摘要
目的探讨重庆市九龙坡区老年人跌倒伤害严重程度的流行特征及其独立影响因素,为制定针对性的跌倒严重伤害防控策略提供依据。方法本研究采用横断面调查设计。数据来源于2024年7月至2025年7月,重庆市九龙坡区22家伤害监测哨点医院通过“重庆市慢病监测系统-伤害监测”平台报告的全部伤害病例。筛选年龄≥60岁、且伤害发生原因为跌倒的病例作为研究对象。收集其社会人口学特征、伤害发生情况与基础疾病等信息。以伤害严重程度(分为轻度、中/重度)作为因变量,采用χ2检验进行单因素分析,多因素非条件Logistic回归模型进行老年人跌倒后发生中/重度伤害的独立影响因素。检验水准α=0.05。结果共纳入3709例老年跌倒病例。女性偏多,占68.46%,年龄以60~69岁(1502例,40.50%)和70~79岁(1336例,36.02%)为主。跌倒发生地点主要在家中(2675例,72.12%)。轻度伤害1842例(49.66%),中/重度伤害1867例(50.34%)。伤害性质与伤害程度密切相关,中/重度伤害中骨折比例高达91.64%(1711/1867)。多因素Logistic回归分析显示,女性(OR=1.376,95%CI:1.194~1.585)、年龄70~79岁(OR=1.415,95%CI:1.159~1.727)及≥80岁(OR=1.221,95%CI:1.045~1.425)、患有糖尿病(OR=2.181,95%CI:1.680~2.831)、中心性肥胖(OR=1.342,95%CI:1.040~1.731)人群有更高的中/重度伤害检出率,小学(OR=0.749,95%CI:0.597~0.940)和初中及以上(OR=0.784,95%CI:0.633~0.971)文化程度中/重度伤害检出率更低。结论重庆市九龙坡区老年人跌倒后中/重度伤害发生率高,女性、高龄(≥70岁)、糖尿病和中心性肥胖是其主要危险因素,跌倒防控策略应聚焦高危人群,通过健康宣教、慢病与体重管理以及家庭环境适老化改造等综合性措施,可有效降低严重伤害的发生风险。
Objective The aim of this study was to investigate the epidemiological characteristics and independent risk factors for fall-related injury severity among older adults in Jiulongpo District,Chongqing,providing evidence for developing targeted strategies to prevent severe fall injuries.Methods This study employed a cross-sectional survey design.Data were sourced from all injury cases reported through the“Chongqing Chronic Disease Surveillance System-Injury Surveillance”by 22 sentinel hospitals in Jiulongpo District,Chongqing,between July 2024 and July 2025.Cases aged≥60 years with falls as the injury cause were selected as study subjects.Demographic characteristics,injury circumstances,and underlying medical conditions were collected.Injury severity(classified as mild or moderate/severe)served as the dependent variable.Univariate analysis employed the chi-square test,while univariate analysis and multivariate unconditional logistic regression models identified independent factors associated with moderate/severe injuries following falls among the elderly.The significance level was set atα=0.05.Results A total of 3,709 elderly fall cases were included.Females predominated,accounting for 68.46%.The primary age groups were 60~69 years(1,502 cases,40.50%)and 70~79 years(1,336 cases,36.02%).The main location of falls was at home(2,675 cases,72.12%).Mild injuries occurred in 1,842 cases(49.66%),while moderate/severe injuries occurred in 1,867 cases(50.34%).The nature of injury was closely correlated with injury severity,with fractures accounting for 91.64%(1,711/1,867)of moderate/severe injuries.Multivariate logistic regression analysis revealed that female gender(OR=1.376,95%CI:1.194~1.585),age 70~79 years(OR=1.415,95%CI:1.159~1.727)and≥80 years(OR=1.221,95%CI:1.045~1.425),diabetes(OR=2.181,95%CI:1.680~2.831),central obesity(OR=1.342,95%CI:1.040~1.731)had higher detection rates of moderate/severe injuries.Individuals with primary school education(OR=0.749,95%CI:0.597~0.940)and junior high school education or higher(OR=0.784,95%CI:0.633~0.971)had lower detection rates of moderate/severe injuries.Conclusion The incidence of moderate/severe injuries following falls among older adults in Jiulongpo District,Chongqing is high.Key risk factors include female gender,advanced age(≥70 years),diabetes,and central obesity.Fall prevention strategies should target high-risk populations through comprehensive measures such as health education,chronic disease and weight management,and home modifications for aging-friendly environments to effectively reduce the risk of severe injury.
作者
周瑜
罗诗月
黄耀
马周俊
ZHOU Yu;LUO Shiyue;HUANG Yao;MA Zhoujun(Jiulongpo District Center for Disease Control and Prevention,Chongqing 400000,China;School of Public Health,Chongqing Medical University,Chongqing 401331,China)
出处
《西南医科大学学报》
2026年第2期187-191,210,共6页
Journal of Southwest Medical University
基金
重庆市九龙坡区公共卫生重点学科和实验室建设项目(2023-03-029-D)。
