2004-2017 年美国老年人的致命和非致命伤害趋势。
Trends in Fatal and Nonfatal Injuries Among Older Americans, 2004-2017.
机构信息
IPUMS and the Minnesota Population Center, University of Minnesota-Twin Cities, Minneapolis, Minnesota.
School of Nursing, Purdue University, West Lafayette, Indiana.
出版信息
Am J Prev Med. 2020 Jul;59(1):3-11. doi: 10.1016/j.amepre.2020.01.008. Epub 2020 Mar 20.
INTRODUCTION
This study (1) provides annual population estimates of fatal and nonfatal injury incidence rates for older adults for 2004-2017; (2) determines if trends differ by whether the injury was fatal or nonfatal, a fall or nonfall injury, and for nonfatal injuries, minor or serious; and (3) investigates whether trends vary by age, sex, and race.
METHODS
This study used National Vital Statistics System and National Health Interview Survey data covering the population of adults aged ≥65 years for 2004-2017. Fatal injury incidence rates were estimated using negative binomial models; nonfatal injury incidence rates were estimated using Poisson models. All models compared overall risk and trend differences by year, age, sex, and race, and interactions between year and age, sex, and race. All analyses were conducted in 2019.
RESULTS
Fatal injury incidence was stable over time, but this apparent stability masked a 35% increase in fatal falls and a 17% decrease in fatal nonfall injuries. Increases in fall-related deaths were concentrated among those aged ≥85 years, men, and white older adults. The trend in fatal falls accelerated over time for those aged ≥85 years and white older adults. By contrast, there was a large increase in nonfatal injury incidence, occurring across all injury types. Nonfatal injury risk grew with age and was higher for women and white older adults, but trends did not vary by age, sex, or race.
CONCLUSIONS
Large increases in fatal and nonfatal injuries underscore the urgency of national implementation of fall prevention programs and expanding fall prevention efforts to more general injury prevention.
简介
本研究（1）提供了 2004-2017 年老年人致命和非致命伤害发生率的年度人口估计；（2）确定了伤害是否致命或非致命、是否为跌倒或非跌倒伤害以及非致命伤害是轻微还是严重，这些因素是否会导致趋势不同；（3）研究了趋势是否因年龄、性别和种族而异。
方法
本研究使用了国家生命统计系统和国家健康访谈调查数据，涵盖了 2004-2017 年≥65 岁成年人的人口。使用负二项式模型估计致命伤害发生率；使用泊松模型估计非致命伤害发生率。所有模型均比较了整体风险和年度、年龄、性别和种族的趋势差异，以及年度、年龄、性别和种族之间的相互作用。所有分析均于 2019 年进行。
结果
致命伤害发生率在一段时间内保持稳定，但这种表面上的稳定掩盖了致命跌倒发生率增加了 35%，非致命非跌倒伤害发生率下降了 17%。跌倒相关死亡人数的增加主要集中在≥85 岁、男性和白人老年人中。对于≥85 岁和白人老年人来说，致命跌倒的趋势随着时间的推移而加速。相比之下，非致命伤害发生率大幅上升，涉及所有伤害类型。非致命伤害风险随着年龄的增长而增加，女性和白人老年人的风险更高，但趋势不因年龄、性别或种族而异。
结论
致命和非致命伤害的大幅增加突显了全国实施跌倒预防计划以及将跌倒预防工作扩展到更普遍的伤害预防工作的紧迫性。
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