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老年门诊患者的坠床事件:损伤与后果

Falls From Beds Among Elderly Outpatients: Injuries and Outcomes.

作者信息

Nugent Kyle, McCague Andrew, Henken-Siefken Austin

机构信息

Surgery, Desert Regional Medical Center, Palm Springs, USA.

Trauma and Acute Care Surgery, Desert Regional Medical Center, Palm Springs, USA.

出版信息

Cureus. 2024 Apr 2;16(4):e57458. doi: 10.7759/cureus.57458. eCollection 2024 Apr.

Abstract

Introduction Falls from beds (FFBs) among outpatient elderly individuals are a prevalent issue, particularly for those aged 65 and above. This presents a notable health challenge with consequences that extend beyond personal well-being, placing a considerable strain on healthcare systems. Fall-related injuries often result in reduced independence, increased morbidity, and, in severe instances, fatalities. It is crucial to address these outpatient falls to safeguard the health and independence of the elderly population. Methods This review presents data sourced from a trauma registry covering admissions from March 31, 2016, to December 27, 2021, at Desert Regional Medical Center, a Level 1 Trauma Center in Palm Springs, USA. Over this period, 3,148 patients sought emergency care following falls. The study specifically investigates cases following FFBs, revealing 164 admissions out of the total. Furthermore, it contrasts patient demographics, injury types, and outcomes with existing literature. Results This retrospective analysis found that, among the 164 patients admitted to the emergency department over a five-year and eight-month period due to FFBs, 143 were classified as elderly, aged 65 and above. The mean age of those admitted was 76, whereas those not admitted had a mean age of 71. A significant majority, 87%, were hospitalized; within this group, 16% required intensive care. Surgical intervention was necessary for 27 individuals, and there were three fatalities. Soft tissue hematomas were the most common injuries, representing 24% of injuries at admission, closely followed by upper extremity fractures at 21%. Over half of these patients could not return home post-hospitalization, with 41% being transferred to skilled nursing facilities (SNF). Conclusions As the aging population in the United States continues to grow, the incidence of falls is on the rise, resulting in injuries like fractures and head trauma. The objectives of this review are to provide an overview of the current literature on FFBs, as well as to emphasize the significant impact of such injuries on the elderly population. Additionally, it includes an analysis of a dataset detailing injuries resulting from bed-related falls, offering a comparison to existing research.

摘要

引言 门诊老年患者的坠床事件是一个普遍存在的问题,对于65岁及以上的老年人尤为如此。这带来了一个显著的健康挑战,其后果不仅影响个人健康,还给医疗系统带来了相当大的压力。与跌倒相关的伤害往往会导致独立性下降、发病率增加,严重时甚至会导致死亡。解决这些门诊患者的跌倒问题对于保障老年人群的健康和独立性至关重要。

方法 本综述呈现的数据来源于一个创伤登记处,涵盖了美国棕榈泉市一级创伤中心沙漠地区医疗中心在2016年3月31日至2021年12月27日期间的入院情况。在此期间,有3148名患者因跌倒寻求急诊治疗。该研究专门调查了坠床后的病例,在总数中发现了164例入院病例。此外,它还将患者的人口统计学特征、损伤类型和结果与现有文献进行了对比。

结果 这项回顾性分析发现,在因坠床在五年零八个月期间入住急诊科的164名患者中,143名被归类为老年人,年龄在65岁及以上。入院患者的平均年龄为76岁,而未入院患者的平均年龄为71岁。绝大多数患者(87%)住院治疗;在这一组中,16%的患者需要重症监护。27人需要进行手术干预,有3人死亡。软组织血肿是最常见的损伤,占入院时损伤的24%,紧随其后的是上肢骨折,占21%。这些患者中超过一半在出院后无法回家,41%的患者被转至专业护理机构(SNF)。

结论 随着美国老年人口的持续增长,跌倒的发生率在上升,导致骨折和头部创伤等伤害。本综述的目的是概述当前关于坠床的文献,并强调此类伤害对老年人群的重大影响。此外,它还包括对一组详细记录与床相关跌倒导致的伤害的数据集的分析,并与现有研究进行了比较。

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