Large Julienne, Gan Neesha, Basic David, Jennings Natalie
Department of Physiotherapy, Liverpool Hospital, Sydney, Australia.
Clin Rehabil. 2006 May;20(5):421-8. doi: 10.1191/0269215506cr959oa.
To determine whether the Timed Up and Go Test is useful at stratifying acutely unwell elderly inpatients according to their risk for subsequent falls.
Prospective cohort study.
Multidisciplinary acute care unit for the elderly at Liverpool Hospital, in Sydney, Australia.
A total of 2388 consecutive admissions to the unit of mean age 82 years.
The Timed Up and Go, administered on admission to the unit, and two modifications (an ordinal scale and a dichotomous scale, both incorporating patients unable to complete the Timed Up and Go) were evaluated.
Number of falls, and reasons for the inability to complete the Timed Up and Go.
During a median length of stay of nine days, 180 patients had at least one fall. The Timed Up and Go was unable to identify those patients who subsequently fell (P = 0.78). When the Timed Up and Go was modified to include the majority of patients unable to complete the test, both the ordinal (range of values 1-8, odds ratio (OR) 1.12, 95% confidence interval (95% CI) 1.03-1.21, P = 0.01) and dichotomous (OR 1.59, 95% CI 1.09-2.32, P = 0.02) modifications significantly predicted falls in multivariate analyses. Patients unable to do the Timed Up and Go due to non-physical disability had the highest fall rate (11%), followed by those with physical disability (9%), while those able to do the Timed Up and Go had the lowest fall rate (6%) (P< 0.001). Acutely unwell, immobile patients with dementia and delirium were not at excessive risk of falls.
In the acute care setting, the value of the Timed Up and Go lies in the inability to complete the test, and the reasons for this inability, rather than the time recorded.
确定定时起立行走测试是否有助于根据急性不适老年住院患者随后跌倒的风险进行分层。
前瞻性队列研究。
澳大利亚悉尼利物浦医院的老年多学科急性护理病房。
该病房共连续收治2388例平均年龄82岁的患者。
对患者入院时进行定时起立行走测试，并评估两种修改方式（一种序数量表和一种二分法量表，均纳入无法完成定时起立行走测试的患者）。
跌倒次数以及无法完成定时起立行走测试的原因。
在中位住院时间9天内，180例患者至少跌倒1次。定时起立行走测试无法识别出随后跌倒的患者（P = 0.78）。当对定时起立行走测试进行修改以纳入大多数无法完成测试的患者时，在多变量分析中，序数量表（取值范围1 - 8，比值比（OR）1.12，95%置信区间（95%CI）1.03 - 1.21，P = 0.01）和二分法量表（OR 1.59，95%CI 1.09 - 2.32，P = 0.02）的修改方式均能显著预测跌倒情况。因非身体残疾而无法进行定时起立行走测试的患者跌倒率最高（11%），其次是身体残疾患者（9%），而能够进行定时起立行走测试的患者跌倒率最低（6%）（P<0.001）。患有痴呆和谵妄的急性不适、行动不便患者跌倒风险并不高。
在急性护理环境中，定时起立行走测试的价值在于无法完成测试以及无法完成测试的原因，而非记录的时间。
