Service de surveillance, recherche et evaluation, Direction de santé publique et d'evaluation, Agence de la santé et des services sociaux de Lanaudière, Joliette, QC.
Can J Public Health. 2009 Jul-Aug;100(4):263-7. doi: 10.1007/BF03403944.
A prospective, observational study was undertaken to identify risk profiles of subjects regarding the recurrence of falling among community-dwelling seniors using home-care services.
A convenience sample of 868 community-dwelling older persons, aged 65 years or older, who use home-care services offered by public community-based centres in the province of Québec. Subjects were recruited between 2002 and 2005, assessed for fall-related risk factors, and monitored for prospective falls. Data were examined by a classification and regression tree (CART) and survival analyses.
Ninety-nine participants reported two falls within six months of entry to the study. Thus, the incidence of recurrent fallers was 11.4%. The tree analysis classified the population into five groups differing in risk of recurrent falling, based on history of falls in the three months prior to the initial interview, Berg balance score, type of housing, and usual alcohol consumption in the six months preceding study entry. The relative risks varied from 0.7 to 5.1. The survival analysis showed that the length of time before becoming a recurrent faller varies among risk profiles.
The study permitted the construction of easily interpretable risk profiles of recurrent falling. These can guide clinicians and public health practitioners to identify high-risk individuals and to decide on the appropriate intervention and follow-up.
采用前瞻性观察研究方法，确定使用家庭护理服务的社区居住老年人再次跌倒的风险特征。
便利选取了 868 名年龄在 65 岁及以上、使用魁北克省公立社区中心提供的家庭护理服务的社区居住老年人。2002 年至 2005 年间招募了这些研究对象，评估了与跌倒相关的风险因素，并对前瞻性跌倒进行了监测。采用分类回归树（CART）和生存分析对数据进行了分析。
99 名参与者在进入研究后的 6 个月内报告了两次跌倒。因此，复发性跌倒者的发生率为 11.4%。树状分析根据初始访谈前三个月的跌倒史、Berg 平衡评分、住房类型和研究前六个月的常规饮酒情况，将人群分为五个具有不同复发性跌倒风险的组。相对风险从 0.7 到 5.1 不等。生存分析表明，在成为复发性跌倒者之前的时间长短因风险特征而异。
该研究构建了易于解释的复发性跌倒风险特征。这些可以为临床医生和公共卫生工作者提供帮助，以便识别高风险个体，并决定适当的干预和随访措施。
