2018年中国因跌倒/坠落就诊患者损伤严重程度及影响因素

The severity and influencing factors of injuries among patients attending hospitals due to falls in China,2018

目的了解中国因跌倒/坠落就诊病例流行特征和影响损伤严重程度的因素,为制定跌倒/坠落防控措施、政策提供依据。方法通过提取2018年中国伤害监测系统(national injury surveillance system,NISS)中跌倒/坠落病例数据,描述其流行特征,采用多因素Logistic回归分析模型分析损伤严重程度影响因素。结果共收集跌倒/坠落病例500621例。损伤严重程度以轻度为主(76.00%),中、重度损伤所占比例为24.00%。单因素分析显示,性别、年龄、城乡、发生季节、发生时段、发生地点、发生时活动、发生前饮酒情况的跌倒/坠落病例损伤严重程度差异具有统计学意义(均有P<0.001)。多因素分析显示,男性(OR=1.056,95%CI:1.041~1.071);年龄为5~岁(OR=1.412,95%CI:1.366~1.460)、15~岁(OR=1.382,95%CI:1.337~1.427)、30~岁(OR=1.844,95%CI:1.787~1.903)、45~岁(OR=2.746,95%CI:2.666~2.829)、≥65岁(OR=4.524,95%CI:4.390~4.663);夏季(OR=1.097,95%CI:1.077~1.118)、秋季(OR=1.110,95%CI:1.089~1.131)、冬季(OR=1.137,95%CI:1.116~1.159);地点为家中(OR=1.169,95%CI:1.143~1.196)、学校与公共场所(OR=1.102,95%CI:1.069~1.136)、体育和运动场所(OR=1.066,95%CI:1.016~1.119)、工业和建筑场所(OR=1.800,95%CI:1.727~1.877)、农场/农田(OR=1.257,95%CI:1.196~1.320);活动为步行(OR=1.084,95%CI:1.045~1.126);发生前饮酒(OR=1.318,95%CI:1.257~1.381)是中重度损伤的危险因素。结论中国因跌倒/坠落就诊患者中重度损伤占一定比例,且影响因素较多,相关部门应开展针对性的防控工作。

Objective To analyze the epidemiological characteristic and influencing factors of injury severity among patients attending hospitals due to falls in China,so as to provide the evidence for the work of preventing falls and the formulation of policies.Methods Descriptive analysis was applied by using the data from National Injury Surveillance System(NISS).Multivariate logistic regression was used for analysis on influencing factors of injury severity.Results In total,500621 cases of falls were collected by NISS.The injury severity was mainly mild(76.00%),and moderate and severe injury accounted for 24.00%.Results of univariate analysis showed that gender,age,urban-rural,season,time,places,drinking condition before falls,and activities when falls occurred were influencing factors of injury severity.The multivariate analysis showed that male(OR=1.056,95%CI:1.041-1.071),age group of 5-years old(OR=1.412,95%CI:1.366-1.460),15-years old(OR=1.382,95%CI:1.337-1.427),30-years old(OR=1.844,95%CI:1.787-1.903),45-years old(OR=2.746,95%CI:2.666-2.829)and 65 years old and older(OR=4.524,95%CI:4.390-4.663),occurring in summer(OR=1.097,95%CI:1.077-1.118),autumn(OR=1.110,95%CI:1.089-1.131)and winter(OR=1.137,95%CI:1.116-1.159),places where falls occurred were home(OR=1.169,95%CI:1.143-1.196),school and school-related area(OR=1.102,95%CI:1.069-1.136),sports and athletics area(OR=1.066,95%CI:1.016-1.119),industrial and construction area(OR=1.800,95%CI:1.727-1.877)and farm/farmland(OR=1.257,95%CI:1.196-1.320),activity when falls occurred was walking(OR=1.084,95%CI:1.045-1.126),and drinking condition before falls(OR=1.318,95%CI:1.257-1.381)were risk factors of injury severity for falls.Conclusions Moderate and severe injuries account for a certain proportion of patients treated for falls and the influencing factors are various.Relevant departments should carry out targeted falls prevention and control.