Epidemiologic characteristics of fall related-injuries and related factors among elderly population in Wuhan, 2018
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摘要:
目的 探讨武汉市老年人跌倒现状和影响因素, 为预防老年人跌倒提供科学依据。 方法 通过问卷调查和健康体检收集2018年武汉市65岁以上老年人免费体检数据387 476条, 采用SAS 9.4软件进行描述性分析、χ2检验和多因素Logistic回归分析。 结果 2018年老年人跌倒报告率为3.44%, 城市(4.42%)高于农村(2.39%), 女性(4.22%)高于男性(2.47%); 家中是老年人跌倒的好发地点(占46.48%); 最常见的跌倒伤害性质为扭伤/拉伤(占31.07%); 多因素分析表明, 跌倒的主要危险因素有女性, 轻中度依赖的生活自理能力, 运动能力减弱—双手不能放脑后、不能捡起地上物品, 骨关节疾病, 眼部疾病, 脑卒中(均有P < 0.05)。 结论 2018年武汉市65岁以上老年人过去一年内跌倒伤害的报告率为3.44%, 生活自理能力减弱、运动能力减弱、患骨关节疾病、眼部疾病、脑卒中是老年人跌倒的重要危险因素。 Abstract:Objective To investigate the status and impact factors of fall among elderly people in Wuhan Province, so as to provide scientific basis for preventing falls among elderly. Methods A total of 387 476 elders were collected by questionnaire survey and medical examination from health status census on all elder people aged over 65 in Wuhan. SAS 9.4 was used for descriptive analysis, chi-square test and multivariate Logistic regression analysis. Results The report rate of falls among elderly people in 2018 was 3.44%. The rate in urban area(4.42%) was higher than that in rural area(2.39%)and the rate in female(4.22%) was higher than that in male(2.47%). 46.48% falls occurred at home. Sprains/strains(accounted for 31.07%) was the mainly fall injury. Logistic regression analysis showed that female, slightly or moderate dependent self-care ability, hands cannot put behind the head, could not pick up things on the floor, osteoarticular diseases, eye disease and stroke were the main risk factors of falls in elderly people. Conclusions The report rate of fall in elderly people is 3.44%. In this study, weakened self-care ability, diminished exercise ability, osteoarticular diseases, eye disease, stroke are the major risk factors for falls in the elderly people. -
Key words:
- Fall related-injuries /
- Risk factor /
- Elderly population
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表 1 老年人一年内跌倒伤害报告率(%)
Table 1. The report rate of fall among elderly people in one year(%)
特征 调查人数 跌倒人数 跌倒报告率(95% CI) χ2值 P值 总人群 387 476 13 317 3.44(3.08~3.80) 城乡 1 211 < 0.001 城市 199 783 8 831 4.42(4.02~4.82) 农村 187 693 4 486 2.39(2.09~2.69) 性别 891 < 0.001 男 172 872 4 264 2.47(2.17~2.77) 女 214 604 9 053 4.22(3.83~4.61) 年龄组(岁) 275 < 0.001 65~ 144 363 4 391 3.04(2.70~3.38) 70~ 123 722 4 098 3.31(2.96~3.66) 75~ 69 309 2 549 3.68(3.31~4.05) ≥80 50 082 2 279 4.55(4.14~4.96) 文化程度 378 < 0.001 小学及以下 211 516 6 274 2.97(2.64~3.30) 初中 92 041 3 430 3.73(3.36~4.10) 中专或高中 47 935 2 099 4.38(3.98~4.78) 大专及以上 34 828 1 514 4.35(3.95~4.75) 婚姻状况 283 < 0.001 有配偶 296 989 9 399 3.16(2.82~3.50) 无配偶 90 486 3 918 4.33(3.93~4.73) 
