870所三级甲等医院老年住院患者跌倒伤害发生现状与影响因素分析

doi:10.3761/j.issn.0254-1769.2026.09.013

摘要/Abstract

摘要：

目的了解老年住院患者发生跌倒伤害的情况，探讨跌倒伤害发生的影响因素，识别跌倒伤害高危人群，从而为临床护理人员制订老年住院患者跌倒伤害预防策略提供参考。方法该研究为全国性多中心回顾性研究，数据来源于国家护理质量数据平台2019—2020年系统上报的老年住院患者跌倒事件。采用描述性分析描述跌倒伤害特征，通过单因素分析筛选变量，并进一步采用二元Logistic回归进行多因素分析，确定老年住院患者跌倒伤害发生的风险因素。结果共纳入全国870所三级甲等医院33 984例老年住院患者跌倒事件，其中21 408例老年住院患者发生跌倒伤害（62.99%），伤害程度以轻度为主（37.63%），但中重度伤害占比为25.28%，共导致28例死亡（0.08%）。康复医学科跌倒伤害比例最高（65.42%），且中重度伤害占比为29.05%；06：00—08：00为跌倒伤害的高发时段。二元Logistic回归分析显示，性别、跌倒发生地点、时间、日期是否为工作日、患者活动能力、跌倒风险评估是否高危、时点护患比及全院床护比是跌倒伤害发生的风险因素（P<0.05）。结论国内老年住院患者跌倒伤害发生率高，应重点关注老年女性、晨间及休息日、病区外等危险因素，加强对使用助行工具患者的评估与干预，并通过合理配置护理人力、优化工作流程等落实预防措施，以降低跌倒伤害的发生风险。

关键词: 老年人, 住院患者, 跌倒伤害, 护理质量

Abstract:

Objective This study was conducted to determine the incidence of fall-related injuries among elderly hospitalized patients，to identify influencing factors and high-risk populations，and to provide evidence for the development of targeted fall-prevention strategies by clinical nursing staff. Methods This nationwide，multicenter retrospective study was conducted using data on fall incidents among elderly inpatients reported to the National Nursing Quality Data Platform from 2019 to 2020. Descriptive analyzes were used to characterize fall patterns；univariate analyzes were performed to screen variables；binary logistic regression was applied to identify independent influencing factors associated with fall-related injuries among elderly inpatients. Results A total of 33，984 fall incidents among elderly inpatients from 870 tertiary A hospitals across China were included in the analysis. Among these，21，408 cases resulted in fall-related injuries（62.99%），with the severity being predominantly mild（37.63%）. Moderate-to-severe injuries accounted for 25.28% of cases，including 28 deaths（0.08%）. The Department of Rehabilitation Medicine reported the highest proportion of fall-related injuries（65.42%），among which moderate-to-severe injuries accounted for 29.05%. The period between 06：00 and 08：00 was identified as a peak time for fall-related injuries. Binary logistic regression analysis identified gender，fall location，time of occurrence，date，patient mobility，fall risk assessment grade，point-in-time nurse-to-patient ratio，and hospital-wide bed-to-nurse ratio as independent influencing factors associated with fall-related injuries（P<0.05）. Conclusion The incidence of fall-related injuries among elderly inpatients in China remains high. Particular attention should be given to risk factors elderly women，morning hours，rest days，and locations outside the ward. Enhanced assessment and targeted interventions for patients using mobility aids are essential. Preventive measures，including rational allocation of nursing staff and optimization of workflows，should be implemented to reduce the risk of fall-related injuries.

Key words: Aged, Hospitalized Patients, Fall-Related Injuries, Quality of Care

韩媛媛, 石玉竹, 尚文涵, 么莉. 870所三级甲等医院老年住院患者跌倒伤害发生现状与影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1245-1252.

HAN Yuanyuan, SHI Yuzhu, SHANG Wenhan, YAO Li. Analysis of incidence and influencing factors of fall injuries among elderly inpatients across 870 hospitals[J]. Chinese Journal of Nursing, 2026, 61(9): 1245-1252.

图/表 5

表1 老年住院跌倒患者一般资料及跌倒伤害发生情况的单因素分析[例（百分比，%）]

Table 1 Univariate analysis of falls and injuries in elderly inpatients[cases（percentage，%）]

表2 不同病区老年住院患者跌倒事件分布及伤害等级构成情况[例（百分比，%）]

Table 2 Distribution of fall events and injury severity among elderly hospitalized patients in different wards[cases（percentage，%）]

表3 老年住院患者跌伤害发生时间分布（n=21 408）

Table 3 Temporal distribution of fall-related injuries among elderly hospitalized patients（n=21 408）

表4 自变量赋值说明

Table 4 Assignment of independent variables

表5 老年住院跌倒患者发生伤害的Logistic回归分析（n=33 984）

Table 5 Logistic regression analysis of fall-related injuries in elderly hospitalized patients（n=33 984）

