老年人跌倒及跌伤常见11个影响因素的相对重要性评价

李伟强; 饶蓁蓁; 傅晏红; 宁佩珊; 李黎; 胡国清

文章摘要

李伟强,饶蓁蓁,傅晏红,宁佩珊,李黎,胡国清.老年人跌倒及跌伤常见11个影响因素的相对重要性评价[J].中华流行病学杂志,2024,45(8):1103-1111

老年人跌倒及跌伤常见11个影响因素的相对重要性评价

Comparison of importance of 11 common influencing factors for fall and fall-induced injury in the elderly

收稿日期:2023-12-11 出版日期:2024-08-22

DOI：10.3760/cma.j.cn112338-20231211-00345

中文关键词: 跌倒跌伤老年人影响因素队列研究

英文关键词: Fall Fall-induced injury The elderly Influencing factor Cohort study

基金项目:国家重点研发计划（2022YFC3603000）

作者	单位	E-mail
李伟强	中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410078
饶蓁蓁	中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410078
傅晏红	中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410078
宁佩珊	中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410078
李黎	中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410078
胡国清	中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410078 中南大学湘雅医院国家老年疾病临床医学研究中心, 长沙 410078	huguoqing009@gmail.com

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中文摘要:

目的评价既往文献报道的11个常见老年人跌倒及跌伤影响因素的相对重要性。方法数据来自2011-2018年中国健康与养老追踪调查的2、3、4、5和7年随访数据。拟合二分类logistic回归模型与负二项回归模型检验11个影响因素与跌倒及跌伤的相关性，采用$\hat{\beta}$绝对值比较11个因素的相对重要性。结果 5次随访分别纳入9 279、6 153、4 142、4 148及3 583名老年人，其中随访2、3、4、5和7年的跌倒累计发生率分别为19.4%（95%CI：18.6%~20.2%）、22.1%（95%CI：21.0%~23.1%）、31.9%（95%CI：30.4%~33.3%）、35.1%（95%CI：33.6%~36.5%）和43.2%（95%CI：41.6%~44.8%），5次随访对应的跌伤累计发生率分别为8.4%（95%CI：7.8%~8.9%）、9.4%（95%CI：8.7%~10.1%）、15.1%（95%CI：14.0%~16.2%）、16.2%（95%CI：15.1%~17.3%）及22.0%（95%CI：20.6%~23.3%）。跌倒与跌伤的多变量logistic回归及负二项回归分析结果显示，11个因素中仅性别、跌倒史、是否具有抑郁症状在5次随访中为我国老年人跌倒和跌伤的共同危险因素（均P<0.05）；跌倒史的$\hat{\beta}$绝对值在所有模型中均排在首位，性别除5年跌伤模型外均排在第二位。结论既往文献报道的11个跌倒及跌伤的影响因素在我国老年人的2、3、4、5和7年随访中，仅性别、跌倒史、是否具有抑郁症状被识别为共性危险因素。跌倒史和性别对我国老年人跌倒及跌伤发生的相对重要性较大。

英文摘要:

Objective To compare the importance of 11 common influencing factors for fall and fall-induced injury reported previously in the elderly. Methods The data were collected from the follow-up of the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. Binary logistic regression model and negative binomial regression model were used to test the significance of correlations between 11 factors and the incidence of fall and fall-induced injury during this period. The absolute value of the $\hat{\beta}$ was used to evaluate importance of 11 influencing factors. Results This study included 9 279, 6 153, 4 142, 4 148, and 3 583 old persons. The cumulative incidence rates of fall in the 2^nd, 3^rd, 4^th, 5^th, and 7^th years were 19.4% (95%CI: 18.6%-20.2%), 22.1% (95%CI: 21.0%-23.1%), 31.9% (95%CI: 30.4%-33.3%), 35.1% (95%CI: 33.6%-36.5%), and 43.2% (95%CI: 41.6%-44.8%), respectively. The cumulative incidence rates of fall-induced injury were 8.4% (95%CI: 7.8%-8.9%), 9.4% (95%CI: 8.7%-10.1%), 15.1% (95%CI: 14.0%-16.2%), 16.2% (95%CI: 15.1%-17.3%), and 22.0% (95%CI: 20.6%-23.3%). The results of multivariate logistic regression and negative binomial regression analyses showed that in the 11 factors, only gender, history of fall, and depressive symptoms were identified as common risk factors for fall and fall-induced injury in the elderly in all the follow up visits (all P<0.05); the history of fall had the highest absolute value of $\hat{\beta}$ in all models, while gender ranked second except for the 5-year fall-induced injury model. Conclusions Of the 11 influencing factors for fall and fall-induced injury reported by previous literature, only gender, history of falls, and depressive symptoms were identified as common risk factors for fall and fall-induced injury in the eldely in the 2^nd, 3^rd, 4^th, 5^th, and 7^th years follow-up visits. History of fall and gender were important influencing factors for fall and fall-induced injury in the elderly.

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