2014-2018年广州市60岁及以上老年人跌倒/坠落伤害流行病学特征

林伟权; 刘慧; 利耀辉; 黄婷苑; 杨韵鸥; 孙敏英; 秦发举; 刘览; 沈纪川; 刘华章

doi:10.16462/j.cnki.zhjbkz.2020.03.005

2014-2018年广州市60岁及以上老年人跌倒/坠落伤害流行病学特征

doi: 10.16462/j.cnki.zhjbkz.2020.03.005

1.
510440 广州, 广州市疾病预防控制中心基本公共卫生科
2.
510440 广州, 广州市疾病预防控制中心慢性非传染性疾病预防控制科
3.
510440 广州, 广州市疾病预防控制中心健康教育科

林伟权与刘慧为共同第一作者。

基金项目: 广州市科技计划项目(201707010204;201804010191);广州市卫生健康科技项目(20201A01158)

详细信息

通讯作者:
沈纪川, E-mail:shenjic@163.com

中图分类号: R181.2
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出版历程
- 收稿日期: 2019-09-20
- 修回日期: 2019-12-10
- 刊出日期: 2020-03-10

Epidemiological characteristics of injury caused by fall in the elderly aged≥60 years in Guangzhou in 2014-2018

1.
Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou 510440, China
2.
Department of Control and Prevention for Chronic Non-infective Disease, Center for Disease Control and Prevention of Guangzhou, Guangzhou 510440, China
3.
Department of Health Education, Center for Disease Control and Prevention of Guangzhou, Guangzhou 510440, China

Lin Wei-quan and Liu Hui contributed equally to this article

Funds: Science and Technology Plan Project of Guangzhou(201707010204, 201804010191); Project of the Science Technology of Guangzhou Municipal Health Commission(20201A01158)

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Corresponding author: SHEN Ji-chuan, E-mail:shenjic@163.com

摘要

摘要: 目的探讨2014-2018年广东省广州市≥60岁老年人跌倒/坠落伤害病例流行病学特征及其影响因素, 为制定老年人伤害预防提供依据。方法对2014-2018年广州市伤害监测哨点医院的首诊伤害病例进行分布描述及流行病学特征分析。结果 5间伤害监测哨点医院共报告老年跌倒/坠落患者9 503例, 占其总伤害的49.41%, 连续5年顺位第一。男女性别比为1:1.67。患者多为小学或初中文化, 发生于10-12月构成比较高, 多发生在家中, 常见于休闲活动或生命活动; 跌倒常导致头部或下肢受伤, 多为挫伤/擦伤或骨折; 程度为轻中度。多因素Logistic回归分析模型分析显示, 女性、高龄、文化程度较高、12月-次年2月、家中、步行、休闲活动和生命活动是广州市老年跌倒/坠落伤害的危险因素(均有P < 0.001)。结论跌倒/坠落是广州市老年人伤害发生的首要原因, 特别是老年女性人群, 应根据其分布特征制定相应的预防和干预措施。
- 跌倒/坠落 /
- 老年人 /
- 流行病学 /
- 监测 /
- 影响因素
Abstract: Objective To explore the epidemiological characteristics and influencing factors of fall of elderly aged ≥ 60 years in Guangzhou from 2014 to 2018, so as to provide evidence for effective prevention and control measures. Methods Data on fall of the elderly was collected from the first diagnosis in injury surveillance hospitals in Guangzhou from 2014 to 2018, and distribution description and epidemiological analysis were adopted. Results 9 503 cases of fall of the elderly were reported in 5 injury surveillance hospitals, accounting for 49.41% of injuries in the elderly, and had occupied the first place in the cause of injury in 5 consecutive years. The sex ratio of men to women was 1:1.67. Most of the patients had a primary or junior school degree, high rate in October-December, mainly occurred at home when doing leisure activities or life activities. The fall mainly led to injuries of head or lower extremities, contributed to contusion/bruise or fracture. And most of them were mild and moderate injury. Logistic regression showed that female, old age, high educational level, December to February, at home, walking, leisure activities and life activities were risk factors for falling among the elderly in Guangzhou(all P < 0.001). Conclusions Fall is the primary cause of injuries to the elderly in Guangzhou, especially the elderly female population. The targeted prevention and intervention measures should be developed according to their distribution characteristics.
- Fall /
- Elderly /
- Epidemiology /
- Surveillance /
- Influencing factor

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表 1 2014-2018年广州市≥60岁老年跌倒/坠落病例按分布特征比较[n(%)]

