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气象参数与医院获得性跌倒——一项基于10年不良事件报告系统数据的多中心回顾性研究

Meteorological parameters and hospital-acquired falls-A multicenter retrospective study based on 10 years of adverse events reporting system data.

作者信息

Ren Yuanyuan, Li Jinyan, Yang Jun, Hu Lei, Xu Zhihui, Fu Rongjuan, Wu Kaihui, Guo Min, Hu Mei, Ran Liu, Li Xia, Qiu Huicheng, Liao Lianmei, Zhang Mengmeng, Luo Yetao, Zhou Sumei, Ding Fu

机构信息

Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

出版信息

Heliyon. 2024 Jul 5;10(13):e34193. doi: 10.1016/j.heliyon.2024.e34193. eCollection 2024 Jul 15.

Abstract

OBJECTIVE AND RATIONALE

Hospital-acquired falls are common and serious adverse events in medical institutions, with high incidence and injury rates. Studying the occurrence patterns of hospital-acquired falls is important for preventing falls in hospitalized patients. However, the effect of meteorological factors on hospital-acquired falls has not been elucidated. Therefore, this study explored the impact of meteorological parameters on hospital-acquired falls in Chongqing, China, and provided new ideas for the clinical prevention of falls in patients.

METHODS

Correlation analysis and distributed lag nonlinear models were employed to analyze the relationship between 3890 cases of hospital-acquired falls and meteorological data in 13 hospitals in 11 districts and counties in Chongqing from January 2013 to April 2023.

RESULTS

The number of hospital-acquired falls demonstrated a nonlinear correlation with the daily average relative humidity and negatively correlated with sunshine duration; however, temperature, air pressure, and wind speed were not correlated. Compared to the reference humidity (87 %), the immediate effects of daily average relative humidity (65-68 % and 90-97 %) increased the risk of hospital-acquired falls on the same day (relative risk [RR]:1.027-1.243). When the daily average relative humidity was 95-97 %, lags of 0-1 d and 8-12 d had greater effects on falls (RR:1.073-1.243). The daily average relative humidities of 62-74 % and 91-97 % were statistically significant at cumulative relative risk (CRR)of 4, 7, 10, and 14 d with a cumulative lag (CRR: 1.111-4.277). On sex and age stratification, the lag and cumulative effects of relative humidity more significantly impacted falls in women and patients aged ≥65 years.

CONCLUSION

Daily average relative humidity had a nonlinear correlation and lag effect on hospital-acquired falls; therefore, medical institutions should pay attention to the effect of relative humidity on hospital-acquired falls in patients, especially old and female patients.

摘要

目的与原理

医院获得性跌倒在医疗机构中是常见且严重的不良事件,发生率和伤害率都很高。研究医院获得性跌倒的发生模式对于预防住院患者跌倒很重要。然而,气象因素对医院获得性跌倒的影响尚未阐明。因此,本研究探讨了气象参数对中国重庆医院获得性跌倒的影响,并为临床预防患者跌倒提供新思路。

方法

采用相关性分析和分布滞后非线性模型,分析了2013年1月至2023年4月重庆11个区县13家医院3890例医院获得性跌倒与气象数据之间的关系。

结果

医院获得性跌倒的数量与日平均相对湿度呈非线性相关,与日照时长呈负相关;然而,温度、气压和风速无相关性。与参考湿度(87%)相比,日平均相对湿度(65 - 68%和90 - 97%)的即时效应增加了当日医院获得性跌倒的风险(相对风险[RR]:1.027 - 1.243)。当日平均相对湿度为95 - 97%时,滞后0 - 1天和8 - 12天对跌倒的影响更大(RR:1.073 - 1.243)。日平均相对湿度62 - 74%和91 - 97%在累积相对风险(CRR)为4、7、10和14天且有累积滞后时具有统计学意义(CRR:1.111 - 4.277)。在性别和年龄分层上,相对湿度的滞后和累积效应在女性和≥65岁患者中对跌倒的影响更显著。

结论

日平均相对湿度与医院获得性跌倒呈非线性相关且具有滞后效应;因此,医疗机构应关注相对湿度对患者医院获得性跌倒的影响,尤其是老年和女性患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b29/11279767/39361e131046/gr1.jpg

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