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    Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/1263


    Title: 跌倒的流行病學分析 ( 319位病人的事件序列研究法 )
    Epidemiological analysis of falls: Case series study of 319 patients from hospital Database
    Authors: 葉兆斌
    Chao-Bin Yeh
    Contributors: 中山醫學大學:醫學研究所;周明智
    Keywords: 跌倒;髖部骨折;預防
    Fall;hip fracture;prevention
    Date: 2001
    Issue Date: 2010-04-23T08:00:03Z (UTC)
    Abstract: 社會上,因跌倒而受傷是最主要存在人群之間的健康問題。故而,根據統計,跌倒而受傷是急診病患中佔最多的原因之一。國外的研究報告也指出,他們的急診病患中因跌倒而受傷且送急診的有10﹪以上。此外,在原因方面,除了車禍造成受傷,從高處跌落更是造成死亡及殘廢的主因。
    跌倒並不似其它的一些傷害,它可能發生在任何年齡層,從小孩到老人都有可能;而且,跌倒所造成的成本效益是很高且無法評估的,因此會造成醫療的沉重負擔。
    這個研究的目的就是要觀察在中山附設醫院中跌倒病患的流行病學,為期12個月。數據則來自中山附設醫院的急診部,以前瞻研究法蒐集,包括痊癒者及急診中死亡者作探討研究分析。
    共有319個病患,男性162人,女性157人;但我們發現,小孩子比較容易有撕裂傷及頭部外傷,老人則多為骨折尤其以髖骨骨折為主。而主要死因是多發生在頭部及胸部的創傷(在我們的研究,其死亡率約在1.6﹪),其中更發現以同一個高度來講,在家裡跌倒發生的情形最多,而老人最常發生的地方是在浴室(31﹪),嬰幼兒則最常發生在客廳(22﹪)。若以不同高度來比較,反而是從樓梯上或階梯跌倒是最常見的。所以,我們的研究方向由以下幾點來進行分析:
    一、由受傷發生的時間地點分析;
    二、病人的年齡、性別;
    三、受傷的程度、部位及嚴重度、結果;
    四、個人生活習慣及相關環境因素的影響;
    從上述幾點來做為交叉分析以及探討。
    經由以上研究結果及其討論,歸納總結,有以下幾點建議:
    1. 首先要教育一般民眾有關跌倒的知識。瞭解造成跌倒的危險因子並 對其做適當的預防措施,如:避免飲酒、吃錯藥等;
    2. 需多多運動(尤其是老年人);
    3. 居家安全防護的觀念(如改善浴室、樓梯的安全)。
    如此才是降低跌倒受傷之發生的最有效法則。
    Fall is the major health problem in our society. One of the most common causes that result in the patient visiting the emergency department are injuries due to fall. It accounts for about 10% or even more in several study series. Moreover, high level fall is the secondary leading cause of accidental death and disability after motor vehicle crash in most countries. Unlike other types of trauma, injuries due to fall occur in all age groups ranging from infants to elders. Therefore, the cost-effectiveness is too high to make estimation.
    The aim of this study is to obtain an epidemiological data of all fall over a 12 months'' period in Chung Shan Medical and Dental College Hospital (CSM&DCH). The data on hospital survivors and hospital deaths were collected prospectively from emergency department database of CSM&DCH. There were 319 patients in this study, 162 were male, and 157 were female. Laceration and head injury predominated in children victim. Hip fracture predominated in the old age group. Head and chest injuries were the major cause of death. The mortality rate is 1.6% in our study. Fall at home, in the old age group, the bathroom accidents are the most common cause (31%); guest room accidents are prevalent in babies and children(22%)occurs in the same level. However, fall from stairs or steps is the most common place in difference level.
    In conclusion, education and safety training for all ages especially the elder, prevention such as stairs & bathroom design and risk control (alcohol or mistaken eating of drugs) may be the most effective policy to reduce fall.
    URI: http://140.128.138.153:8080/handle/310902500/1263
    Appears in Collections:[醫學研究所] 博碩士論文

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