Wielinski Catherine L, Erickson-Davis Cordelia, Wichmann Rose, Walde-Douglas Maria, Parashos Sotirios A
Struthers Parkinson's Center, Golden Valley, Minnesota, USA.
The Minneapolis Clinic of Neurology, Ltd., Golden Valley, Minnesota, USA.
Mov Disord. 2005 Apr;20(4):410-415. doi: 10.1002/mds.20347.
We sought to ascertain frequency, type, risk factors of falling, and resulting injuries among parkinsonian patients. A survey was mailed to all patients treated at our center between 1/1/2000 and 4/30/2002 (N = 1,417). Information was collected on falls within the past 2 years, related injuries, and use of health care services. A total of 1,131 responses (response rate, 79.8%) were received. After the exclusion of nonparkinsonian disorders, statistics for the remaining group (n = 1,092) and predictive statistics for those diagnosed before 1/1/2000 (n = 1,013) were calculated. Outcomes included falls, fractures, injuries, surgery, and related use of health care services. Explanatory variables included sex, age, age at diagnosis, disease duration, atypical parkinsonism, and dementia. Most patients (55.9%) were men; 12.2% had atypical parkinsonism; 12.5% had dementia; median age was 74.7 years; median disease duration was 7 years; 55.9% had at least one fall in the past 2 years; 65.0% of them sustained an injury; 33.0% sustained a fracture; 75.5% of injuries required health care services; 40.6% of fractures required surgery. Older age, atypical parkinsonism, longer disease duration, and dementia were risk factors for falling; female sex and older age were predictors of fractures. Need for health care services after an injury was higher among older patients. Further prospective studies will be necessary to elucidate the specific prognostic outcomes of injuries due to falls among parkinsonian patients, and the impact of these injuries on disease progression and quality of life.
我们试图确定帕金森病患者跌倒的频率、类型、危险因素以及由此导致的损伤情况。我们向2000年1月1日至2002年4月30日期间在我们中心接受治疗的所有患者（N = 1417）邮寄了一份调查问卷。收集了过去2年内跌倒情况、相关损伤以及医疗服务使用情况的信息。共收到1131份回复（回复率为79.8%）。排除非帕金森病性疾病后，计算了其余组（n = 1092）的统计数据以及2000年1月1日前确诊患者（n = 1013）的预测统计数据。结果包括跌倒、骨折、损伤、手术以及相关医疗服务的使用情况。解释变量包括性别、年龄、诊断时年龄、病程、非典型帕金森病以及痴呆。大多数患者（55.9%）为男性；12.2%患有非典型帕金森病；12.5%患有痴呆；中位年龄为74.7岁；中位病程为7年；55.9%的患者在过去2年内至少跌倒过一次；其中65.0%的患者受到了损伤；33.0%的患者发生了骨折；75.5%的损伤需要医疗服务；40.6%的骨折需要手术。年龄较大、非典型帕金森病、病程较长以及痴呆是跌倒的危险因素；女性和年龄较大是骨折的预测因素。老年患者受伤后对医疗服务的需求更高。有必要进行进一步的前瞻性研究，以阐明帕金森病患者跌倒所致损伤的具体预后结果，以及这些损伤对疾病进展和生活质量的影响。
