Nikolaus T, Specht-Leible N, Bach M
Bethesda Geriatrische Klinik/Universität Ulm, Zollernring 26-28, D-89073 Ulm.
Z Gerontol Geriatr. 1999 Oct;32(5):307-11. doi: 10.1007/s003910050121.
The purpose of the study was to identify associations between drug prescriptions and the risk of falls in community-dwelling frail elderly people. 360 frail elderly patients underwent a comprehensive geriatric assessment during hospital stay. After discharge, the home falls were recorded by a questionnaire during the follow-up year and a home visit was carried out at the end of the year. Of 279 final patients with complete data, 141 subjects (50.5%) fell once; 62 subjects (22.2%) had a history of two or more falls during the follow-up period. Compared with subjects who did not fall or fell at the most once, those subjects with two or more falls showed a significantly higher prescription of tranquillizers/hypnotics, neuroleptics, diuretics, nitrates, and five or more different drugs. In multivariate analysis the prescription of tranquillizers/hypnotics with an adjusted odds ratio of 2.02 (95 percent confidence interval, 1.14 to 3.68) and the prescription of five or more different drugs with an adjusted odds ratio of 2.25 (95 percent confidence interval, 1.03 to 4.49) were found to be independent risk factors for multiple falls. In this prospective study in community-dwelling frail, elderly people the prescription of tranquillizers/hypnotics and five or more different medications could be identified as independent risk factors for multiple falls.
该研究的目的是确定社区居住的体弱老年人药物处方与跌倒风险之间的关联。360名体弱老年患者在住院期间接受了全面的老年评估。出院后，在随访年度通过问卷调查记录家中跌倒情况，并在年底进行家访。在279名具有完整数据的最终患者中，141名受试者（50.5%）跌倒过一次；62名受试者（22.2%）在随访期间有两次或更多次跌倒史。与未跌倒或最多跌倒一次的受试者相比，跌倒两次或更多次的受试者使用镇静剂/催眠药、抗精神病药、利尿剂、硝酸盐以及五种或更多不同药物的处方显著更高。在多变量分析中，镇静剂/催眠药的处方调整后比值比为2.02（95%置信区间，1.14至3.68），五种或更多不同药物的处方调整后比值比为2.25（95%置信区间，1.03至4.49），被发现是多次跌倒的独立危险因素。在这项针对社区居住的体弱老年人的前瞻性研究中，镇静剂/催眠药和五种或更多不同药物的处方可被确定为多次跌倒的独立危险因素。
