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目的了解社区老年人跌倒的流行病学特征及医疗负担。方法对居住在长宁区某2个居委会的1 690名老年人进行监测,对发生跌倒的老年人进行跟踪调查。结果监测到304例跌倒老人,男性86人(28.3%),女性218人(71.7%),平均(75.14±8.34)岁。跌倒发生在家中占41.78%,家外小区内占21.71%,小区以外占36.51%;不同地点跌倒老人自身原因的构成差异有统计学意义(χ2=47.83,P<0.001),在家中因头昏(10.2%)和不小心(74.0%)跌倒为主,而在小区内和小区以外跌倒均以不小心(87.9%,86.5%)为主;不同地点跌倒老人的环境原因的构成差异有统计学意义(χ2=115.67,P<0.001),在家中因没有保护措施(48.4%)跌倒为主,而在小区内跌倒以地面不平(32.3%)和没有保护措施(32.3%)为主,小区以外以路滑(24.3%)和地面不平(35.1%)为主。跌倒老年人中,57.9%去医院就诊,住院率为14.1%;最常见的受伤性质是浅表伤和骨折,分别占38.8%和32.2%;跌倒后的医疗花费中位数为700元;跌倒后有49.3%的老年人的运动能力受到不同程度的影响,尚有23.4%的老年人未采取正确的预防跌倒措施。结论社区老年人跌倒对健康危害较严重,造成一定的医疗负担,急需采取预防措施。
Objectives To understand the epidemiological and medical burden of falls in the elderly in the community. Methods A total of 1 690 elderly people living in a neighborhood of 2 residents in Changning District were monitored and follow-up surveys were conducted on the elderly who fell. Results A total of 304 elderly people were detected as falling, with 86 males (28.3%) and 218 females (71.7%), with an average of (75.14 ± 8.34) years. 41.78% of them fell into the home, 21.71% of them were outside the home, and 36.51% of them were outside the residential area. There were significant differences in the causes of falling among the elderly in different locations (χ2 = 47.83, P <0.001) (10.2%) and carelessness (74.0%). Most of them fell carelessly (87.9%, 86.5%) in or out of the community. The differences in the causes of the environmental causes of falling elderly in different locations were statistically significant (Χ2 = 115.67, P <0.001). At home, there was no fall in protection due to lack of protection measures (48.4%), while the fall in the community was dominated by uneven ground (32.3%) and no protection measures (32.3%), The main road slip (24.3%) and uneven ground (35.1%). Among the elderly who fell, 57.9% went to the hospital for treatment, with a hospitalization rate of 14.1%. The most common injuries were superficial injuries and fractures, accounting for 38.8% and 32.2% respectively. The median medical cost after the fall was $ 700. After 49.3% of elderly people’s motor ability to varying degrees, there are still 23.4% of the elderly did not take proper prevention and fall measures. Conclusion The fall of the elderly in the community is more harmful to health, causing some medical burden and urgently requiring preventive measures.