Mathers L J, Weiss H B
Department of Emergency Medicine, Center for Violence and Injury Control, Allegheny University of the Health Sciences, Pittsburgh, PA, USA.
Acad Emerg Med. 1998 Nov;5(11):1064-70. doi: 10.1111/j.1553-2712.1998.tb02663.x.
Unintentional falls are the leading cause of injury and the second most common cause of unintentional injury deaths in the United States, and place a great burden on EDs. In this study, the objective was to describe the incidence and characteristics of ED visits associated with unintentional falls in the United States.
The authors performed a secondary analysis on data from the National Center for Health Statistics' National Hospital Ambulatory Medical Care Survey for 1992-1994. An ED visit was defined as fall-related if an ICD-9-CM cause of injury code was reported as E880.0-886.9 or E888.
There were an estimated 7,946,000 fall-related ED visits per year, corresponding to an annual rate of 3.1 per 100 persons (95% CI=2.8 to 3.4). Children under 5 years of age comprised the largest proportion of visits (14%). Among those visits coded with respect to place of occurrence, the rate of visits associated with falls occurring at home (1.7/100; 95% CI=1.6 to 1.9) was significantly higher than that associated with falls occurring in all other locations combined (1.1/100; 95% CI=1.0 to 1.2). The mean injury severity score increased significantly with the age of the patient. Fall-related ED visits resulted in an estimated 860,000 hospitalizations, 62% of which involved individuals aged 65 years and older. An estimated $2.45 billion per year was paid for fall-related ED visits. Government sources paid all or part of 41% of visits.
This study reports nationally representative data describing the incidence and characteristics of fall-related ED visits. These data expand what is known about the epidemiology of falls and help to define the burden that fall injuries place on EDs in the United States. The results of this study could serve as a benchmark to evaluate the effectiveness of future fall prevention efforts.
在美国，意外伤害跌倒既是受伤的首要原因，也是非故意伤害死亡的第二大常见原因，给急诊科带来了巨大负担。本研究旨在描述美国与意外伤害跌倒相关的急诊就诊的发生率及特征。
作者对国家卫生统计中心1992 - 1994年的国家医院门诊医疗调查数据进行了二次分析。如果国际疾病分类第九版临床修正本（ICD - 9 - CM）损伤原因编码报告为E880.0 - 886.9或E888，则将急诊就诊定义为与跌倒相关。
每年估计有794.6万次与跌倒相关的急诊就诊，相当于每100人中有3.1次的年发生率（95%置信区间=2.8至3.4）。5岁以下儿童的就诊比例最高（14%）。在按发生地点编码的就诊中，在家中发生跌倒相关的就诊率（1.7/100；95%置信区间=1.6至1.9）显著高于在所有其他地点发生跌倒相关就诊率的总和（1.1/100；95%置信区间=1.0至1.2）。平均损伤严重程度评分随患者年龄显著增加。与跌倒相关的急诊就诊导致估计86万次住院治疗，其中62%涉及65岁及以上的个体。每年因与跌倒相关的急诊就诊支付的费用估计为24.5亿美元。政府来源支付了41%的就诊费用的全部或部分。
本研究报告了关于与跌倒相关的急诊就诊发生率及特征的全国代表性数据。这些数据扩展了对跌倒流行病学的认识，并有助于确定跌倒伤害给美国急诊科带来的负担。本研究结果可作为评估未来跌倒预防工作效果的基准。
