RISK-FACTORS FOR INJURIOUS FALLS - A PROSPECTIVE-STUDY
RISK-FACTORS FOR INJURIOUS FALLS - A PROSPECTIVE-STUDY
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DOI：
10.1093/geronj/46.5.m164
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发表时间：
1991-09-01
期刊：
影响因子：
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通讯作者：
HUDES, ES
中科院分区：
文献类型：
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作者：
NEVITT, MC;CUMMINGS, SR;HUDES, ES
我们进行了一项前瞻性研究的后果福尔斯在325名老年社区居住的人，所有这些人都下降了在过去的一年。 我们每周联系受试者，持续一年，以确定福尔斯，并确定福尔斯的情况和后果。 在539例福尔斯跌倒中，只有6%导致严重损伤（骨折、脱位或需要缝合的撕裂伤），但超过一半（55%）导致轻微软组织损伤。 十分之一的福尔斯跌倒后至少5分钟无法起身，四分之一的福尔斯跌倒后限制了受试者的活动。 每次跌倒受伤的风险几乎相同，无论一个人在随访期间福尔斯的次数如何。 与非晕厥性福尔斯跌倒相比，意识丧失相关的福尔斯跌倒的严重损伤风险增加（年龄和性别校正比值比：5.9; 95%置信区间：2.3-14.9）。 在对非晕厥性福尔斯跌倒的多变量分析中，既往跌倒伴骨折者（6.7; 2.1-21.5）、追踪B时间较慢者（1.9; 1.1-3.2）和白人（18.4; 7.5-44.6）每次跌倒的严重损伤风险较高。 非晕厥性跌倒导致轻伤的风险（与没有受伤的人相比）在手部反应时间较慢的人中增加（1.8; 1.0-3.2），握力下降（1.5; 1.0-2.3），白人（2.0; 1.0-3.7），使用楼梯和台阶时福尔斯（2.2; 1.0-5.0），转身或伸手（3.5; 1.7-7.3）。 我们的研究结果表明，神经肌肉和认知障碍，以及福尔斯的情况，影响跌倒时受伤的风险。
We conducted a prospective study of the consequences of falls in 325 elderly community-dwelling persons, all of whom had fallen in the previous year. We contacted subjects every week for one year to ascertain falls and to determine the circumstances and consequences of falls. Only 6% of 539 falls resulted in a major injury (fracture, dislocation, or laceration requiring suture), but over half (55%) resulted in minor soft tissue injury. One in ten falls left the faller unable to get up for at least 5 minutes, and one in four falls caused subjects to limit their activities. The risk of injury per fall was about the same regardless of the number of falls a person had during follow-up. The risk of major injury was increased (age- and sex-adjusted odds ratio: 5.9; 95% confidence interval: 2.3-14.9) in falls associated with loss of consciousness compared to nonsyncopal falls. In multivariate analyses of nonsyncopal falls, the risk of major injury per fall was higher in persons having a previous fall with fracture (6.7; 2.1-21.5), a slower Trail Making B time (1.9; 1.1-3.2), and in Whites (18.4; 7.5-44.6). The risk that a nonsyncopal fall would result in minor injury (versus no injury) was increased in persons with a slower hand reaction time (1.8; 1.0-3.2), decreased grip strength (1.5; 1.0-2.3), in Whites (2.0; 1.0-3.7), in falls while using stairs and steps (2.2; 1.0-5.0), and turning around or reaching (3.5; 1.7-7.3). Our findings suggest that neuromuscular and cognitive impairment, as well as the circumstances of falls, affect the risk of injury when a fall occurs.