参考文献 31

[1]	World Heath Organization. Falls[EB/OL]. (2021-04-26)[2025-10-23]. https://www.who.int/news-room/fact-sheets/detail/falls/.
[2]	何梦欣, 陈德凤, 李蓓, 等. 智能化交互式认知运动干预在老年人跌倒预防中应用的范围综述[J]. 中华护理杂志, 2025, 60(7):884-890.
	He MX, Chen DF, Li B, et al. Intelligent interactive cognitive-motor training for fall prevention in older adults:a scoping review[J]. Chin J Nurs, 2025, 60(7):884-890.
[3]	张雪, 蔡燕, 王聪, 等. 认知-运动双任务训练在预防老年人跌倒中的研究进展[J]. 中华护理杂志, 2025, 60(3):297-302.
	Zhang X, Cai Y, Wang C, et al. Research progress on cognitive-motor dual-task training for preventing falls in older adults[J]. Chin J Nurs, 2025, 60(3):297-302.
[4]	周毅恒, 张瑜, 姜杰. 辽宁省大连市60岁及以上人群跌倒伤害流行特征分析[J]. 中国健康教育, 2025, 41(6):548-552.
	Zhou YH, Zhang Y, Jiang J. Epidemic characteristics of fall injury in the elderly aged 60 years and above in Dalian City[J]. Chin J Health Educ, 2025, 41(6):548-552.
[5]	吴志军, 尚文涵, 简伟研, 等. 我国住院患者跌倒发生率现状分析:基于490家三级甲等医院的调查[J]. 中国卫生质量管理, 2019, 26(3):14-17.
	Wu ZJ, Shang WH, Jian WY, et al. Incidence of falls among inpatient in China:a survey of 490 tertiary hospitals[J]. Chin Health Qual Manag, 2019, 26(3):14-17.
[6]	Costantinou E, Spencer JA. Analysis of inpatient hospital falls with serious injury[J]. Clin Nurs Res, 2021, 30(4):482-493.
[7]	Kim MS, Jung HM, Lee HY, et al. Risk factors for fall-related serious injury among Korean adults:a cross-sectional retrospective analysis[J]. Int J Environ Res Public Health, 2021, 18(3):1239.
[8]	Kobayashi K, Kido N, Wakabayashi S, et al. Association between fall-related serious injury and activity during fall in an acute care hospital[J]. PLoS One, 2023, 18(7):e0288320.
[9]	Li XY, Li HZ, Gan SB, et al. Falls,sleep disorders and cognitive frailty in hospitalized older adults with hypertension:a cross-sectional study[J]. Clin Interv Aging, 2025, 20:859-872.
[10]	Waterval NFJ, Claassen CM, van der Helm FCT, et al. Predictability of fall risk assessments in community-dwelling older adults:a scoping review[J]. Sensors, 2023, 23(18):7686.
[11]	朱姣, 夏丽莉, 许敏铮, 等. 老年住院病人跌倒伤害事件的特征及影响因素分析[J]. 实用老年医学, 2024, 38(1):81-85.
	Zhu J, Xia LL, Xu MZ, et al. Analysis of characteristics and influencing factors of fall injury in hospitalized elderly patients[J]. Pract Geriatr, 2024, 38(1):81-85.
[12]	刘迪智, 倪晓琳, 贾春媛, 等. 老年人跌倒损伤发生现状及危险因素分析[J]. 中国老年保健医学, 2022, 20(6):23-28.
	Liu DZ, Ni XL, Jia CY, et al. Analysis of the occurrence status and risk factors of fall injury in the elderly[J]. Chin J Geriatr Care, 2022, 20(6):23-28.
[13]	葛乐, 王楚怀. 老年住院患者跌倒的研究现状[J]. 中华物理医学与康复杂志, 2023, 45(2):182-185.
	Ge L, Wang CH. Research status of falls in elderly inpatients[J]. Chin J Phys Med Rehabil, 2023, 45(2):182-185.
[14]	黄婷苑, 林伟权, 秦发举, 等. 广州市跌倒/坠落老年患者中度及重度损伤发生情况及影响因素:基于2015—2021年伤害监测数据分析[J]. 中国公共卫生, 2025, 41(12):1445-1449.
	Huang TY, Lin WQ, Qin FJ, et al. Incidence and influencing factors for moderate and severe fall-related injuries among older adults in Guangzhou:an analysis of injury surveillance data from 2015 to 2021[J]. Chin J Public Health, 2025, 41(12):1445-1449.
[15]	李卫卫, 陆美艳, 宫友慧, 等. 团队合作降低康复科住院患者跌倒发生率及跌倒伤害[J]. 护理学杂志, 2017, 32(11):39-41.
	Li WW, Lu MY, Gong YH, et al. Team cooperation reduces fall rate and fall-related injury in patients hospitalized in rehabilitation departments[J]. J Nurs Sci, 2017, 32(11):39-41.
