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哪些65岁及以上的成年人在低水平跌倒后面临椎损伤的低风险?
Jessica McCallum1,2, Debra Eagles3,4, Ian Stiell3,4
1School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. j.harrismccallum@gmail.com.
CJEM
|September 2, 2024
概括
经历低水平跌倒的老年人患椎损伤的患病率较低. 头部受伤或部疼痛是关键指标,这表明在没有这些症状的患者中,成像可能是不必要的.
科学领域:
- 老年急救医学的医学
- 创伤外科 手术 创伤外科
- 放射学 放射学是一门学科.
背景情况:
- 布是老龄化人口前往急诊室的重要原因之一.
- 适当的诊断成像对于识别老年人跌倒后受伤至关重要.
- 椎损伤需要及时和准确的诊断,以防止长期的并发症.
研究的目的:
- 为了确定65岁及以上的成年人中部脊柱损伤的患病率,在低水平跌倒后.
- 在这个人口群体中确定与椎脊椎损伤相关的特定因素.
- 为老年患者在轻微跌倒后的成像指南提供信息.
主要方法:
- 进行了一项前性观察队列研究,重点关注65岁以上的患者在低水平下降后.
- 椎损伤是主要结果,风险因素包括格拉斯哥昏迷度量 (GCS) 评分,头部损伤,部疼痛,年龄和虚弱.
- 多变量逻辑回归分析了风险因素和椎损伤之间的关联;描述性分析确定了可能不需要成像的患者.
主要成果:
- 在4308名老年人中,23名 (0.5%) 在低位跌倒后遭受了椎损伤.
- 与伤害显著相关的因素包括头部伤害 (aOR 5.3),部疼痛 (aOR 13.0) 和年龄较大 (aOR 1.4 每5年).
- 所有确定的椎脊柱损伤都发生在头部受伤或部疼痛的患者身上.
结论:
- 头部受伤,部疼痛和晚年与老年人低水平跌倒后的椎损伤有关.
- 没有头部受伤和部疼痛与没有椎脊椎损伤相关.
- 这些发现表明,在低水平跌倒后没有头部受伤或部疼痛的老年患者可能不需要宫脊椎成像.
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