老年跌倒：荷兰基于注册的研究。

Geriatric Falls: A Registry-Based Study in the Netherlands.

机构信息

School of Health Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands (Mr Verbeek); Institute of Nursing Studies, University of Applied Sciences, and Emergency Department, University Medical Center Utrecht, Utrecht, the Netherlands (Dr Ham); Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands (Dr Verbeek); Julius Center for Health Science and Primary Care, and Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Dr de Man-van Ginkel); School of Health, Saxion University of Applied Sciences, Deventer/Enschede, the Netherlands (Dr van Os-Medendorp); Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Dr Westers); and Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands (Dr Leenen).

出版信息

J Trauma Nurs. 2022;29(3):111-118. doi: 10.1097/JTN.0000000000000648.

DOI:10.1097/JTN.0000000000000648

PMID:35536337

Abstract

BACKGROUND

Falls in people 65 years and older evaluated in the emergency department are increasing. Of all unintentional injury-related deaths among older people, 55% are due to falls. The impact of falls, especially concerning Dutch older people with the highest proportion of living independently worldwide, is unclear.

OBJECTIVE

To identify the influence of age, gender, health conditions, and type of fall on the severity of injury, hospital length of stay, mortality, and discharge destination.

METHODS

A total number of 6,084 patients from a comprehensive regional trauma care system, 65 years and older and hospitalized after a fall, were included. Groups were compared for patient-related factors and multivariable logistic regression analysis to explore the consequences.

RESULTS

Mean age was 82 years (SD = 8.3), and 70% were female. Most falls (66.4%) were due to "slipping and tripping" or "falls on the same level," 57.4% had Injury Severity Scores between 9 and 12, and 43.3% were discharged home. Higher age and type of fall increased the likelihood of severe injuries. Men experienced shorter hospital stays than women and were less frequently discharged home. Mortality was higher in males (10.8%) than in females (6.7%) and increased with the American Society of Anesthesiologists scores for preexisting health conditions.

CONCLUSION

Advanced age, gender, type of fall, and prior health status play a significant role in the severity of injuries, length of hospital stay, 30-day mortality, and higher discharge destination to care homes in older people hospitalized after a fall.

摘要

背景

在急诊科就诊的 65 岁及以上人群的跌倒人数正在增加。在所有老年人因非故意伤害导致的死亡中，有 55%是由跌倒引起的。跌倒的影响，特别是对全球独立生活比例最高的荷兰老年人来说，尚不清楚。

目的

确定年龄、性别、健康状况和跌倒类型对损伤严重程度、住院时间、死亡率和出院去向的影响。

方法

纳入了一个综合性区域创伤救治系统的 6084 名 65 岁及以上因跌倒而住院的患者。对患者相关因素进行比较，并进行多变量逻辑回归分析，以探讨其后果。

结果

平均年龄为 82 岁（标准差=8.3），70%为女性。大多数跌倒（66.4%）是由于“滑倒和绊倒”或“同一水平跌倒”，57.4%的损伤严重程度评分在 9 至 12 分之间，43.3%出院回家。较高的年龄和跌倒类型增加了严重损伤的可能性。男性的住院时间短于女性，出院回家的比例也较低。男性（10.8%）的死亡率高于女性（6.7%），并且随着术前健康状况美国麻醉医师协会评分的增加而升高。