养老机构老年人跌倒发生流行特征与危险因素分析  

Analysis of epidemic features and risk factors of the elderly falls among nursing home residents

作　　者：赵鸣[1,2] 王浩[2] 何勇 许坚[4] 罗央努[4] 孙军 朱善宽[1] 俞敏[2] 

机构地区：[1]浙江大学公共卫生学院,杭州310058 [2]浙江省疾病预防控制中心,杭州310053 [3]杭州市富阳区疾病预防控制中心,杭州311400 [4]慈溪市疾病预防控制中心,浙江省慈溪315300

出　　处：《中华急诊医学杂志》2016年第5期654-658,共5页Chinese Journal of Emergency Medicine

基　　金：浙江省医药卫生一般项目（2013KYB056）

摘　　要：目的了解养老机构老年人跌倒发生现状及存在的主要危险因素，为开展针对性干预提供依据。方法选择2地区5所养老机构370例60岁及以上老年人为调查对象，应用自行设讣的调查表，采用面访方式了解调查对象在2012年11门至2013年10门期间的跌倒发生情况及柑关因素。结果养老机构老年人跌倒发生率为12．97％，主要发生地点为卧室和楼梯／过道，发生跌倒的主要自身原因为腿软、头晕和未保持平衡，主要环境因素为路滑和路面不平；跌伤发生率为5．95％，主要伤及下肢和头部，17．24％为骨折，24．14％需住院治疗，10．34％留有残疾。单因素分析显示年龄（OR=1．044），骨质疏松症（OR=18．488）、眩晕症（OR=5．571）、总体健康评价差（OR：1．608）、有既往跌倒史（OR=20．173），担心跌倒减少活动（OR=2．192）为养老机构老年人跌倒的危险因素；经多因素logistic回归分析，患有骨质疏松症（OR=19．394）和有既往跌倒史（OR=26．751）进入主效应模型。结论跌倒威胁养老机构老年人的身心健康，应采用综合性干预措施预防跌倒发生。Objective To survey the status and related risk factors for elderly falls among nursing home residents and to provide evidence for the development of specific measures. Methods Totally 370 elderly residents aged over 60 years old from 5 nursing homes in two districts were selected and the situation and relevant factors to falls occurred from November 2012 to October 2013 were collected by face-to-face interview with self-designed questionnaire. Results The incidence of falls was 12. 97% and the main places of occurrence were bedroom and stairs/passage way, the main self-reasons for falls were weak legs, dizzy and not keep balance while the main environmental reasons were slippery uneven ground. Of them, 5.95% elder residents injured by falls and the main injured body parts were lower limbs and head, 17.24% suffered from fracture, 24. 14% to be hospitalized and 10. 34% were disabled. The risk factors included age （ OR = 1. 044）, osteoporosis （ OR = 18. 488 ）, vertigo （ OR = 5. 571 ）, poor health （ OR = 1. 608 ）, fall history （ OR = 20. 173）, restricted activities for fear of falling （ OR = 2. 192）. Osteoporosis （ OR = 19. 394） and fall history （ OR = 26. 751 ） were the main harmful factors. Conclusions Since falls threaten the physical and mental health of nursing home residents, integrated intervention measures should be done to reduce the occurrence of falls.

关 键 词：跌倒 发生率 危险因素 养老机构 

分 类 号：R592[医药卫生—老年医学]