Chippendale Tracy, Gentile Patricia A, James Melissa K, Melnic Gloria
New York University, Steinhardt School of Culture, Education, and Human Development, Department of Occupational Therapy, New York, NY, USA.
Jamaica Hospital Medical Center, Department of Surgery, Jamaica, NY, USA.
Geriatr Gerontol Int. 2017 Jun;17(6):905-912. doi: 10.1111/ggi.12800. Epub 2016 May 3.
The aim of the present study was to examine significant differences in patient characteristics, associated factors and outcomes for indoor versus outdoor falls among trauma patients.
A retrospective cross-sectional study using data from the trauma registry and electronic medical records at a level 1 trauma center in the USA was carried out. People aged 55 years or older, for whom fall location could be identified (n = 712), were included in the study. Demographic information, functional status before admission, comorbid conditions, activation level, Injury Severity Score, discharge disposition and injury type were included in the comparative analyses. Associated factors for falls and fractures in each location were also examined using logistic regression.
Significant differences were found in patient characteristics between indoor and outdoor fallers. Significant differences in outcomes were found related to discharge disposition and injury type. Open wounds were more common among outdoor fallers (26.5%) as compared with indoor fallers (16.3%, P = 0.002). Although disorders of joints with difficulty walking were associated with fractures among both indoor (OR 7.20, CI 2.19-23.66) and outdoor fallers (OR 5.65, CI 1.27-25.06), sex was only associated with fractures among those who fell indoors (OR 1.69 CI 1.12-2.56).
Significant differences exist in characteristics of indoor and outdoor fallers, and for discharge disposition and injury type for each fall location among patients admitted for trauma care. Factors associated with fractures differ between indoor and outdoor fallers. Results can help to inform targeted primary and secondary prevention initiatives. Geriatr Gerontol Int 2017; 17: 905-912.
本研究旨在探讨创伤患者室内跌倒与室外跌倒在患者特征、相关因素及结局方面的显著差异。
采用美国一家一级创伤中心创伤登记处和电子病历数据进行回顾性横断面研究。纳入年龄在55岁及以上、跌倒地点可确定的患者（n = 712）。比较分析纳入人口统计学信息、入院前功能状态、合并症、活动水平、损伤严重程度评分、出院处置方式及损伤类型。还采用逻辑回归分析各地点跌倒和骨折的相关因素。
发现室内跌倒者与室外跌倒者在患者特征方面存在显著差异。在出院处置方式和损伤类型方面发现结局存在显著差异。与室内跌倒者（16.3%）相比，开放性伤口在室外跌倒者中更常见（26.5%，P = 0.002）。尽管行走困难的关节疾病在室内跌倒者（OR 7.20，CI 2.19 - 23.66）和室外跌倒者（OR 5.65，CI 1.27 - 25.06）中均与骨折相关，但性别仅与室内跌倒者的骨折相关（OR 1.69，CI 1.12 - 2.56）。
创伤护理入院患者中，室内跌倒者与室外跌倒者在特征方面存在显著差异，且各跌倒地点的出院处置方式和损伤类型也存在差异。室内跌倒者和室外跌倒者与骨折相关的因素不同。研究结果有助于为有针对性的一级和二级预防措施提供参考。《老年医学与老年病学国际杂志》2017年；17：905 - 912。
