lavatory visits (hall and bathroom); 2) Indoor falls during other activities of daily living; 3) Outdoor falls near the home during instrumental activities of daily living; 4) Outdoor falls away from home, occurring during walking, cycling, and shopping for groceries. These injurious fall types were significantly related to age, cause of the fall, activity avoidance and daily functioning.
The face validity of the injurious fall typology is obvious. However, we found no relationship between the injurious fall types and severity of the consequences of the fall. Nevertheless, there appears to be a difference between the prevalence of fractures and the cause of the fall between the injurious fall types. Our data suggests that with regard to prevention of serious injuries, we should pay special attention to outdoor fallers and indoor fallers during lavatory visits. In addition, we should have special attention for causes of the fall. However, the conclusions reached in this exploratory analysis are tentative and need to be validated in a separate dataset.
了解伤害性跌倒发生的情况可以为医护人员提供更好的工具来预防跌倒和跌倒相关伤害。因此，我们评估了受伤跌倒的老年人是否可以根据跌倒地点和跌倒前的活动组合分为特定的跌倒类型。此外，我们评估了特定的伤害性跌倒类型是否与跌倒的原因、跌倒的后果、社会人口统计学特征和与健康相关的特征有关。
采用探索性、横断面研究设计来确定伤害性跌倒类型。研究人群包括 333 名居住在社区的荷兰 65 岁及以上的老年人，他们在跌倒后到急诊室就诊。所有参与者在出院回家后都接受了一份自我管理的问卷。问卷包括伤害性跌倒的情况、跌倒的原因、跌倒的后果、社会人口统计学特征和与健康相关的特征等项目。通过 HOMALS（交替最小二乘法的同质性分析）分析数据来区分伤害性跌倒类型。
我们确定了 4 种伤害性跌倒类型：1）与厕所使用有关的室内跌倒（大厅和浴室）；2）日常生活活动中的室内跌倒；3）日常生活活动中户外跌倒靠近家；4）户外活动远离家，发生在步行、骑自行车和购买杂货时。这些伤害性跌倒类型与年龄、跌倒原因、活动回避和日常功能显著相关。
伤害性跌倒类型学的表面有效性是显而易见的。然而，我们没有发现伤害性跌倒类型与跌倒后果的严重程度之间存在关系。尽管如此，在伤害性跌倒类型之间，骨折的发生率和跌倒的原因似乎存在差异。我们的数据表明，在预防严重伤害方面，我们应该特别注意户外活动者和使用厕所时的室内跌倒者。此外，我们应该特别注意跌倒的原因。然而，在这个探索性分析中得出的结论是试探性的，需要在单独的数据集上进行验证。
