Gerdhem Paul, Ringsberg Karin A M, Akesson Kristina, Obrant Karl J
Department of Orthopaedics, Malmö University Hospital, SE-205 02 Malmö, Sweden.
J Clin Epidemiol. 2005 Mar;58(3):226-32. doi: 10.1016/j.jclinepi.2004.06.013.
Fall risk assessment is important because the consequences, such as a fracture, may be devastating. The objective of this study was to find the test or tests that best predicted falls in a population-based sample of elderly women.
The fall-predictive ability of a questionnaire, a subjective estimate of biologic age and objective functional tests (gait, balance [Romberg and sway test], thigh muscle strength, and visual acuity) were compared in 984 randomly selected women, all 75 years of age.
A recalled fall was the most important predictor for future falls. Only recalled falls and intake of psycho-active drugs independently predicted future falls. Women with at least five of the most important fall predictors (previous falls, conditions affecting the balance, tendency to fall, intake of psychoactive medication, inability to stand on one leg, high biologic age) had an odds ratio of 11.27 (95% confidence interval 4.61-27.60) for a fall (sensitivity 70%, specificity 79%).
The more time-consuming objective functional tests were of limited importance for fall prediction. A simple clinical history, the inability to stand on one leg, and a subjective estimate of biologic age were more important as part of the fall risk assessment.
跌倒风险评估很重要，因为其后果（如骨折）可能是灾难性的。本研究的目的是在一个基于人群的老年女性样本中找出最能预测跌倒的一项或多项测试。
在984名随机选取的75岁女性中，比较了一份问卷、生物年龄的主观估计以及客观功能测试（步态、平衡[罗姆伯格试验和摇摆试验]、大腿肌肉力量和视力）的跌倒预测能力。
既往跌倒史是未来跌倒最重要的预测因素。只有既往跌倒史和精神活性药物的使用独立预测未来跌倒。具有至少五项最重要跌倒预测因素（既往跌倒、影响平衡的状况、跌倒倾向、精神活性药物摄入、无法单腿站立、生物年龄高）的女性跌倒的优势比为11.27（95%置信区间4.61 - 27.60）（敏感性70%，特异性79%）。
耗时的客观功能测试对跌倒预测的重要性有限。简单的临床病史、无法单腿站立以及生物年龄的主观估计作为跌倒风险评估的一部分更为重要。
