Furuya Takefumi, Yamagiwa Kiyotaka, Ikai Tetsuo, Inoue Eisuke, Taniguchi Atuo, Momohara Shigeki, Yamanaka Hisashi
Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan.
Clin Rheumatol. 2009 Nov;28(11):1325-30. doi: 10.1007/s10067-009-1229-5. Epub 2009 Jul 18.
The objective of this is to determine factors associated with falls in Japanese patients with rheumatoid arthritis (RA). Among the patients who participated in a single-institute-based prospective observational cohort study of patients with RA, namely, Institute of Rheumatology Rheumatoid Arthritis, 4,996 (male 765, female 4231, median age 60 years) responded to questions related to falls during the previous 6 months in April or May 2008. Logistic regression was used to determine the association between variables and falls. Five hundred and five (10.1%), 110 (2.2%), and 958 patients (19.2%) reported at least one fall, multiple falls, and fear of falling, respectively. Those who fell tended to report incident fractures during the same 6 months compared to those who did not (14.7% versus 1.1%, P < 0.001). In multivariate models, Japanese health assessment questionnaire (HAQ) scores (odds ratios (OR) 1.52, 2.49, and 3.88), tender joint counts (OR 1.39, 1.72, and 1.36), patient-reported visual analog scale for general health (OR 1.08, 1.16, and 1.20), and body mass index (OR 1.05, 1.08, and 1.04) were associated (P < 0.05) with at least one fall, multiple falls, and fear of falling, respectively. Other clinical variables and medications were also associated with falls and fear of falling. HAQ disability score, tender joint counts, and impaired general health appear to be associated with falls in Japanese patients with RA, as previously reported for patients of other ethnicities.
本研究的目的是确定与日本类风湿关节炎（RA）患者跌倒相关的因素。在参与了一项基于单机构的RA患者前瞻性观察队列研究（即风湿病研究所类风湿关节炎研究）的患者中，4996名患者（男性765名，女性4231名，中位年龄60岁）在2008年4月或5月回答了与前6个月内跌倒相关的问题。采用逻辑回归分析来确定变量与跌倒之间的关联。分别有505名（10.1%）、110名（2.2%）和958名患者（19.2%）报告至少发生过一次跌倒、多次跌倒和害怕跌倒。与未跌倒者相比，跌倒者在同一6个月内更倾向于报告发生过骨折（14.7%对1.1%，P<0.001）。在多变量模型中，日本健康评估问卷（HAQ）评分（比值比（OR）分别为1.52、2.49和3.88）、压痛关节数（OR分别为1.39、1.72和1.36）、患者报告的一般健康视觉模拟量表评分（OR分别为1.08、1.16和1.20）以及体重指数（OR分别为1.05、1.08和1.04）分别与至少一次跌倒、多次跌倒和害怕跌倒相关（P<0.05）。其他临床变量和药物治疗也与跌倒及害怕跌倒有关。HAQ残疾评分、压痛关节数和一般健康受损似乎与日本RA患者的跌倒有关，正如之前在其他种族患者中所报道的那样。
