Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.
Dalla School of Public Health, University of Toronto, Toronto, Canada.
BMC Geriatr. 2024 May 11;24(1):418. doi: 10.1186/s12877-024-05032-y.
The public health measures associated with the COVID-19 pandemic may have indirectly impacted other health outcomes, such as falls among older adults. The purpose of this study was to examine trends in fall-related hospitalizations and emergency department visits among older adults before and during the COVID-19 pandemic in Ontario, Canada.
We obtained fall-related hospitalizations (N = 301,945) and emergency department visit (N = 1,150,829) data from the Canadian Institute for Health Information databases from 2015 to 2022 for adults ages 65 and older in Ontario. Fall-related injuries were obtained using International Classification of Diseases, 10th edition, Canada codes. An interrupted time series analysis was used to model the change in weekly fall-related hospitalizations and emergency department visits before (January 6, 2015-March 16, 2020) and during (March 17, 2020-December 26, 2022) the pandemic.
After adjusting for seasonality and population changes, an 8% decrease in fall-related hospitalizations [Relative Rate (RR) = 0.92, 95% Confidence Interval (CI): 0.85, 1.00] and a 23% decrease in fall-related emergency department visits (RR = 0.77, 95%CI: 0.59, 1.00) were observed immediately following the onset of the pandemic, followed by increasing trends during the pandemic for both outcomes.
Following an abrupt decrease in hospitalizations and emergency department visits immediately following the onset of the pandemic, fall-related hospitalizations and emergency department visits have been increasing steadily and are approaching pre-pandemic levels. Further research exploring the factors contributing to these trends may inform future policies for public health emergencies that balance limiting the spread of disease among this population while supporting the physical, psychological, and social needs of this vulnerable group.
与 COVID-19 大流行相关的公共卫生措施可能间接地影响了其他健康结果，例如老年人跌倒。本研究的目的是在加拿大安大略省检查 COVID-19 大流行前后老年人与跌倒相关的住院和急诊就诊趋势。
我们从加拿大健康信息研究所数据库中获得了 2015 年至 2022 年安大略省 65 岁及以上成年人与跌倒相关的住院（N=301945）和急诊就诊（N=1150829）数据。使用加拿大第十版国际疾病分类对跌倒相关伤害进行编码。采用中断时间序列分析模型来模拟大流行前（2020 年 3 月 16 日之前）和大流行期间（2020 年 3 月 17 日至 2022 年 12 月 26 日）每周与跌倒相关的住院和急诊就诊量的变化。
调整季节性和人口变化后，与跌倒相关的住院率下降了 8%[相对比率（RR）=0.92，95%置信区间（CI）：0.85，1.00]，与跌倒相关的急诊就诊率下降了 23%（RR=0.77，95%CI：0.59，1.00），这两种结果在大流行开始后立即观察到，随后在大流行期间均呈上升趋势。
在大流行开始后，与跌倒相关的住院和急诊就诊立即急剧下降，此后，与跌倒相关的住院和急诊就诊持续稳定增加，且接近大流行前的水平。进一步研究探索导致这些趋势的因素，可能为平衡在该人群中控制疾病传播和支持这一弱势群体的身体、心理和社会需求的公共卫生紧急事件的未来政策提供信息。
