Díaz Grávalos Gabriel J, Gil Vázquez Carmen, Andrade Pereira Vanesa, Alonso Payo Rosario, Alvarez Araujo Susana, Reinoso Hermida Santiago
Centro de Salud Cea, Cea (Ourense), Galicia, España.
Rev Esp Geriatr Gerontol. 2009 Nov-Dec;44(6):301-4. doi: 10.1016/j.regg.2009.06.013. Epub 2009 Oct 24.
To determine factors associated with falls in institutionalized elderly.
A prospective cohort study was carried out, over a 18 months period. We included 203 subjects aged 65 and over who were able to walk. We recorded: age, sex, BMI, Barthel, Pfeiffer, Tinetti and FRAT tests, history of falls during the previous year, walking aids, the existence of orthostatic hypotension, delirium in the previous month, presence of various chronic diseases (10), number and nature of the usual drugs (15). Each fall was recorded by the nurse in charge of the patient. The analysis was carried out using logistic regression.
The average age of participants was 80.1 (SD=9.1) years, male 37.9%. There were 35 losses (11.5%/year). 204 falls were registered in 99 people (48.8% cumulative incidence at 18 months of follow-up). 44 people (21.7%) suffered repeated falls. Regression analysis showed association with the presence of delirium in the month prior to the inclusion in the study (OR 6.7; CI95% 1.6-30.3) and a smaller BMI (OR 1.1; CI95% 1.01-1.12), and visual impairment in the case of repeated falls (OR 2.2; CI95% 1.1-4.5).
The incidence of falls in institutionalized elderly is high. It was found strong association with some conditions of fragility as indicators of risk.
确定与机构养老老年人跌倒相关的因素。
进行了一项为期18个月的前瞻性队列研究。我们纳入了203名65岁及以上能够行走的受试者。我们记录了：年龄、性别、体重指数、巴氏指数、 Pfeiffer测试、Tinetti测试和FRAT测试、上一年的跌倒史、助行器、体位性低血压的存在情况、前一个月的谵妄情况、各种慢性病（10种）的存在情况、常用药物的数量和种类（15种）。每次跌倒均由负责该患者的护士记录。采用逻辑回归进行分析。
参与者的平均年龄为80.1（标准差=9.1）岁，男性占37.9%。发生了35次跌倒事件（每年11.5%）。在99人中共记录到204次跌倒（随访18个月时累积发病率为48.8%）。44人（21.7%）遭受多次跌倒。回归分析显示，与纳入研究前一个月存在谵妄（比值比6.7；95%置信区间1.6 - 30.3）、较小的体重指数（比值比1.1；95%置信区间1.01 - 1.12）以及多次跌倒情况下的视力障碍（比值比2.2；95%置信区间1.1 - 4.5）有关。
机构养老老年人跌倒的发生率很高。发现与一些脆弱状况存在密切关联，这些状况可作为风险指标。