[16]	顾汝英, 蒋海燕, 赖清旺, 等. 2016—2020年上海市某社区老年人跌倒/坠落伤害流行病学特征[J]. 中国初级卫生保健, 2022, 36(8):94-96.
	Gu RY, Jiang HY, Lai QW, et al. Epidemiological characteristics of injury caused by fall in the elderly in a community in Shanghai from 2016 to 2020[J]. Chin Prim Health Care, 2022, 36(8):94-96.
[17]	Ghosh M, O’Connell B, Afrifa-Yamoah E, et al. A retrospective cohort study of factors associated with severity of falls in hospital patients[J]. Sci Rep, 2022, 12(1):12266.
[18]	加悦悦, 杨支兰, 翟艳萍, 等. 膝关节骨性关节炎患者跌倒发生率及其危险因素的Meta分析[J]. 中华护理杂志, 2025, 60(10):1177-1183.
	Jia YY, Yang ZL, Zhai YP, et al. Prevalence and risk factors of falls in patients with knee osteoarthritis:a Meta-analysis[J]. Chin J Nurs, 2025, 60(10):1177-1183.
[19]	刘驰, 石磊, 王林, 等. 老年骨质疏松性股骨颈骨折住院患者的人口学特征及临床特征分析[J]. 中华老年医学杂志, 2021, 40(11):1401-1406.
	Liu C, Shi L, Wang L, et al. Analysis of demographic and clinical characteristics of elderly inpatients with osteoporotic femoral neck fractures[J]. Chin J Geriatr, 2021, 40(11):1401-1406.
[20]	闫畅, 孙乐菲, 鲁琦, 等. 老年人跌倒恐惧影响因素的Meta分析[J]. 中华现代护理杂志, 2023, 29(28):3865-3870.
	Yan C, Sun LF, Lu Q, et al. Meta-analysis of influencing factors of fear of falling in the elderly[J]. Chin J Mod Nurs, 2023, 29(28):3865-3870.
[21]	Cooke M, de la Fuente M, Stringfield C, et al. The impact of nurse staffing on falls performance within a health care system:a descriptive study[J]. J Nurs Manag, 2022, 30(3):750-757.
[22]	Mikos M, Banas T, Czerw A, et al. Hospital inpatient falls across clinical departments[J]. Int J Environ Res Public Health, 2021, 18(15):8167.
[23]	曾雅琳, 李霞, 霍洁. 血液透析患者跌倒风险预测模型的构建与效能分析[J]. 现代医药卫生, 2024, 40(20):3464-3470.
	Zeng YL, Li X, Huo J. Construction and efficacy of fall risk prediction model for hemodialysis patients[J]. J Mod Med Health, 2024, 40(20):3464-3470.
[24]	邱启祥, 王小敏, 刘浩. 助行设备在美国老年人群中防跌倒作用的现状分析[J]. 中国康复理论与实践, 2014, 20(1):85-87.
	Qiu QX, Wang XM, Liu H. Assessment of using assistive ambulatory device among older adults in America[J]. Chin J Rehabil Theory Pract, 2014, 20(1):85-87.
[25]	Restrepo F, Mali N, Sands LP, et al. Defective assistive device involvement in older adult emergency department visits[J]. Innov Aging, 2024, 8(1):igad138.
[26]	Lee MJ, Seo BJ, Kim MY. Time-varying hazard of patient falls in hospital:a retrospective case-control study[J]. Healthcare, 2023, 11(15):2194.
[27]	鲍冠君, 朱琳, 罗烨. 糖尿病病人跌倒风险感知与客观跌倒风险的一致性及其影响因素[J]. 护理研究, 2025, 39(21):3590-3595.
	Bao GJ, Zhu L, Luo Y. Consistency between perceived fall risk and objective fall risk in patients with diabetes mellitus and its influencing factors[J]. Chin Nurs Res, 2025, 39(21):3590-3595.
[28]	Tana C, Di Risio A, Moffa S, et al. Perceived knowledge and attitudes toward fall prevention among nurses and healthcare assistants:a cross-sectional survey study[J]. Ann Med, 2025, 57(1):2559127.
[29]	Morita K, Matsui H, Fushimi K, et al. Association between nurse staffing and in-hospital bone fractures:a retrospective cohort study[J]. Health Serv Res, 2017, 52(3):1005-1023.
[30]	Bowden V, Bradas C, McNett M. Impact of level of nurse experience on falls in medical surgical units[J]. J Nurs Manag, 2019, 27(4):833-839.
[31]	Wang LM, Lu H, Dong X, et al. The effect of nurse staffing on patient-safety outcomes:a cross-sectional survey[J]. J Nurs Manag, 2020, 28(7):1758-1766.