Wallace Carolyn, Reiber Gayle E, LeMaster Joseph, Smith Douglas G, Sullivan Katrina, Hayes Shane, Vath Christy
Health Services and Rehabilitation Research and Development, VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, Washington 98108, USA.
Diabetes Care. 2002 Nov;25(11):1983-6. doi: 10.2337/diacare.25.11.1983.
To describe the incidence of falls, risk factors for falls, and the frequency of fall-related fractures in a cohort of individuals with diabetes and a prior foot ulcer.
A total of 400 individuals with diabetes and a prior foot ulcer were recruited from two western Washington State health care organizations and followed prospectively for 2 years. Diabetes, demographic, and health information was collected at baseline, 1 year, and 2 years. Data on falls were collected at baseline, 4 weeks, and every 17 weeks thereafter. Medical records were abstracted to confirm fall-related morbidity.
The average age of the study population was 62 years, with 77% male and 23% female. Approximately 32% had fixed foot deformities, 58% had insensate feet, and 76% had comorbid conditions. Of the participants, 252 (64%) reported at least one fall during the 2-year study period. The overall incidence of falls in this cohort was 1.25 falls/person-year (95% CI 1.17-1.33). For the 164 participants (41%) who reported two or more falls, a BMI >/=30 kg/m(2), the presence of one or more comorbid conditions, and insensate feet increased the risk. Two or more falls of any type were associated with a higher fracture risk. Although women were not at significantly greater risk for falls than men, their fracture incidence was 3.6 times higher.
Falls are very common in individuals with diabetes and prior foot ulcers. A small percentage of falls resulted in fractures. The risk of a fall-related fracture was significantly higher in women than in men. Increased attention to falls and fall prevention is indicated for diabetes care providers.
描述糖尿病合并既往足部溃疡患者队列中的跌倒发生率、跌倒危险因素以及与跌倒相关骨折的发生频率。
从华盛顿州西部的两个医疗保健机构招募了400名糖尿病合并既往足部溃疡的患者，并对其进行了为期2年的前瞻性随访。在基线、1年和2年时收集糖尿病、人口统计学和健康信息。在基线、4周以及此后每17周收集跌倒数据。提取医疗记录以确认与跌倒相关的发病率。
研究人群的平均年龄为62岁，男性占77%，女性占23%。约32%的患者有固定足部畸形，58%的患者足部感觉减退，76%的患者有合并症。在参与者中，252人（64%）报告在2年研究期间至少发生过一次跌倒。该队列中跌倒的总体发生率为1.25次/人年（95%可信区间1.17 - 1.33）。对于报告两次或更多次跌倒的164名参与者（41%），体重指数（BMI）≥30 kg/m²、存在一种或多种合并症以及足部感觉减退会增加跌倒风险。任何类型的两次或更多次跌倒与更高的骨折风险相关。尽管女性跌倒风险并不显著高于男性，但其骨折发生率高3.6倍。
跌倒在糖尿病合并既往足部溃疡的患者中非常常见。一小部分跌倒导致了骨折。女性与跌倒相关的骨折风险显著高于男性。糖尿病护理人员应更加关注跌倒及预防跌倒。
