Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut.
J Am Geriatr Soc. 2019 Jan;67(1):119-123. doi: 10.1111/jgs.15639. Epub 2018 Oct 16.
To evaluate the relationship between number of falls and risk of injury after a specific fall.
Prospective cohort study.
Greater New Haven, Connecticut.
Probability sample of 1,103 community-living persons aged 72 and older.
Falls and fall-related injuries were ascertained monthly for 3 years using a fall calendar and follow-up telephone interviews.
Of 606 participants with a fall, 164 (27.0%) had at least 1 fall with a serious injury, and 455 (75.1%) had at least 1 fall with any injury; mean number of falls was 2.6±2.3 (range 1-18), of falls with serious injury was 0.3±0.6 (range 0-4), and of falls with any injury was 1.4±1.4 (range 0-9). On a per-participant basis, risk of serious injury and any injury increased progressively as the number of falls increased (P < .001). On a per-fall basis, risk of serious injury and any injury increased from 1 to 2 falls but then decreased from 2 to 3 or 4 falls and from 3 or 4 to 5 or more falls, although these differences were not statistically significant. The results were consistent for women and men and for analyses that evaluated the proportion of falls with injuries.
In community-living older persons, risk of injury from a specific fall did not differ as the number of falls increased. Falls appear to operate independently in terms of conferring risk of injury in the setting of multiple falls. J Am Geriatr Soc 67:119-123, 2019.
评估特定跌倒后跌倒次数与受伤风险之间的关系。
前瞻性队列研究。
康涅狄格州大纽黑文地区。
概率抽样选取的 1103 名 72 岁及以上的社区居住者。
使用跌倒日历和后续电话访谈,在 3 年内每月确定跌倒和与跌倒相关的伤害情况。
在 606 名发生跌倒的参与者中,164 名(27.0%)至少发生 1 次伴有严重伤害的跌倒,455 名(75.1%)至少发生 1 次伴有任何伤害的跌倒;平均跌倒次数为 2.6±2.3(范围 1-18),严重伤害跌倒次数为 0.3±0.6(范围 0-4),任何伤害跌倒次数为 1.4±1.4(范围 0-9)。在个体参与者基础上,随着跌倒次数的增加,严重伤害和任何伤害的风险呈递增趋势(P <.001)。在每次跌倒的基础上,严重伤害和任何伤害的风险从 1 次跌倒增加到 2 次跌倒,但随后从 2 次跌倒减少到 3 次或 4 次跌倒,从 3 次或 4 次跌倒减少到 5 次或更多次跌倒,尽管这些差异没有统计学意义。这些结果在女性和男性以及评估受伤跌倒比例的分析中是一致的。
在社区居住的老年人中,特定跌倒后受伤的风险与跌倒次数的增加无关。在多次跌倒的情况下,跌倒似乎独立地增加受伤的风险。美国老年医学会杂志 67:119-123,2019。