Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand.
School of Health Sciences, University of Canterbury-Te Whare Wānanga o Waitaha, Christchurch, New Zealand.
BMC Geriatr. 2021 Nov 4;21(1):630. doi: 10.1186/s12877-021-02576-1.
Falls and falls-related injuries are common among older adults. Injuries in older adults lead to poor outcomes and lower quality of life. The objective of our study was to identify factors associated with fall-related injuries among home care clients in New Zealand.
The study cohort consisted of 75,484 community-dwelling people aged 65 years or older who underwent an interRAI home care assessment between June 2012 and June 2018 in New Zealand. The injuries included for analysis were fracture of the distal radius, hip fracture, pelvic fracture, proximal humerus fracture, subarachnoid haemorrhage, traumatic subdural haematoma, and vertebral fracture. Unadjusted and adjusted competing risk regression models were used to identify factors associated with fall-related injuries.
A total of 7414 (9.8%) people sustained a falls-related injury over the 6-year period, and most injuries sustained were hip fractures (4735 63.9%). The rate of injurious falls was 47 per 1000 person-years. The factors associated with injury were female sex, older age, living alone, Parkinson's disease, stroke/CVA, falls, unsteady gait, tobacco use, and being underweight. Cancer, dyspnoea, high BMI, and a decrease in the amount of food or fluid usually consumed, were associated with a reduced risk of sustaining an injury. After censoring hip fractures the risks associated with other types of injury were sex, age, previous falls, dyspnoea, tobacco use, and BMI.
While it is important to reduce the risk of falls, it is especially important to reduce the risk of falls-related injuries. Knowledge of risk factors associated with these types of injuries can help to develop focused intervention programmes and development of a predictive model to identify those who would benefit from intervention programmes.
跌倒和与跌倒相关的伤害在老年人中很常见。老年人受伤会导致不良后果和生活质量下降。我们的研究目的是确定与新西兰家庭护理客户相关的跌倒伤害因素。
研究队列由 75484 名年龄在 65 岁或以上的居住在社区的人组成，他们在 2012 年 6 月至 2018 年 6 月期间接受了新西兰的 interRAI 家庭护理评估。分析中包括的伤害包括桡骨远端骨折、髋部骨折、骨盆骨折、肱骨近端骨折、蛛网膜下腔出血、创伤性硬脑膜下血肿和椎体骨折。使用未经调整和调整后的竞争风险回归模型来确定与跌倒相关伤害相关的因素。
在 6 年期间，共有 7414 人（9.8%）发生了与跌倒相关的伤害，大多数伤害是髋部骨折（4735 例，63.9%）。伤害性跌倒的发生率为每 1000 人年 47 次。与伤害相关的因素是女性、年龄较大、独居、帕金森病、中风/脑卒、跌倒、步态不稳、吸烟和体重不足。癌症、呼吸困难、高 BMI，以及食物或液体摄入量减少，与降低受伤风险有关。在排除髋部骨折后，其他类型伤害的风险与性别、年龄、既往跌倒、呼吸困难、吸烟和 BMI 有关。
虽然降低跌倒风险很重要，但降低与跌倒相关的伤害风险尤为重要。了解与这些类型伤害相关的风险因素有助于制定有针对性的干预计划，并开发预测模型以确定那些受益于干预计划的人。
