Boston University School of Medicine, Boston, MA, USA.
Liaison to ACS COT, Injury Prevention and Control Committee, USA.
Am Surg. 2023 Apr;89(4):968-974. doi: 10.1177/00031348211047509. Epub 2021 Nov 8.
Approximately 27.5% of adults 65 and older fall each year, over 3 million are treated in an emergency department, and 32 000 die. The American College of Surgeons and its Committee on Trauma (ACSCOT) have urged trauma centers (TCs) to screen for fall risk, but information on the role of TC in this opportunity for prevention is largely unknown.
A 29-item survey was developed by an ACSCOT Injury Prevention and Control Committee, Older Adult Falls workgroup, and emailed to 1000 trauma directors of the National Trauma Data Bank using Qualtrics. US TCs were surveyed regarding fall prevention, screening, intervention, and hospital discharge practices. Data collected and analyzed included respondent's role, location, population density, state designation or American College of Surgeons (ACS) level, if teaching facility, and patient population.
Of the 266 (27%) respondents, 71% of TCs include fall prevention as part of their mission, but only 16% of TCs use fall risk screening tools. There was no significant difference between geographic location or ACS level. The number of prevention resources (F = 31.58, < .0001) followed by the presence of a formal screening tool (F = 21.47, < .0001) best predicted the presence of a fall prevention program.
Older adult falls remain a major injury risk and injury prevention opportunity. The majority of TCs surveyed include prevention of older adult falls as part of their mission, but few incorporate the components of a fall prevention program. Development of best practices and requiring TCs to screen and offer interventions may prevent falls.
每年约有 27.5%的 65 岁及以上成年人跌倒,超过 300 万人在急诊科接受治疗,32000 人死亡。美国外科医师学会及其创伤委员会(ACSCOT)敦促创伤中心(TC)筛查跌倒风险,但关于 TC 在这一预防机会中的作用的信息在很大程度上尚不清楚。
ACSCOT 伤害预防和控制委员会、老年跌倒工作组制定了一份 29 项的调查问卷,并通过 Qualtrics 向国家创伤数据库的 1000 名创伤主任发送电子邮件进行调查。美国 TC 就跌倒预防、筛查、干预和出院实践进行了调查。收集和分析的数据包括受访者的角色、位置、人口密度、州指定或美国外科医师学会(ACS)级别、是否为教学设施以及患者人群。
在 266 名(27%)受访者中,71%的 TC 将预防跌倒作为其使命的一部分,但只有 16%的 TC 使用跌倒风险筛查工具。地理位置或 ACS 级别之间没有显著差异。预防资源的数量(F=31.58,<.0001),其次是正式筛查工具的存在(F=21.47,<.0001),最好地预测了跌倒预防计划的存在。
老年人跌倒仍然是一个主要的伤害风险和伤害预防机会。大多数接受调查的 TC 将预防老年人跌倒作为其使命的一部分,但很少有 TC 纳入跌倒预防计划的组成部分。制定最佳实践并要求 TC 进行筛查和提供干预措施可能会预防跌倒。