Restrepo Felipe, Mali Namrata, Sands Laura P, Abrahams Alan, Goldberg David M, Gruss Richard, Zaman Nohel, Shields Wendy, Omaki Elise, Ehsani Johnathon, Ractham Peter, Kaewkitipong Laddawan
Department of Industrial and Systems Engineering Information Technology, Virginia Tech, Blacksburg, Virginia, USA.
Department of Computer Science, Virginia Tech, Blacksburg, Virginia, USA.
Innov Aging. 2024 Jan 10;8(1):igad138. doi: 10.1093/geroni/igad138. eCollection 2024.
Many older adults adopt equipment to address physical limitations and reduce dependence on others to complete basic activities of daily living. Although a few prior studies have considered injuries associated with assistive devices for older adults, those studies focused on older adults' health and functional risks for injury. There is limited analysis of older adult injuries involving defective or malfunctioning assistive devices.
Data from this study are from the National Electronic Surveillance System All Injury Program which collected data on consumer product-related injuries from a probability sample of 66 hospital Emergency Departments across the United States. Data from 30 776 older adult Emergency Department (ED) injury narratives from 2016 to 2020 were coded according to the assistive device involved and whether malfunctioning led to the injury. The study team manually examined all narratives in which the assistive device was coded to have malfunctioned.
A total of 10 974 older adult ED cases were treated for 12 488 injuries involving a defective device. Injuries included 4 212 head and neck injuries (eg, concussion), 4 317 trunk injuries (eg, hip fractures), and 3 959 arm or leg injuries (eg, leg fracture). Of these patients, 4 586 were admitted to a hospital ward for further evaluation and treatment. Seventy percent of these patients were injured while using a walker; in contrast, wheelchairs were implicated in only 4% of the above cases. Design flaws were identified in 8 158 cases and part breakage/decoupling incidents in 2 816 cases.
Our findings provide evidence that assistive devices are actively involved in older adult injuries. Further research is needed to reduce injuries associated with assistive devices by educating patients and their careproviders about device use and assembly and developing effective methods for informing manufacturers about malfunctioning devices.
许多老年人使用辅助设备来应对身体限制，并减少在完成日常生活基本活动时对他人的依赖。尽管先前有一些研究考虑了与老年人辅助设备相关的伤害，但这些研究主要关注老年人因使用辅助设备而面临的健康和功能损伤风险。对于涉及有缺陷或故障辅助设备导致的老年人伤害，相关分析较为有限。
本研究数据来自国家电子监测系统全损伤项目，该项目从美国66家医院急诊科的概率样本中收集了与消费品相关的伤害数据。对2016年至2020年30776例老年急诊科（ED）伤害记录，根据所涉及的辅助设备以及故障是否导致伤害进行编码。研究团队人工检查了所有辅助设备被编码为出现故障的记录。
共有10974例老年ED病例因涉及有缺陷设备的12488起伤害接受治疗。伤害包括4212例头颈部伤害（如脑震荡）、4317例躯干伤害（如髋部骨折）和3959例手臂或腿部伤害（如腿部骨折）。其中，4586例患者被收入医院病房进行进一步评估和治疗。这些患者中有70%在使用助行器时受伤；相比之下，轮椅仅涉及上述病例的4%。在8158例病例中发现设计缺陷，2816例病例中出现部件破损/脱开事件。
我们的研究结果表明辅助设备与老年人伤害密切相关。需要进一步开展研究，通过对患者及其护理人员进行设备使用和组装方面的教育，以及开发向制造商通报故障设备的有效方法，来减少与辅助设备相关的伤害。
