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社區老人之跌倒機轉與傷害嚴重度 Fall Mechanism and Injury Severity in Community-dwelling Elderly Fallers

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社區老人之跌倒機轉與傷害嚴重度

Fall Mechanism and Injury Severity in Community-dwelling Elderly Fallers

中文摘要

大部分老人跌倒預防研究著重在跌倒危險因子探討,對於跌倒機轉與傷害嚴重度 之相關研究並不多。因此,我們以前瞻性世代研究(prospective cohort study)方法 對 1200 位社區老人進行一年(2003/4-2004/3)追蹤研究,收集跌倒的相關資料,並 將跌倒老人的傷害嚴重度分為 Abbreviated Injury Scale(AIS)≧2、AIS=1 及未受傷 三個等級,以比例式勝算模式(Proportional Odds Model)分析導致傷害等級較嚴重 的危險因子。結果發現在 12 個月追蹤研究期間,共有 128 位老人發生跌倒,其 中 26.0% AIS≧2、49.6% AIS=1 及 24.4%未受傷。多變項結果顯示女性的傷 害較男性嚴重(勝算比為 4.08;95%信賴區間 1.80-9.21);宅外跌倒的傷害較宅內 嚴重(勝算比為 3.05;95%信賴區間 1.32-7.04);上下床(勝算比為 7.62;95%信賴 區間 1.51-38.6)與做家事(勝算比為 4.35;95%信賴區間 0.95-19.9)的傷害較行走嚴 重;前方跌倒(勝算比為 4.85;95%信賴區間 1.96-12.0)與側面跌倒(勝算比為 7.95;

95%信賴區間 2.72-23.2)的傷害較後方嚴重。結論為本研究發現跌倒方向(前方、

側面)、女性、宅外跌倒、上下床及做家事與嚴重跌傷有密切相關,可提供老人 如何安全跌倒以及如何保護跌倒時免於傷害的參考。

英文摘要

Background: There were only a few studies analyzed the relation between the fall mechanism and injury severity in elderly. Study objective: A cohort of 1,200 community-indwelling persons aged 65 and older was studied to determine risk factors for increased injury severity of falls. Methods: Fall mechanism and other characteristics were collected by home interview soon after falls were noted. The proportional odds model was used to investigate the 3 levels of fall injuries:

non-injuries, Abbreviated Injury Scale (AIS) =1, and AIS≧2, with the multiple potential risk factors. Result: A total of 128 fall events occurred over a 12-month period from April 2003 to March 2004. There were 24.4% non-injuries, 49.6% AIS=1, and 26.0% AIS≧2. The odds ratio (OR) of female to male having a greater level of injury severity was 4.08. Compared with indoor, outdoor (OR=3.05) increased the odds for greater level of injury severity. Forward (OR=4.85) and sideway (OR=7.95) falls had greater level of injury compared with backward. Falls while housekeeping (OR=4.35) and getting into or out of bed (OR=7.62) also increased the odds of greater injury severity compared with walking. Conclusion: Several risk factors such as fall direction (forward or sideways), female, outdoor, housekeeping, and getting into or

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out of bed increased the severity of fall injuries. These factors may provide the information about safety fall and fall injuries prevention for the elderly

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