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

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