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长期护理机构中老年人的跌倒与骨折

[Falls and fractures among older adults living in long-term care].

作者信息

Del Duca Giovâni Firpo, Antes Danielle Ledur, Hallal Pedro Curi

机构信息

Programa de Pós-graduação em Educação Física da Universidade Federal de Santa Catarina. Florianópolis, SC, Brazil.

出版信息

Rev Bras Epidemiol. 2013 Mar;16(1):68-76.

Abstract

OBJECTIVE

To investigate the prevalence of falls and fractures over the past 12 months and associated factors among older adults living in long-term care.

METHODS

Census of all long-term care located in the city of Pelotas, Brazil, in 2008. Falls over the past 12 months were assessed using the following question: "Over the last 12 months, have you fallen?" For those who replied positively, another question was asked: "In any of these falls, have you fractured a bone?" Sex, age, schooling, disability relating to basic activities of daily living, type of financing of the long-term care and hospital admissions were the independent variables. We used chi-square tests for heterogeneity and linear trend in the unadjusted analysis, and Poisson regression with robust variance in the adjusted one.

RESULTS

Within the 24 long-term care studied, we collected data for 466 individuals. The prevalence of falls in the past year was 38.9% (95%CI 34.5; 43.4). Among those who have fallen, 19.2% had fractures. Femur (hip) was the most frequent site fractured (43.4%), followed by wrist (10%). In the adjusted analysis, older age, disability for 1-5 basic activities of daily living, living in public institutions and hospital admissions in the last year were associated with higher risk of falls.

CONCLUSION

The high prevalence of falls and fractures highlights the fragility of the individuals living in long-term care. Special attention should be paid to older adults and those with hospital admissions in the last year.

摘要

目的

调查过去12个月中生活在长期护理机构中的老年人跌倒和骨折的发生率及其相关因素。

方法

对巴西佩洛塔斯市2008年所有长期护理机构进行普查。使用以下问题评估过去12个月内的跌倒情况:“在过去12个月里,您跌倒过吗?”对于回答为肯定的人,再问一个问题:“在这些跌倒中,您有骨折吗?”性别、年龄、受教育程度、与日常生活基本活动相关的残疾情况、长期护理的资金类型以及住院情况为自变量。在未经调整的分析中,我们使用卡方检验来检验异质性和线性趋势,在调整后的分析中使用稳健方差的泊松回归。

结果

在所研究的24个长期护理机构中,我们收集了466名个体的数据。过去一年中跌倒的发生率为38.9%(95%置信区间34.5;43.4)。在跌倒的人群中,19.2%发生了骨折。股骨(髋部)是最常发生骨折的部位(43.4%),其次是腕部(10%)。在调整后的分析中,年龄较大、日常生活1 - 5项基本活动存在残疾、居住在公共机构以及去年有住院经历与跌倒风险较高相关。

结论

跌倒和骨折的高发生率凸显了生活在长期护理机构中的个体的脆弱性。应特别关注老年人以及去年有住院经历的人。

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