Table 1. Analysis on distribution characteristics of injuries of fall based on age group and gender in the elderly aged ≥60 years in Guangzhou in 2014-2018 [n(%)]

年龄组(岁)	男性		女性		合计
年龄组(岁)	非跌倒/坠落病例	跌倒/坠落病例	非跌倒/坠落病例	跌倒/坠落病例	非跌倒/坠落病例	跌倒/坠落病例
60~	2 075(71.06)	845(28.94)	1 833(63.10)	1 027(36.90)	3 908(67.09)	1 917(32.91)
65~	1 146(66.86)	568(33.14)	1 291(62.16)	786(37.84)	2 437(64.28)	1 354(35.72)
70~	631(57.84)	460(42.16)	714(47.28)	796(52.72)	1 345(51.71)	1 256(48.29)
75~	444(46.25)	516(53.75)	532(37.62)	882(62.38)	976(41.11)	1 398(58.89)
80~	249(31.16)	550(68.84)	400(26.90)	1 087(73.10)	649(28.39)	1 637(71.61)
≥85	147(19.14)	621(80.86)	269(16.93)	1 320(83.07)	416(17.65)	1 941(82.35)
合计	4 692(56.86)	3 560(43.14)	5 039(45.88)	5 943(54.12)	9 731(50.59)	9 503(49.41)

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表 2 2014-2018年广州市≥60岁老年跌倒/坠落伤害严重程度及结局分布特征[n(%)]

Table 2. Distribution characteristics of severity of injury and outcome in injuries of fall in the elderly aged ≥60 years in Guangzhou in 2014-2018[n(%)]

变量	非跌倒/坠落病例	跌倒/坠落病例	χ²值	P值
伤害性质			6 625.878	< 0.001
挫伤/擦伤	2 324(33.86)	4 540(66.14)
骨折	522(15.76)	2 790(84.24)
锐器/咬伤/开放伤	4 650(82.96)	955(17.04)
扭伤/拉伤	209(23.59)	677(76.41)
脑震荡/脑挫裂伤	221(32.22)	465(67.78)
其他	1 805(95.96)	76(4.04)
严重程度			1 079.070	< 0.001
轻度	8 211(57.57)	6 051(42.43)
中度	1 386(30.18)	3 207(69.82)
重度	134(35.36)	245(64.64)
伤害结局			1 036.418	< 0.001
治疗后离开	8 556(56.65)	6 547(43.35)
留观/住院/转院	1 150(28.26)	2 920(71.74)
其他	25(40.98)	36(59.02)

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表 3 2014-2018年广州市≥60岁老年跌倒/坠落伤害多因素Logistic回归分析

Table 3. Logistic regression analysis of risk factors of injuries of fall in the elderly aged ≥60 years in Guangzhou in 2014-2018

变量	β值	S_x	P值	OR(95% CI)值
女性(参照组:男性)	0.304	0.034	< 0.001	1.355(1.269~1.447)
年龄组(岁, 参照组:60~岁)
70~岁	0.647	0.038	< 0.001	1.910(1.772~2.059)
≥80岁	1.492	0.045	< 0.001	4.448(4.073~4.857)
文化程度(参照组:文盲或半文盲)
小学	0.036	0.048	0.457	1.037(0.943~1.140)
初中及以上	0.168	0.050	< 0.001	1.183(1.073~1.304)
月份(参照组:3-月)
5-月	-0.108	0.046	0.020	0.897(0.819~0.983)
8-月	0.038	0.046	0.413	1.039(0.949~1.137)
12月-次年2月	0.177	0.048	< 0.001	1.194(1.086~1.312)
发生地点(参照组:其它公共场所)
家中	0.238	0.051	< 0.001	1.269(1.148~1.402)
公路/街道	-0.587	0.060	< 0.001	0.556(0.494~0.626)
所处活动(参照组:家务)
休闲活动	1.033	0.047	< 0.001	2.808(2.561~3.080)
生命活动	1.114	0.050	< 0.001	3.047(2.765~3.357)
步行	1.850	0.068	< 0.001	6.360(5.569~7.265)
其它	0.054	0.077	0.484	1.055(0.908~1.227)
注:非跌倒/坠落伤害=0, 跌倒/坠落伤害=1;男=0, 女=1; 60~岁=0, 70~岁=1, ≥80岁=2;文盲或半文盲=0, 小学=1, 初中及以上=2;3-月=0, 5-月=1, 8-月=2, 12月-次年2月=3;其它公共场所=0, 家中=1, 公路/街道=2;家务=0, 休闲活动=1, 生命活动=2, 步行=3, 其它=4。

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