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中风后跌倒:奥克兰地区社区中风(ARCOS)研究(2002年至2003年)的结果

Falls after stroke: results from the Auckland Regional Community Stroke (ARCOS) Study, 2002 to 2003.

作者信息

Kerse Ngaire, Parag Varsha, Feigin Valery L, McNaughton Harry, Hackett Maree L, Bennett Derrick A, Anderson Craig S

机构信息

Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.

出版信息

Stroke. 2008 Jun;39(6):1890-3. doi: 10.1161/STROKEAHA.107.509885. Epub 2008 May 15.

Abstract

BACKGROUND AND PURPOSE

Falls are an important issue in older people. We aimed to determine the incidence, circumstances, and predictors of falls in patients with recent acute stroke.

METHODS

The Auckland Regional Community Stroke (ARCOS) study was a prospective population-based stroke incidence study conducted in Auckland, New Zealand (NZ) during 2002 to 2003. Among 6-month survivors, the location and consequences of any falls were ascertained by self-report as part of a structured interview. Multivariable logistic regression was used to establish associations between risk factors and "any" and "injurious" falls.

RESULTS

Of 1104 stroke survivors who completed an interview, 407 (37%) reported at least 1 fall, 151 (37% of fallers, 14% of stroke survivors) sustained an injury that required medical treatment, and 31 (8% of fallers, 3% of stroke survivors) sustained a fracture. The majority of falls occurred indoors at home. Independent factors associated with falls were depressive symptoms, disability, previous falls, and older age. For injurious falls, the positively associated factors were female sex and NZ/European ethnicity and dependence before the stroke, whereas higher levels of activity and normal cognition were negatively associated factors.

CONCLUSIONS

Falls are common after stroke, and their predictive factors are similar to those for older people in general. Falls prevention programs require implementation in stroke services.

摘要

背景与目的

跌倒在老年人中是一个重要问题。我们旨在确定近期急性卒中患者跌倒的发生率、情况及预测因素。

方法

奥克兰地区社区卒中(ARCOS)研究是一项于2002年至2003年在新西兰奥克兰进行的基于人群的前瞻性卒中发病率研究。在6个月的幸存者中,通过结构化访谈中的自我报告来确定任何跌倒的地点及后果。采用多变量逻辑回归来确定危险因素与“任何”跌倒和“致伤性”跌倒之间的关联。

结果

在1104名完成访谈的卒中幸存者中,407人(37%)报告至少有1次跌倒,151人(跌倒者中的37%,卒中幸存者中的14%)受到需要医疗治疗的损伤,31人(跌倒者中的8%,卒中幸存者中的3%)发生骨折。大多数跌倒发生在室内家中。与跌倒相关的独立因素为抑郁症状、残疾、既往跌倒史及高龄。对于致伤性跌倒,正相关因素为女性、新西兰/欧洲族裔以及卒中前的依赖状态,而较高的活动水平和正常认知则为负相关因素。

结论

卒中后跌倒很常见,其预测因素与一般老年人相似。卒中服务中需要实施跌倒预防项目。

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