Circumstances around the fall in a multinational hip fracture risk study: A diverse pattern for prevention
Circumstances around the fall in a multinational hip fracture risk study: A diverse pattern for prevention
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DOI：
10.1016/s0001-4575(98)00016-5
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发表时间：
1998-09-01
影响因子：
5.9
通讯作者：
Elffors, L
中科院分区：
文献类型：
--
作者：
Allander, E;Gullberg, B;Elffors, L
髋部骨折是一个主要的公共卫生问题，但具有预防的潜力。采用病例对照设计的欧洲多中心髋部骨折流行病学研究MEDOS研究的数据被用来描述和分析与髋部骨折有关的跌倒情况。这项研究包括来自南欧14个中心的2185例50岁以下的骨折患者：葡萄牙、西班牙、法国、意大利、希腊和土耳其。资料是通过翻译成六种语文的标准化和有效问卷收集的，并由训练有素的面谈人员管理。跌倒前后的情况根据：(1)地点、年龄组和一天中的时间进行分类；(2)功能障碍、并存疾病；(3)包括酒精在内的药物消费；以及(4)环境因素。还分析了预防的可能性。使用7个合理确定的风险因素来识别高风险跌倒，类似地使用8个风险因素来识别高风险跌倒者。还对选定的一系列事件进行了研究。在跌倒的人和他们摔倒和髋部骨折的环境中都发现了一种非常多样化的模式。涉及一个以上因素的骨折仅占女性骨折的14.7%，占男性骨折的19.7%。大多数病例在跌倒之前并不是身体残疾。大多数人(66.5%)在室内摔倒并摔断了髋部，只有4.3%的人在室外黑暗中摔倒并骨折。心脑血管合并症发生率分别为4.9%和7.8%。楼梯上的坠落占坠落的11%。跌倒危险因素与环境的相关系数为0.07，男女之间无差异。导致髋部骨折的跌倒背后的因果关系模式包括许多有时很小的群体和错综复杂的时间顺序。结果表明，目前无法实施全球预防战略。相反，预防模式应包括不同的目标群体，并因国家和地点而异。对于住院患者的高危人群，可以毫不拖延地实施预防。(C)1998爱思唯尔科学有限公司。保留所有权利。
Hip fracture is a major public health problem, but with a potential for prevention. Data from a European multicentre study on hip fracture epidemiology with a case control design, the MEDOS study, were used to describe and analyse circumstances around falls associated with hip fracture. The study includes 2185 fracture cases age >50 years from 14 centres in southern Europe: Portugal, Spain, France, Italy, Greece and Turkey. Information was collected by a standardized and validated questionnaire translated into six languages and administered by trained interviewers. Circumstances around the fall were categorized according to: (1) place, age group and time of day; (2) functional disability, co-morbidity; (3) drug consumption including alcohol; and (4) environmental factors. Possibilities for prevention were also analysed. High risk falls were identified using seven reasonably well-established risk factors, and similarly eight risk factors were used to identify high risk fallers. Selected trains of events were also studied. A pattern of great diversity was found both among the fallers and the environment in which they fell and fractured the hip. Those with more than one factor involved constituted only 14.7% of female and 19.7% of male fractures. A majority of cases were not physically disabled before the fall. A majority (66.5%) fell and fractured their hip indoors and only 4.3% outside in darkness. Cardiovascular and cerebrovascular comorbidity were observed with 4.9 and 7.8%, of falls respectively. Falls in a stairway comprised 11% of falls. The correlation between the number of the risk factors of the faller and in the environment was 0.07 and there was no difference between males and females. The pattern of causality behind falls that cause hip fracture and therefore of prevention comprises many sometimes small groups and intricate time sequence. The results suggest that global preventive strategies could presently not be implemented. Instead, the pattern of prevention should include different target groups and be country and site specific. For the high risk group of institutionalized patients prevention can be implemented without delay. (C) 1998 Elsevier Science Ltd. All rights reserved.