Preliminary assessment of the medical and functional factors associated with vehicle crashes by older adults
Preliminary assessment of the medical and functional factors associated with vehicle crashes by older adults
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DOI：
10.1111/j.1532-5415.1998.tb01070.x
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发表时间：
1998-05-01
影响因子：
6.3
通讯作者：
Smoot, TM
中科院分区：
文献类型：
--
作者：
Sims, RV;Owsley, C;Smoot, TM
目的：设计：病例对照研究，地点：三级医疗中心，参与者：居住在亚拉巴马杰斐逊县的老年驾驶员（年龄55-90岁）（n = 174）。案件的司机谁至少有一个故障碰撞在过去的6年中，控制无碰撞在同一时期。测量：自我报告的医疗条件，报告和观察功能的措施，和尿药物屏幕。在1991年评估日期之前的6年中发生的一个或多个故障车祸代表的结果measure.RESULTS：99岁以上的司机经历了一个和七个故障车祸在1985年至1991年期间，而75名司机没有。Logistic回归模型表明，以下变量与碰撞参与独立相关：有用视野减少40%或更多（OR = 6.1; 95%CI，2.9至12.7; P < 0.001），黑人（OR = 6.6; 95% CI，1.7 - 26.2; P = 0.007），过去2年内有跌倒史（OR = 2.6; CI，1.1 - 6.1; P = 0.025），未服用β受体阻滞剂（OR = 4.3; CI，1.2至15.0; P = 0.023）。功能评估，如视觉处理的综合测试，福尔斯的历史，以及审查目前的药物治疗可能比特定的医疗条件在识别老年人的风险驱动程序更相关。如果前瞻性研究确定跌倒和撞车有共同的风险因素，那么就可以采取统一的方法来预防这些运动障碍。黑人种族与故障碰撞的独立关联的发现需要进一步澄清，因为在这个样本中黑人司机的代表性很低。
OBJECTIVES: To examine associations between medical and functional variables and at-fault far crashes in a cohort of older drivers.DESIGN: A case-control study.SETTING: A tertiary care medical center.PARTICIPANTS: Older drivers (ages 55-90 years) residing in Jefferson County, Alabama (n = 174). Cases were drivers who had at least one at-fault crash in the previous 6 years; controls were crash-free during the same period.MEASUREMENTS: Self-reported medical conditions, reported and observed functional measures, and urinary drug screens. The occurrence of one or more at-fault car crashes in the 6 years preceding the 1991 assessment date represented the outcome measure.RESULTS: Ninety-nine older drivers experienced between one and seven at-fault vehicle crashes during the period 1985 through 1991, whereas 75 drivers did not. Logistic regression models indicated that the following variables were independently associated with crash involvement: A 40% or greater reduction in the useful field of view (OR = 6.1; 95% CI, 2.9 to 12.7; P < 0.001), black race (OR = 6.6; 95% CI, 1.7 to 26.2; P = .007), a history of falling in the previous 2 years (OR = 2.6; CI, 1.1 to 6.1; P = .025), and not taking a beta-blocking drug (OR = 4.3; CI, 1.2 to 15.0; P = .023).CONCLUSIONS: Functional assessments, such as a comprehensive test of visual processing, a falls history, and a review of current medications may be of greater relevance than specific medical conditions in the identification of older at risk drivers. If prospective studies determine that falling and crashing share risk factors, a unified approach to the prevention of these mobility disorders could result. The finding of an independent association of black race with at-fault crashing is in need of further clarification because of the low representation of black drivers in this sample.