摘要
目的 探讨60岁及以上病人在院期间发生跌倒不良事件后的伤害程度分布特点,分析其与年龄、实验室指标的相关性。方法 回顾性收集2017~2021年在南京医科大学第一附属医院发生跌倒不良事件病人(年龄≥60岁)的临床资料,根据其跌倒后的伤害程度将其分为无伤害组、一级伤害组、二级伤害组、三级伤害组。收集入组病人发生跌倒不良事件前7 d内最近一次晨空腹生化、凝血指标、血常规检测结果,分析不同跌倒伤害程度住院老年病人基本资料、实验室指标的差异。采用Spearman相关系数表示不同指标间的相关性;采用二元Logistic回归分析老年住院病人跌倒发生伤害的影响因素。结果 382例老年住院病人跌倒伤害程度分布以一级伤害(150例,39.27%)为主,其次为无伤害(145例,37.96%)、三级伤害(52例,13.61%)、二级伤害(35例,9.16%)。单因素分析显示,不同跌倒伤害程度老年病人的年龄、凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平差异有统计学意义(P<0.05或P<0.01)。Spearman相关分析显示,老年住院病人的跌倒伤害程度与年龄、PT、INR、APTT、FIB均呈正相关(r=0.188、0.169、0.177、0.147、0.131,均P<0.05)。Logistic回归分析显示,年龄(OR=1.035)、FIB(OR=1.330)为老年住院病人跌倒发生伤害的独立影响因素。结论 老年住院病人跌倒后伤害程度与年龄、凝血功能存在关联,建议将该部分高伤害风险人群作为跌倒风险管理的切入点,实施分层管理。
Objective To investigate the distribution characteristics of injury degree caused by falls in the elderly inpatients,and to analyze the influencing factors.Methods The clinical data of 382 inpatients aged≥60 years old who had fallen in the First Affiliated Hospital of Nanjing Medical University from 2017 to 2021 were retrospectively collected.According to the degree of injury caused by falls,they were divided into no injury group,first-level injury group,second-level injury group and third-level injury group.Fasting biochemical factors,coagulation indexes and blood routine test results of the latest morning within 7 days before falls were collected and compared among the groups.The correlation between different indicators was represented by Spearman correlation coefficient.The risk factors of injury caused by falls in the elderly inpatients were analyzed by binary Logistic regression analysis.Results Among the 382 elderly inpatients,the main injury degree was first-level injury(n=150,39.27%),followed by no injury(n=145,37.96%),third-level injury(n=52,13.61%)and second-level injury(n=35,9.16%).Univariate analysis showed that there were significant differences in age,prothrombin time(PT),international standard ratio(INR),activated partial thrombin time(APTT),fibrinogen(FIB)among the elderly patients with different degrees of injury caused by falls(P<0.05 or P<0.01).Spearman correlation analysis showed that the degree of injury caused by falls in the hospitalized elderly patients was positively correlated with age,PT,INR,APTT and FIB(r=0.188,0.169,0.177,0.147,0.131,all P<0.05).Logistic regression analysis showed that age(OR=1.035)and FIB(OR=1.330)were the independent influencing factors of injury caused by falls.Conclusions The degree of injury caused by falls is associated with age and coagulation function in the elderly inpatients,and the population with high risk of injury should receive hierarchical management.
作者
朱姣
夏丽莉
许敏铮
刘滢
王迎欣
尤征媛
ZHU Jiao;XIA Lili;XU Minzheng;LIU Ying;WANG Yingxin;YOU Zhengyuan(Department of Cardiovascular Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《实用老年医学》
CAS
2024年第1期81-85,共5页
Practical Geriatrics
基金
江苏省人民医院2021年度临床能力提升工程护理项目(JSPH-NC-2021-30)。
