2002—2018年上海市虹口区居民意外跌落死亡特征及趋势

Characteristics and trend of unintentional fall mortality of residents in Hongkou District, Shanghai, 2002—2018

[背景]跌落伤导致的健康寿命年损失是老年人伤害疾病负担上升的主要原因。掌握居民意外跌落的死亡情况及其变化的主要因素,有助于精准地推进当地伤害防治工作。[目的]了解上海市虹口区居民意外跌落致死情况及人口老龄化带来的影响。[方法]根据2002—2018年虹口区户籍人口死因监测数据库,采用死亡率、标化死亡率、年度变化百分比(annual percentage change,APC)和平均年度变化百分比(average annual percentage change,AAPC)对居民意外跌落致死情况进行分析。[结果]2002—2018年虹口区居民因意外跌落死亡2137人,粗死亡率为16.06/10万,中国标化死亡率为2.81/10万,世界标化死亡率为4.80/10万。男性粗死亡率低于女性(13.48/10万vs 18.58/10万),但男性标化死亡率略高于女性(中国标化死亡率:3.29/10万vs 18.58/10万;世界标化死亡率:5.20/10万vs 4.30/10万)。男性、女性及合计粗死亡率均呈上升趋势(AAPC=5.28%、2.12%、3.39%,均P<0.05)。男、女及合计的中国标化死亡率和世界标化死亡率均呈波动态势(均P>0.05)。在同一平面跌倒(AAPC中国标化=-5.21%,AAPC世界标化=-5.33%)、从家具上跌落(AAPC中国标化=-6.74%)和从楼梯与梯子上跌落(AAPC中国标化=-7.20%,AAPC世界标化=-7.66%)导致的标化死亡率呈逐年下降趋势(均P<0.05);未特指类型跌落导致的粗死亡率(AAPC粗=19.05%)、中国标化死亡率(AAPC中国标化=13.38%)和世界标化死亡率(AAPC世界标化=13.00%)均呈逐年上升趋势(均P<0.05)。65岁以下年龄组和80岁及以上高龄老年人组意外跌落死亡率均无变化趋势(P>0.05),65~79岁低龄老人组呈逐年下降趋势(AAPC=-2.10%,P<0.05)。各性别不同年龄段居民的跌落死因分布存在差异。[结论]虹口区应采取积极措施应对人口老龄化对居民意外跌落死亡率上升的影响。

[Background]The years of life lost attributed by fall injury is the main reason for the increase of disease burden of injury for the elderly.Understanding the mortality and main factors of unintentional fall of residents is beneficial to promote local precision prevention and control program for injury.[Objective]This study explores the mortality of unintentional fall and the impact of an aging population in Hongkou District of Shanghai.[Methods]According to the all-cause deaths database of registered residents from 2002 to 2018 in Hongkou District of Shanghai,mortality rate,standardized mortality rate,annual percentage change(APC),and average annual percentage change(AAPC)were used to analyze deaths from unintentional fall.[Results]During 2002 and 2018,a total of 2137 residents died from unintentional fall in Hongkou District,the crude mortality rate was 16.06/100000,the China’s standardized mortality rate was 2.81/100000,and the world’s standardized mortality rate was 4.80/100000.The male crude morality rate was lower than the female rate(13.48/100000 vs 18.58/100000),but the male standardized mortality rates were slightly higher than the female rates(China’s standardized morality rate:3.29/100000 vs 18.58/100000;world’s standardized morality rate:5.20/100000 vs 4.30/100000).There were significant upward trends in the crude mortalities for males,females,and total population(AAPC=5.28%,2.12%,and 3.39%,respectively,all P<0.05).The China’s and world’s standardized mortalities for males,females,and total population were fluctuating(all P>0.05).The China’s and world’s standardized mortality rates due to fall on the same level(AAPC=-5.21%and-5.33%),fall involving furniture(AAPC for China’s standardized mortality rate=-6.74%),and fall from stairs and ladders(AAPC=-7.20%and-7.66%)were decreasing year by year(all P<0.05).The mortality rate(AAPC=19.05%),China’s standardized mortality rate(AAPC=13.38%),and world’s standardized mortality rate(AAPC=13.00%)of other fall were increasing year by year(all P<0.05).Except the residents<65 years and≥80 years whose unintentional fall mortality rates did not show significant changes(P>0.05),those in the 65-79 years group showed a downward trend in the mortality due to unintentional fall(AAPC=-2.10%,P<0.05).There were differences in the distribution of death causes among the residents of different sex and age groups.[Conclusion]Hongkou District authority should take active measures to deal with the impact of an aging population on the rise of unintentional fall mortality.