髖部骨折老人跌倒之觀察性研究

Predictors of post-operative subsequent falls for hip fractured older persons in Taiwan

葉湘芬(Hsiang-Fen Yeh)

《慈濟科技大學學報》 10期=總34 (2021/06) Pp. 1-26

摘要

髖部骨折有很高的死亡率，90%髖部骨折是跌倒造成。本研究為二次分析法（Secondary Analysis），樣本以方便取樣自兩個台灣髖部骨折老人臨床試驗的對照組，收集資料於出院後兩年內共7次以居家訪視訪談，探討181位髖部骨折術後居住社區老人跌倒危險因子，以羅吉斯分析（Logistic Regression Analysis）進行統計。研究結果發現30.99 %髖部骨折老人於出院後一年跌倒、32.06 %於出院後兩年跌倒。健肢股四頭肌耐力分數（OR=0.616，CI=0.40-0.95）為出院一年內跌倒危險因子、日常生活活動功能（OR=0.969，CI=0.95-0.99）為出院一年至兩年跌倒危險因子。經本研究結果醫護專業團隊須提升防跌衛教，以及髖部老人出院前需有完善復健運動及職能治療指導，如此才可降低髖部骨折老人跌倒再發生率及提升日常活動身體功能復原能力。

關鍵字

跌倒危險因子 ； 再跌倒 ； 髖部骨折 ； 老人

並列摘要

Elderly hip fracture patients have a high probability of falling again after a fall incident. Risk factors for postoperative falls among elderly hip fracture patients in Taiwan remain to be confirmed. To explore risk factors for a single fall and multiple falls in the first and second postoperative years among elderly hip fracture patients. This study used Secondary analysis. Data were collected from control groups of two clinical trials. Overall, 181 older adults who underwent hip fracture surgery were assessed at predischarge and postdischarge. Participant data were collected from structured questionnaires in face-to-face interviews. In total participants' decline in unaffected limb quadriceps muscle endurance [odds ratio (OR) = 0.616, confidence interval (CI) = 0.40 - 0.95] was a crucial risk factors of a fall in the first postoperative year for elderly hip fracture patients. Engagement in activities of daily living was the crucial risk factors for falls (OR = 0.969, CI = 0.95-0.99) during the first to second postoperative years among elderly hip fracture patients. Early postoperative lower extremity muscular endurance rehabilitation must be provided. Furthermore, as part of the healthcare plan before hospital discharge, it must be ensured that the community where the older adults live has nutritional education, cognitive screening, and psychological support.

並列關鍵字

hip fracture ； older adults ； risk factors for falls ； quadriceps muscle endurance

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