Penninx B W, Ferrucci L, Leveille S G, Rantanen T, Pahor M, Guralnik J M
Epidemiology, Demography, and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA.
J Gerontol A Biol Sci Med Sci. 2000 Nov;55(11):M691-7. doi: 10.1093/gerona/55.11.m691.
This study examines, in initially nondisabled older persons, the impact of reduced lower extremity performance on subsequent hospitalizations.
A 4-year prospective cohort study was conducted among 3381 persons, aged 71 years and older, who initially reported no disability. At baseline, lower extremity performance was measured by an assessment of standing balance, a timed 2.4-m walk, and a timed test of rising from a chair five times. Data on subsequent hospital admissions and discharge diagnoses over 4 years were obtained from the Medicare database.
During the follow-up period, nondisabled persons with poor lower extremity performance spent significantly more days in the hospital (17.7 days) than those with intermediate and high performance (11.6 and 9.7 days, respectively). Poor lower extremity performance in nondisabled persons significantly predicted subsequent hospitalization over 4 years (relative risk for hospitalization in those with poor vs high performance: 1.78; 95% confidence interval, 1.45-2.17). This increased hospitalization risk could not be explained by several indicators of baseline health status. Increased hospitalization risks were especially found for geriatric conditions, such as dementia, decubitus ulcer, hip fractures, other fractures, pneumonia, dehydration, and acute infections.
Even in persons who are currently nondisabled, a simple measure of lower extremity performance is predictive of subsequent hospitalization, especially for geriatric conditions.
本研究在最初无残疾的老年人中，考察下肢功能下降对随后住院情况的影响。
对3381名71岁及以上、最初报告无残疾的人群进行了一项为期4年的前瞻性队列研究。在基线时，通过评估站立平衡、2.4米定时步行以及从椅子上起身5次的定时测试来测量下肢功能。4年期间随后的住院入院和出院诊断数据来自医疗保险数据库。
在随访期间，下肢功能较差的无残疾者在医院的天数（17.7天）显著多于下肢功能中等和较好者（分别为11.6天和9.7天）。无残疾者下肢功能较差显著预测了4年期间随后的住院情况（下肢功能差者与功能好者相比的住院相对风险：1.78；95%置信区间，1.45 - 2.17）。这种增加的住院风险无法用基线健康状况的几个指标来解释。尤其在老年疾病方面发现住院风险增加，如痴呆、褥疮、髋部骨折、其他骨折、肺炎、脱水和急性感染。
即使在目前无残疾的人群中，一项简单的下肢功能测量也能预测随后的住院情况，尤其是对于老年疾病。
