Vlahov D, Myers A H, al-Ibrahim M S
Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205.
Arch Phys Med Rehabil. 1990 Jan;71(1):8-12.
Falls in institutional settings have been associated with considerable morbidity. Although risk factors for falls have been described for acute care and geriatric settings, data from the rehabilitation setting are sparse. To provide a descriptive epidemiology, incident reports of falls were reviewed at a 151-bed rehabilitation facility. Of 567 patients admitted between January 1 and December 31, 1984, 71 (12.5%) experienced at least one fall; most (75%) of the falls occurred in patients using wheelchairs. Risk for falls was associated with increasing age (p less than 0.05), a diagnosis of stroke, or lower extremity amputation (p less than 0.05). Of the 71 fallers, 31% experienced repeat falls which tended to occur more frequently with older age, disorientation, and nonambulatory status at first fall. Nearly 13% sustained injuries, which tended to occur more frequently among disoriented and wheelchair or bedfast patients. These data suggest that groups of patients who are at high risk for falls within the rehabilitation setting can be identified for the purposes of prevention, and targeted for preventive measures.
在医疗机构中，跌倒与相当高的发病率相关。尽管已经描述了急性护理和老年护理环境中的跌倒风险因素，但康复环境中的相关数据却很稀少。为了提供描述性流行病学信息，我们在一家拥有151张床位的康复机构中审查了跌倒事件报告。在1984年1月1日至12月31日期间收治的567名患者中，有71名（12.5%）至少经历了一次跌倒；其中大多数跌倒（75%）发生在使用轮椅的患者身上。跌倒风险与年龄增长（p<0.05）、中风诊断或下肢截肢（p<0.05）相关。在71名跌倒患者中，31%经历了再次跌倒，再次跌倒在年龄较大、定向障碍以及首次跌倒时非步行状态的患者中往往更频繁发生。近13%的患者受到了伤害，在定向障碍以及使用轮椅或卧床不起的患者中受伤往往更频繁。这些数据表明，为了预防目的，可以在康复环境中识别出跌倒高风险患者群体，并针对他们采取预防措施。
