因跌倒至急診就診之老年病患分析

Characteristics of Community-dwelling Elderly Patients Visiting an Emergency Department Due to Fall Incidents

史芳瑛(Fang-Ying Shih) ； 徐祥清(Hsiang-Chin Hsu) ； 林育瑩(Yu-Ying Lin) ； 佘翠紋(Tsui-Wen She) ； 吳秋慧(Chiu-Hui Wu) ； 林念蓉(Nien-Jung Lin) ； 張家銘(Chia-Ming Chang) ； 王雅麗(Ya-Li Wang) ； 紀志賢(Chih-Hsien Chi) ； 施欣怡(Hsin-I Shih)

《台灣老年醫學暨老年學雜誌》 10卷1期 (2015/02) Pp. 16-27

https://doi.org/10.29461/TGG.201502_10(1).0002

摘要

跌倒是我國老人事故傷害的第二大死因，跌倒後會造成個案生理和心理的負擔，提高健康照護的成本。本研究旨在探討社區老年病患因跌倒而至急診就診之特性與急診醫護人員常規介入措施之預後追蹤。2010年9月至2012年4月期間，38,234人次（27.6%）的老年病患至某醫學中心急診就診，其中有766人次（2%）的就診原因與跌倒有關；平均每月有39位老人因跌倒而就醫，就診科別以外傷（60%）為主；因跌倒而就醫的老年病患中，大部分病患（62%）皆從急診直接離院，直接離院者在急診的平均停留時間中位數為5.1小時。多數病患（85%）離院時需要人協助，有53%出院後仍繼續住在家中，多數需專人照護，約有25%未返回本院門診追蹤。急診老年跌倒病患停留急診時間短，急診醫護人員對於老年跌倒高危險群評估與相關衛教皆有限。改善急診老年跌倒病患照護仍需更多不同專業人力投入以達顯著效果。

關鍵字

社區老年人 ； 跌倒評估 ； 急診

並列摘要

Fall is the second leading cause of incident for elderly in Taiwan. In addition to physical and psychological damages, falls also indirectly lead to disability, reduced quality of life, and death. This research aims to review characteristics and prognosis of the elderly community dwellers visiting an emergency department (ED) because of fall incidents. During the period from September 2010 to April 2012, elderly accounted for approximately twenty-seven percent of the patients visiting the ED of the medical center where the study was conducted. Around 2% of those elderly patients visited the ED due to fall incidents, resulting in an average of 39 elderly fall cases per month. Nearly sixty percent of them were treated in the trauma division of the ED. The median stay among patients who were discharged from the ED was 5.1 hours. A great majority of the elderly fall patients (85%) needed assistance when they left the ED. About 53 percent of them continued to live at home, and most of them required special care and assistance. Twenty-five percent of the elderly fall patients did not return to the hospital for further evaluation and treatment. Fall assessment and management provided by health care professionals working in the ED remained limited because of the higher number of patients and short stay duration. Coordination and cooperation between cross-disciplinary health care professionals are needed to improve the quality of treating elderly fall patients.

並列關鍵字

community-dwelling elderly ； falls assessment ； emergency department