Saadat Soheil, Hafezi-Nejad Nima, Ekhtiari Yalda Soleiman, Rahimi-Movaghar Afarin, Motevalian Abbas, Amin-Esmaeili Masoumeh, Sharifi Vandad, Hajebi Ahmad, Radgoodarzi Reza, Hefazi Mitra, Eslami Vahid, Karimi Hasti, Mohammad Kazem, Rahimi-Movaghar Vafa
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran; School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Injury. 2016 Jul;47(7):1404-9. doi: 10.1016/j.injury.2016.05.001. Epub 2016 May 4.
Fall-related injuries are considered to be a leading cause of morbidity and disability worldwide. The aim of this study was to investigate the incidence of fall-related injuries and its determinants in Iran.
A cross-sectional household survey of a representative sample of 15-64 years old Iranians was carried out in 2011. A three-stage cluster sampling design was used. Total of 1525 clusters were randomly selected. Six households in each cluster were randomly selected, and one member of each household was interviewed. Data on the demographics and history of fall-related injury were obtained using the previously validated and reliability tested Short Form Injury Questionnaire 7 (SFIQ7). In all, 7886 subjects responded to the survey.
The incidence rate of all fall-related injuries was 59 (95%CI: 45-72) per 1000 person-year. The incidence rate of First Aid Fall-Related Injuries (FAFRIs) and Medical Attended Fall-Related Injuries (MAFRIs) were 30±5 and 28±12, respectively. Homes were the most common place of falls (52.5%). For all and MAFRIs, the most common activity leading to fall injury was walking (37.8% and 47.6%, respectively) whereas for FAFRIs was playing (31.9%). For all and FAFRIs, the most common description was as follows: upper limb as the injured organ (52.0% and 61.2%, respectively) and superficial wound as the most prevalent type of injury (39.0% and 61.8%, respectively). However, for MAFRIs, lower limb injuries (52.9%) and fracture (43.6%) were more pronounced. Risk factors for MAFRI were as follows: paid work activity (OR: 3.11; 95%CI: 2.07-4.67), playing (OR: 14.64; 95%CI: 6.34-33.80), walking (OR: 57.09; 95%CI: 28.95-112.59), driving (OR: 2.86; 95%CI: 1.23-6.63), and recreation activities (OR: 44.11; 95%CI: 14.04-138.54). Higher age and education were the other risk factors for MAFRI, as well as residing in rural areas.
This study revealed considerable incidence of fall injuries in Iranian population especially in rural regions who need access to protective equipment. People need to be warned about the constant risk of fall even during non-avoidable activities such as walking, playing, driving and paid/unpaid working especially in older ages. Implementation of fall prevention measures, home and behavioural modifications are recommended.
在全球范围内,与跌倒相关的伤害被认为是发病和残疾的主要原因。本研究旨在调查伊朗与跌倒相关伤害的发生率及其决定因素。
2011年对15 - 64岁具有代表性的伊朗人群样本进行了横断面家庭调查。采用三阶段整群抽样设计。总共随机选择了1525个群组。每个群组随机选择6户家庭,每户一名成员接受访谈。使用先前经过验证和可靠性测试的简式伤害问卷7(SFIQ7)获取人口统计学和与跌倒相关伤害史的数据。共有7886名受试者回应了调查。
每1000人年所有与跌倒相关伤害的发生率为59(95%置信区间:45 - 72)。急救跌倒相关伤害(FAFRI)和就医跌倒相关伤害(MAFRI)的发生率分别为30±5和28±12。家庭是最常见的跌倒场所(52.5%)。对于所有跌倒及MAFRI,导致跌倒受伤最常见的活动是行走(分别为37.8%和47.6%),而对于FAFRI是玩耍(31.9%)。对于所有跌倒及FAFRI,最常见的描述如下:上肢为受伤器官(分别为52.0%和61.2%),浅表伤口是最常见的伤害类型(分别为39.0%和61.8%)。然而,对于MAFRI,下肢受伤(52.9%)和骨折(43.6%)更为突出。MAFRI的危险因素如下:有偿工作活动(比值比:3.11;95%置信区间:2.07 - 4.67)、玩耍(比值比:14.64;95%置信区间:6.34 - 33.80)、行走(比值比:57.09;95%置信区间:28.95 - 112.59)、驾驶(比值比:2.86;95%置信区间:1.23 - 6.63)以及娱乐活动(比值比:44.11;95%置信区间:14.04 - 138.54)。年龄较大和受教育程度较高以及居住在农村地区也是MAFRI的其他危险因素。
本研究表明伊朗人群中跌倒伤害的发生率相当高,尤其是在农村地区,这些地区需要获得防护设备。需要提醒人们,即使在诸如行走、玩耍、驾驶和有偿/无偿工作等不可避免的活动中,尤其是在老年人中,也要时刻注意跌倒风险。建议实施预防跌倒措施、家庭和行为方面的改进。