Guerini Fabio, Frisoni Giovanni B, Marrè Alessandra, Turco Renato, Bellelli Giuseppe, Trabucchi Marco
Rehabilitation and Aged Care Unit Ancelle della Carità Hospital, Cremona, Italy.
Arch Phys Med Rehabil. 2008 Aug;89(8):1522-7. doi: 10.1016/j.apmr.2008.01.018.
To test whether subcortical vascular lesions are associated with falls in elderly patients with gait disorder discharged from a rehabilitation ward.
Secondary 12-month follow-up analysis of an observational survey focusing on the prevalence of subcortical vascular lesions in a population of elderly patients discharged from rehabilitation hospitals.
A rehabilitation and aged care unit.
Consecutively admitted elderly patients (N=214) with gait disorder.
Not applicable.
On admission, all patients underwent comprehensive geriatric assessment including sociodemographics, cognitive and depressive symptoms, nutritional status, physical health, and functional status. Subcortical vascular lesions were assessed on computed tomography films with a validated rating scale. All patients received a standardized rehabilitative program. Twelve months after discharge, all patients were interviewed by telephone, mainly focusing on the occurrence of falls during the follow-up period. Potential predictors of falls were assessed in univariate and multivariate analyses.
Univariate predictors of falls were age, sex, Mini-Mental State Examination, Barthel Index on admission, and subcortical vascular lesions. In multivariate analyses, subcortical vascular lesions were the only significant predictor of risk of falling; patients with moderate and severe subcortical vascular lesions scores had a greater risk of falling (odds ratio [OR]=3.0; 95% confidence interval [CI], 1.3-7.1; P=.012; OR=3.9; 95% CI, 1.6-9.2; P=.002, respectively) than those with no subcortical vascular lesions.
Subcortical vascular lesions are associated with falls at 12 months in elderly patients with gait disorder discharged from a rehabilitative ward. Future research is needed to confirm our results.
检验皮质下血管病变是否与从康复病房出院的步态障碍老年患者跌倒有关。
对一项观察性调查进行为期12个月的二次随访分析，该调查聚焦于从康复医院出院的老年患者群体中皮质下血管病变的患病率。
一个康复及老年护理单元。
连续收治的步态障碍老年患者（N = 214）。
不适用。
入院时，所有患者均接受了全面的老年综合评估，包括社会人口统计学、认知和抑郁症状、营养状况、身体健康和功能状态。使用经过验证的评分量表在计算机断层扫描片上评估皮质下血管病变。所有患者均接受标准化康复计划。出院12个月后，通过电话对所有患者进行访谈，主要关注随访期间跌倒的发生情况。在单因素和多因素分析中评估跌倒的潜在预测因素。
跌倒的单因素预测因素为年龄、性别、简易精神状态检查表、入院时的巴氏指数和皮质下血管病变。在多因素分析中，皮质下血管病变是跌倒风险的唯一显著预测因素；中度和重度皮质下血管病变评分的患者比无皮质下血管病变的患者跌倒风险更高（优势比[OR]分别为3.0；95%置信区间[CI]，1.3 - 7.1；P = 0.012；OR = 3.9；95%CI，1.6 - 9.2；P = 0.002）。
皮质下血管病变与从康复病房出院的步态障碍老年患者12个月时的跌倒有关。需要进一步的研究来证实我们的结果。
