Vind Ane B, Andersen Hanne E, Pedersen Kirsten D, Jørgensen Torben, Schwarz Peter
Research Centre for Aging and Osteoporosis, Glostrup University Hospital, Glostrup, Denmark.
J Am Geriatr Soc. 2009 Oct;57(10):1844-9. doi: 10.1111/j.1532-5415.2009.02435.x. Epub 2009 Aug 13.
To address the external validity of a trial of multifactorial fall prevention through an analysis of differences between participants and nonparticipants regarding socioeconomic and morbidity variables.
Analysis of nonresponse in a randomized clinical trial.
Geriatric outpatient department.
One thousand one hundred five community-dwelling adults aged 65 and older who had sustained at least one injurious fall.
Marital status, housing tenure, income, comorbidity, hospitalization, fractures, and drug use before invitation to participate in the trial. Fractures, hospitalization and death were measured for 6 months of follow-up.
Four hundred forty-seven responding nonparticipants and 266 nonresponding nonparticipants were compared with 392 participants in the trial. Lower income (odds ratio (OR)=2.38, 95% confidence interval (CI)=1.28-4.28) and more days of hospitalization during the previous 5 years (OR=1.96, 95% CI=1.15-3.33) predicted responding nonparticipation; independent predictors of being a nonresponding nonparticipant were unmarried status (OR=2.0, 95% CI=1.36-2.94), lower income (OR=4.74, 95% CI=2.30-9.78), more days of hospitalization (OR=3.49, 95% CI=1.99-6.11), and prior fractures (OR=1.56, 95% CI=1.02-2.38). Nonresponding nonparticipants were significantly more likely to die (OR=12.99, 95% CI=1.6-105.6) or be hospitalized (OR=2.66, 95% CI=1.7-4.1) than participants during 6 months of follow-up.
Nonresponding nonparticipants of a trial of multifactorial fall prevention differed significantly from participants in terms of socioeconomic and morbidity variables and were more likely to be hospitalized or die during 6 months of follow-up. Because of the differences between the two populations, it is questionable whether results from this randomized trial can be generalized to people potentially eligible for participation.
通过分析参与者与非参与者在社会经济和发病变量方面的差异，探讨多因素预防跌倒试验的外部有效性。
对一项随机临床试验中的无应答情况进行分析。
老年门诊部。
1105名年龄在65岁及以上的社区居住成年人，他们至少发生过一次致伤性跌倒。
在邀请参与试验之前的婚姻状况、住房保有情况、收入、合并症、住院情况、骨折情况和药物使用情况。在6个月的随访期间测量骨折、住院和死亡情况。
将447名有应答的非参与者和266名无应答的非参与者与试验中的392名参与者进行比较。较低的收入（优势比（OR）=2.38，95%置信区间（CI）=1.28 - 4.28）和过去5年中更多的住院天数（OR = 1.96，95% CI = 1.15 - 3.33）预示着有应答的非参与；无应答的非参与者的独立预测因素为未婚状态（OR = 2.0，95% CI = 1.36 - 2.94）、较低的收入（OR = 4.74，95% CI = 2.30 - 9.78）、更多的住院天数（OR = 3.49，95% CI = 1.99 - 6.11）和既往骨折（OR = 1.56，95% CI = 1.02 - 2.38）。在6个月的随访期间，无应答的非参与者比参与者死亡（OR = 12.99，95% CI = 1.6 - 105.6）或住院（OR = 2.66，95% CI = 1.7 - 4.1）的可能性显著更高。
在多因素预防跌倒试验中，无应答的非参与者在社会经济和发病变量方面与参与者有显著差异，并且在6个月的随访期间更有可能住院或死亡。由于这两个人群之间存在差异，该随机试验的结果是否能推广到可能符合参与条件的人群值得怀疑。
