Dataset Information

Population ageing and injurious falls among one million elderly people who used emergency medical services from 2010 to 2017 in Beijing, China: a longitudinal observational study.

ABSTRACT: OBJECTIVES:To access the epidemiological characteristics of elderly people using emergency medical services (EMS) in Beijing, as a consequence of injurious falls, and the association between an ageing population and injurious falls. DESIGN:A longitudinal observational study based on Beijing EMS data. SETTING:All citizens aged 60 years or above who used EMS from 2010 to 2017 in Beijing, China. PARTICIPANTS:During 2010 to 2017, 2516 128 people used EMS in Beijing. Of these, 1528 938 people aged under 60 years were excluded and the remaining 987 190 people were included in our study. METHODS:Data were from the emergency dispatch database of Beijing's Emergency Medical Centre. We described the proportion of elderly people using EMS in Beijing due to injurious falls with regard to region, time, sex, age and proportion of the elderly population. RESULTS:Among the 987 190 participants who used EMS, 82 694 (8.38%) had had a fall. The proportion of falls rose from 7.12% in 2010 to 9.45% in 2017, and was higher in urban (8.62%) than in suburban (7.80%) regions. Elderly people were more likely to use EMS due to injurious falls during September to November (8.99%) than during December to February (7.68%) (adjusted OR (aOR)=1.19), and during 08:00 to 09:59 (10.02%) than during 00:00 to 01:59 (4.11%) (aOR=2.52). Elderly people in districts with high (8.92%, aOR=1.15) and medium (8.23%, aOR=1.09) proportions of an elderly population were more likely to use EMS due to injurious falls than those in districts with a low proportion of elderly population (7.81%). CONCLUSIONS:In Beijing, the proportion of elderly people using EMS due to injurious falls increased with age, and was positively correlated with the proportion of the elderly population. Taking care of elderly people and preventing injurious falls should be one of the key issues to be handled in a society with an ageing population.

SUBMITTER: Zhao S

PROVIDER: S-EPMC6609050 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Population ageing and injurious falls among one million elderly people who used emergency medical services from 2010 to 2017 in Beijing, China: a longitudinal observational study.

Zhao Siyu S Cao Yu Y Lei Yanni Y Liu Fangchao F Shao Shiyu S Liu Jue J Nie Dongni D Yang Nannan N Liu Min M

BMJ open 20190628 6

<h4>Objectives</h4>To access the epidemiological characteristics of elderly people using emergency medical services (EMS) in Beijing, as a consequence of injurious falls, and the association between an ageing population and injurious falls.<h4>Design</h4>A longitudinal observational study based on Beijing EMS data.<h4>Setting</h4>All citizens aged 60 years or above who used EMS from 2010 to 2017 in Beijing, China.<h4>Participants</h4>During 2010 to 2017, 2516 128 people used EMS in Beijing. Of t ...[more]

PMID: 31256032

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Project description:Purpose Injurious falls seriously threaten the safety of elderly patients. Identifying risk factors for predicting the probability of injurious falls is an important issue that still needs to be solved urgently. We aimed to identify predictors and develop a nomogram for distinguishing populations at high risk of injurious falls from older adults in acute settings. Patients and Methods A retrospective case–control study was conducted at three hospitals in Shanghai, China. Elderly patients with injurious falls from January 2014 to December 2018 were taken as cases, and control patients who did not have falls were randomly matched based on the admission date and the department. The data were collected through a medical record review and adverse events system. The original data set was randomly divided into a training set and a validation set at a 7:3 ratio. A nomogram was established based on the results of the univariate analysis and multivariate logistic regression analysis, and its discrimination and calibration were verified to confirm the accuracy of the prediction. The cut-off value of risk stratification was determined to help medical staff identify the high-risk groups. Results A total of 115 elderly patients with injurious falls and 230 controls were identified. History of fractures, orthostatic hypotension, functional status, sedative-hypnotics and level of serum albumin were independent risk factors for injurious falls in elderly patients. The C-indexes of the training and validation sets were 0.874 (95% CI: 0.784?0.964) and 0.847 (95% CI: 0.771–0.924), respectively. Calibration curves were drawn and showed acceptable predictive performance. The cut-off values of the training and validation sets were 146.3 points (sensitivity: 73.7%; specificity: 87.5%) and 157.2 points (sensitivity: 69.2%; specificity: 85.5%), respectively. Conclusion The established nomogram facilitates the identification of high-risk populations among elderly patients, providing a new assessment tool to forecast the individual risk of injurious falls.

Project description:PURPOSE:To review and update the evidence of the relationship between physical activity, risk of fall-related injury, and physical function in community-dwelling older people that was presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (PAGAC Report). METHODS:Duplicate independent screenings of 1415 systematic reviews and meta-analyses published between 2006 and 2016 identified from PubMed®, Cochrane Library, and CINAHL databases yielded 111 articles used for the PAGAC Report. The PAGAC Aging Subcommittee members graded scientific evidence strength based upon a five-criteria rubric and assigned one of four grades: strong, moderate, limited, or not assignable. An updated search of 368 articles published between January 2017 and March 2018 yielded 35 additional pertinent articles. RESULTS:Strong evidence demonstrated that physical activity reduced the risk of fall-related injuries by 32% to 40%, including severe falls requiring medical care or hospitalization. Strong evidence also supported that physical activity improved physical function and reduced the risk of age-related loss of physical function in an inverse graded manner among the general aging population, and improved physical function in older people with frailty and with Parkinson's disease. Aerobic, muscle-strengthening, and/or multicomponent physical activity programs elicited the largest improvements in physical function in these same populations. Moderate evidence indicated that for older adults who sustained a hip fracture or stroke, extended exercise programs and mobility-oriented physical activity improved physical function. CONCLUSIONS:Regular physical activity effectively helps older adults improve or delay the loss of physical function and mobility while reducing the risk of fall-related injuries. These important public health benefits underscore the importance of physical activity among older adults, especially those living with declining physical function and chronic health conditions.

Dataset Information

Population ageing and injurious falls among one million elderly people who used emergency medical services from 2010 to 2017 in Beijing, China: a longitudinal observational study.

Publications

Population ageing and injurious falls among one million elderly people who used emergency medical services from 2010 to 2017 in Beijing, China: a longitudinal observational study.

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