跌倒老人之傷害型態與離院後居住地點對死亡、住院及日常生活功能之影響

Influence of Injury Pattern and Living Placement after Discharge on Mortality, Hospitalization, and ADLs among Elderly Fallers

施孝穎(Shiao-Ying Shih)

指導教授 ： 林茂榮

臺北醫學大學/公共衛生暨營養學院/傷害防治學研究所/碩士(2011年)

摘要

目的：探討跌倒老人離院後其傷害型態與居住地點是否對他們在死亡、住院及日常生活功能等方面之影響。方法：研究樣本為2005/8/1至2006/12/31因跌倒至台中某醫學中心就醫之65歲以上老人，期間內共有738位完成訪談。資料收集內容包括：基本人口學資料、受傷情形、離院後居住地點與一年後死亡、住院次數及日常生活功能等，傷害型態分為髖骨骨折、軀幹骨骨折、前臂骨折、腦外傷、軟組織傷害，離院後居住地點分為回到受傷前原住處、搬至子女家及入住照護機構。結果：不同傷害型態在死亡風險上皆無顯著差異；而腦外傷老人一年內有較高的住院次數，髖骨骨折與軀幹骨骨折的老人則有較低之日常生活功能，以上兩者達統計上顯著差異。離院後入住照護機構者在死亡風險、住院次數較回原住處者高，日常生活功能較低；搬至子女家者住院次數較低，以上結果皆達統計上顯著差異。結論：本研究結果認為讓受傷或失能的老人回到受傷前原住處或子女家進行照顧對老人而言將優於讓老人入住照護機構。

關鍵字

傷害型態 ； 居住地點 ； 老人跌倒

並列摘要

Purpose: The aim of this study is to investigate whether the outcomes of elderly fallers such as mortality, hospitalization, and activity of daily living (ADL) influenced by injury pattern and living placement after discharge. Method: Study subject were elderly aged 65 or more who visit ER due to fall, data collected from 2005/8/1 to 2006/12/31, from a medical center in Taichung, by a structured questionnaire, total 738 subjects completed the interview, data include such as demographics, injury pattern, living placement after discharge, mortality, hospitalization, and activity of daily living (ADL). Injury pattern divided into five parts: hip fracture, trunk fracture, forearm fracture, traumatic brain injury(TBI), and soft tissue injury. Living placement divided into three categories: back to original home, move to adult children’s home, and institutionalized. Results: mortality between different injury pattern has no significant different. TBI subjects has significant higher hospitalization. Subjects who were hip or trunk fracture has significant lower ADL. Subjects who institutionalized has significant higher mortality and hospitalization, lower ADL. Subjects who moved to their adult children’s home has significant lower hospitalization. Conclusion: Our study suggests that the elderly fallers who discharged to their original home or adult children’s home have better outcomes than who discharged to institution in Taiwan.

並列關鍵字

Injury pattern ； Living placement ； Elderly fallers

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