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表 2 老年人跌倒伤害的特点(%)
Table 2. Characteristics of fall among elderly people(%)
跌倒特征 总人群 城乡 性别 年龄(岁) 城市 农村 男 女 65~ 70~ 75~ ≥80 跌倒发生地点 家中 46.48 39.98 59.25 44.21 47.54 42.66 44.49 49.00 54.59 公共居住场所 26.10 31.25 16.01 24.77 26.75 28.29 25.87 26.01 22.51 道路 21.84 23.07 19.39 24.30 20.67 23.16 23.62 19.62 18.52 体育和运动场所 1.15 1.52 0.42 1.50 0.98 1.02 1.37 1.33 0.79 其他 4.43 4.18 4.93 5.23 4.05 4.87 4.66 4.04 3.60 χ2值 552 45 112 P值 < 0.001 < 0.001 < 0.001 跌倒伤害性质 骨折 30.11 30.53 29.29 25.45 32.31 31.66 30.06 30.25 27.07 扭伤/拉伤 31.07 29.67 33.84 29.64 31.75 31.41 31.45 30.01 30.93 挫伤/擦伤 1.01 1.04 0.94 1.34 0.85 1.00 0.95 0.98 1.14 钝器伤、开放伤 30.31 30.13 30.65 34.29 28.43 28.42 30.43 31.31 32.60 其他 7.50 8.63 5.28 9.29 6.66 7.52 7.10 7.46 8.25 χ2值 63 115 26 P值 < 0.001 < 0.001 0.039
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表 3 变量赋值表
Table 3. Variable assignment table
变量 赋值 城乡 城市=1, 农村=2 性别 男=1, 女=2 年龄(岁) 65~=1, 70~=2, 75~=3, ≥80=4 文化程度 小学及以下=1, 初中=2, 高中/中专=3, 大专及以上=4 婚姻状况 有配偶=0, 无配偶=1 生活自理能力 可自理=1, 轻度依赖=2, 中度依赖=3, 不能自理=4 双手放脑后 可以完成=0, 不能完成=1 捡起地上物品 可以完成=0, 不能完成=1 动态平衡能力(s) < 12=0, ≥12=1 骨密度 骨量正常=1, 骨量减少=2, 骨质疏松=3 骨关节疾病 不患病=0, 患病=1 眼部疾病 不患病=0, 患病=1 听力 不患病=0, 患病=1 脑卒中 不患病=0, 患病=1
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表 4 老年人跌倒的多因素Logistic回归分析
Table 4. Multivariate Logistic analysis results of fall among elderly people
变量 β Sx Waldχ2值 P值 OR(95% CI)值 城乡 城市 1.00 农村 -0.520 0.023 503.53 < 0.001 0.60(0.57~0.63) 性别 男性 1.00 女性 0.497 0.021 546.46 < 0.001 1.64(1.58~1.71) 年龄(岁) 65~ 1.00 70~ 0.074 0.023 10.12 0.002 1.08(1.03~1.12) 75~ 0.101 0.027 13.51 < 0.001 1.10(1.05~1.16) ≥80 0.196 0.031 40.40 < 0.001 1.21(1.14~1.29) 文化程度 小学及以下 1.00 初中 0.133 0.025 27.27 < 0.001 1.14(1.08~1.20) 中专或高中 0.232 0.030 60.57 < 0.001 1.26(1.19~1.34) 大专及以上 0.242 0.035 48.51 < 0.001 1.27(1.19~1.36) 婚姻状况 有配偶 1.00 无配偶 0.172 0.022 60.25 < 0.001 1.19(1.14~1.24) 生活自理能力 可自理 1.00 轻度依赖 0.527 0.075 49.91 < 0.001 1.69(1.46~1.96) 中度依赖 0.475 0.163 8.44 0.004 1.61(1.17~2.21) 不能自理 -0.092 0.428 0.04 0.830 0.91(0.39~2.11) 双手放脑后 可以完成 1.00 不能完成 0.410 0.119 11.94 < 0.001 1.51(1.19~1.90) 捡地上物品 可以完成 1.00 不能完成 0.627 0.080 62.11 < 0.001 1.87(1.60~2.19) 动态平衡能力(s) < 12 1.00 ≥12 0.162 0.020 68.11 < 0.001 1.18(1.13~1.22) 骨密度 骨量正常 1.00 骨量减少 0.073 0.023 10.20 < 0.001 1.08(1.03~1.13) 骨质疏松 0.105 0.025 17.62 < 0.001 1.11(1.06~1.17) 骨关节疾病 不患病 1.00 患病 0.516 0.030 287.38 < 0.001 1.68(1.58~1.78) 眼部疾病 不患病 1.00 患病 0.494 0.026 358.90 < 0.001 1.64(1.56~1.73) 听力 听见 1.00 听不见 0.165 0.036 21.30 < 0.001 1.18(1.10~1.27) 脑卒中 不患病 1.00 患病 0.462 0.031 213.61 < 0.001 1.59(1.49~1.69)
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