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住院康复脊髓损伤病房的跌倒:特征、情况和后果。

Falls on an inpatient rehabilitation spinal injuries unit: the characteristics, circumstances, and consequences.

机构信息

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.

Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, QLD, Australia.

出版信息

Spinal Cord. 2023 Jan;61(1):57-64. doi: 10.1038/s41393-022-00861-3. Epub 2022 Oct 22.

DOI:10.1038/s41393-022-00861-3
PMID:36273103
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9836933/
Abstract

STUDY DESIGN

Retrospective audit OBJECTIVES: To describe the nature of falls and fallers in a spinal injuries unit (SIU) and identify factors associated with having more than one fall (recurrent fallers) and falls with physical or psychological consequences (consequential falls).

SETTING

An Australian inpatient rehabilitation SIU.

METHODS

Data were retrospectively extracted from falls incident reports and electronic medical records over a 5-year period. Data were analysed descriptively to summarise participant and fall details. Univariate analyses identified candidate variables for further investigation in a multivariate model for recurrent fallers and consequential falls.

RESULTS

Of the 566 persons admitted to the SIU, 132 (23%) participants experienced 207 falls over the 5 years. Of the fallers, 41 (31%) were recurrent fallers experiencing between 2 and 7 falls and 78 (59%) experienced a consequential fall. No significant variables were identified for recurrent fallers. For consequential falls, older age (OR = 1.038, 95% CI, 1.012 to 1.064, p = 0.004) and female gender (OR = 3.581, 95% CI, 1.269 to 10.103, p = 0.016) were significant, as well as falls that occurred on a Sunday (OR = 0.196, 95% CI, 0.061 to 0.630, p = 0.006). Falls while transferring were less likely to be consequential (OR = 4.100, 95% CI, 1.706 to 9.856, p = 0.002).

CONCLUSIONS

Nearly one quarter of SIU inpatients experienced a fall with almost a third of those who fell experiencing recurrent falls. Older age, female gender, and Sundays were risk factors for falls with consequence.

摘要

研究设计

回顾性审计

目的

描述脊柱损伤病房(SIU)中跌倒的性质和跌倒者的情况,并确定与多次跌倒(复发性跌倒者)和跌倒造成身体或心理后果(后果性跌倒)相关的因素。

设置

澳大利亚住院康复 SIU。

方法

在 5 年期间,从跌倒事件报告和电子病历中回顾性提取数据。使用描述性分析对参与者和跌倒的详细信息进行总结。单变量分析确定了在多变量模型中进一步研究复发性跌倒和后果性跌倒的候选变量。

结果

在入住 SIU 的 566 人中,有 132 名(23%)参与者在 5 年内经历了 207 次跌倒。在跌倒者中,有 41 名(31%)是复发性跌倒者,跌倒次数为 2 至 7 次,有 78 名(59%)经历了后果性跌倒。未确定复发性跌倒者的显著变量。对于后果性跌倒,年龄较大(OR=1.038,95%CI,1.012 至 1.064,p=0.004)和女性(OR=3.581,95%CI,1.269 至 10.103,p=0.016)以及发生在周日的跌倒(OR=0.196,95%CI,0.061 至 0.630,p=0.006)是显著的。在转移过程中发生的跌倒不太可能造成后果(OR=4.100,95%CI,1.706 至 9.856,p=0.002)。

结论

近四分之一的 SIU 住院患者经历了跌倒,其中近三分之一的跌倒者发生了复发性跌倒。年龄较大、女性和周日是造成跌倒后果的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f9/9836933/2587d267079d/41393_2022_861_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f9/9836933/b8872831fb83/41393_2022_861_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f9/9836933/2587d267079d/41393_2022_861_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f9/9836933/b8872831fb83/41393_2022_861_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f9/9836933/2587d267079d/41393_2022_861_Fig2_HTML.jpg

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Comparing the causes, circumstances and consequences of falls across mobility statuses among individuals with spinal cord injury: A secondary analysis.比较脊髓损伤患者不同移动状态下跌倒的原因、情况和后果:二次分析。
J Spinal Cord Med. 2021;44(sup1):S193-S202. doi: 10.1080/10790268.2021.1956252.
3
Exploring the causes and impacts of falls among ambulators with spinal cord injury using photovoice: a mixed-methods study.
运用影像方法探索脊髓损伤步行者跌倒的原因和影响:一项混合方法研究。
BMJ Open. 2020 Aug 30;10(8):e039763. doi: 10.1136/bmjopen-2020-039763.
4
Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: A mixed methods approach using photovoice.脊髓损伤轮椅使用者对跌倒情况和预防跌倒的看法:使用影像叙事的混合方法。
PLoS One. 2020 Aug 28;15(8):e0238116. doi: 10.1371/journal.pone.0238116. eCollection 2020.
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Current state of fall prevention and management policies and procedures in Canadian spinal cord injury rehabilitation.加拿大脊髓损伤康复中预防和管理跌倒的现行政策和程序。
BMC Health Serv Res. 2020 Apr 15;20(1):299. doi: 10.1186/s12913-020-05168-8.
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