Trends in Fatal and Nonfatal Injuries Among Older Americans, 2004? 2017
Trends in Fatal and Nonfatal Injuries Among Older Americans, 2004? 2017
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DOI：
10.1016/j.amepre.2020.01.008
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发表时间：
2020-07-01
影响因子：
5.5
通讯作者：
Xu, Dongjuan
中科院分区：
文献类型：
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作者：
Drew, Julia A. Rivera;Xu, Dongjuan
本研究(1)提供了2004-2017年老年人致死性和非致死性伤害发生率的年度人口估计；(2)确定伤害是致命的还是非致命的，是坠落的还是非坠落的，非致命的伤害是轻微的还是严重的，这些趋势是否不同；(3)调查趋势是否因年龄、性别和种族而异。方法采用2004-2017年全国生命统计系统和全国健康访谈调查数据，覆盖年龄≥65岁的成年人。致命伤发生率采用负二项模型估计；使用泊松模型估计非致命性伤害发生率。所有模型都比较了不同年份、年龄、性别和种族的总体风险和趋势差异，以及年份与年龄、性别和种族之间的相互作用。所有分析均在2019年进行。结果：随着时间的推移，致死性伤害发生率保持稳定，但这种明显的稳定掩盖了致死性跌倒增加35%和致死性非跌倒伤害减少17%的事实。与跌倒相关死亡的增加主要集中在年龄≥85岁、男性和白人老年人中。随着时间的推移，年龄≥85岁和白人老年人的致命跌倒趋势加速。相比之下，所有伤害类型的非致命性伤害发生率都有大幅增加。非致命性伤害风险随着年龄的增长而增加，女性和白人老年人的风险更高，但趋势并没有因年龄、性别或种族而变化。致命和非致命伤害的大量增加强调了国家实施跌倒预防计划和将跌倒预防工作扩大到更普遍的伤害预防的紧迫性。
IntroductionThis study (1) provides annual population estimates of fatal and nonfatal injury incidence rates for older adults for 2004–2017; (2) determines if trends differ by whether the injury was fatal or nonfatal, a fall or nonfall injury, and for nonfatal injuries, minor or serious; and (3) investigates whether trends vary by age, sex, and race.MethodsThis study used National Vital Statistics System and National Health Interview Survey data covering the population of adults aged ≥65 years for 2004–2017. Fatal injury incidence rates were estimated using negative binomial models; nonfatal injury incidence rates were estimated using Poisson models. All models compared overall risk and trend differences by year, age, sex, and race, and interactions between year and age, sex, and race. All analyses were conducted in 2019.ResultsFatal injury incidence was stable over time, but this apparent stability masked a 35% increase in fatal falls and a 17% decrease in fatal nonfall injuries. Increases in fall-related deaths were concentrated among those aged ≥85 years, men, and white older adults. The trend in fatal falls accelerated over time for those aged ≥85 years and white older adults. By contrast, there was a large increase in nonfatal injury incidence, occurring across all injury types. Nonfatal injury risk grew with age and was higher for women and white older adults, but trends did not vary by age, sex, or race.ConclusionsLarge increases in fatal and nonfatal injuries underscore the urgency of national implementation of fall prevention programs and expanding fall prevention efforts to more general injury prevention.