医院住院老年患者跌倒风险因素分析及防护对策研究

Risk factors of falls in hospitalized elderly patients and countermeasures

摘要:

目的 了解老年人住院期间跌倒发生现状及其影响因素，为住院老年患者预防跌倒措施的制定提供理论依据。方法 对同济大学附属肺科医院60岁以上住院老年患者进行调查。采用现场面对面调查的方式采集研究对象的基本情况、健康状况、跌倒情况。根据患者是否跌倒分为2组，分析住院老年患者跌倒事件发生的原因、特点和分布特征，探究住院老年患者跌倒影响因素。结果 本次调查共收集6 162份问卷，住院期间有23例跌倒在地上或更低的平面，其中4例跌倒在地上，19例站立未站稳跌倒在更低的平面(如床上)，跌倒发生率为0.37%。跌倒的主要地点是病房，其次是浴室/卫生间。多因素Logistic回归的结果显示手脚不灵活(OR=3.872，95%CI: 1.7028.808)、服用抗心律失常药物(OR=4.784,95%CI: 1.42716.045)、尿频尿急和夜尿频繁(OR=3.64,95%CI: 1.14911.534)是老年人跌倒的独立危险因素。结论 重视住院老年人的安全评估，加强高危人群跌倒危险因素的预防，提高患者照顾者的跌倒预防意识，有助于预防和减少导致跌倒的隐患，保护老年人健康。

Abstract:

Objective To analyze the risk factors of falls in hospitalized elderly patient and related countermeasures. Methods A questionnaire survey was conducted among aged ≥60 years in Shanghai Pulmonary Hospital Tongji University. The questionnaire contained the basic information and health status of patients, the experience of falling and related factors. The causes and characteristics of falling and its distribution were analyzed. Results A total of 6 162 valid questionnaires were collected with a recovery rate of 100.0%. There were 23 patients with the experience of falls during hospitalization with a prevalence of 0.37%. The logistic regression showed that taking antiarrhythmic drugs(OR=3.872, 95%CI: 1.702-8.808), mobility impairment(OR=3.872，95%CI: 1.702-8.808), frequent urination and frequent nocturia(OR=3.64, 95%CI: 1.149-11.534) were independent risk factors of falls in elderly patients during hospitalization. Conclusion According to the risk factors appropriate countermeasures should be taken to prevent falls in elderly patients during hospitalization.