Cumming R G, Klineberg R J
Department of Public Health, University of Sydney, Australia.
J Am Geriatr Soc. 1994 Jul;42(7):774-8. doi: 10.1111/j.1532-5415.1994.tb06540.x.
The 2 objectives of this study were to investigate the association between history of falls and risk of hip fracture and to identify characteristics of falls that determine whether or not a hip fracture will occur.
Population-based case-control study.
Subjects were selected from the community and from nursing homes in Sydney, Australia.
There were 412 subjects (205 cases, 207 controls) in the part of the study concerned with falls frequency and risk of hip fracture (age range 65-100 years). Differences between hip fracture-related falls and other falls were studied in 209 cognitively intact subjects: 84 controls who had fallen at least once in the previous 3 years and 125 cases.
Data were collected with an interviewer-administered questionnaire.
There was a strong relationship between reported number of falls in the past year and risk of hip fracture. This relationship was stronger among men than among women. There was only 1 statistically significant fall characteristic associated with risk of hip fracture; falling while turning was much more likely to lead to a hip fracture than falling when walking in one direction (age- and sex-adjusted odds ratio: 7.9, 95% confidence interval: 1.4-43.0).
(1) Taking a simple falls history is a useful way of identifying elderly people, particularly men, at increased risk of hip fracture; (2) The direction of a fall is an important determinant of hip fracture occurrence.
本研究的两个目的是调查跌倒史与髋部骨折风险之间的关联，并确定决定是否会发生髋部骨折的跌倒特征。
基于人群的病例对照研究。
研究对象选自澳大利亚悉尼的社区和养老院。
在有关跌倒频率和髋部骨折风险的研究部分，有412名受试者（205例病例，207例对照）（年龄范围65 - 100岁）。在209名认知功能完好的受试者中研究了与髋部骨折相关的跌倒和其他跌倒之间的差异：84名在过去3年中至少跌倒过一次的对照者和125例病例。
通过访员管理的问卷收集数据。
过去一年报告的跌倒次数与髋部骨折风险之间存在密切关系。这种关系在男性中比在女性中更强。与髋部骨折风险相关的跌倒特征只有一个在统计学上有显著意义；转身时跌倒比沿一个方向行走时跌倒更有可能导致髋部骨折（年龄和性别调整后的优势比：7.9，95%置信区间：1.4 - 43.0）。
（1）简单了解跌倒史是识别髋部骨折风险增加的老年人，尤其是男性的有用方法；（2）跌倒方向是髋部骨折发生的重要决定因素。
