Institute of Bone and Joint Research, Royal North Shore Hospital, New South Wales, Australia.
J Clin Epidemiol. 2010 Jun;63(6):679-85. doi: 10.1016/j.jclinepi.2009.08.018.
The aims of this study were to develop and evaluate a simple index for assessing the risk of fractures after a fall and to propose a selection strategy for identifying elderly individuals at high risk of both falls and fall-related fractures.
Two thousand five institutionalized older men and women were assessed for clinical risk factors and then followed up for falls and fall-related fractures for up to 2 years.
Our fracture risk index is derived from seven previously identified significant independent risk factors: weight, lower leg length, balance, cognitive function, type of institution, fracture history, and falls in the past year. The fracture rate was 6.5 times greater in the one-sixth of the falls with the highest index (9.7/100 falls) than in the lowest sixth (1.5/100 falls). Our proposed approach (based on balance, risk of falls, and the fracture risk index) selected a group of older people with high risk of both falls and fall-related fracture. The fracture incidence rate was 144% higher, and the falls incidence rate was 31% higher in the selected residents than in the remainder.
The index could help rationalize fracture prevention programs for frail older people.
本研究旨在开发和评估一种简单的骨折风险指数，以选择识别易发生跌倒和跌倒相关骨折的高风险老年人。
2500 名居住在养老院的老年人接受了临床风险因素评估，并随访了 2 年，以了解跌倒和跌倒相关骨折情况。
我们的骨折风险指数源自 7 个先前确定的独立显著风险因素：体重、小腿长度、平衡、认知功能、机构类型、骨折史和过去 1 年的跌倒情况。指数最高的六分之一（9.7/100 次跌倒）的骨折发生率是指数最低的六分之一（1.5/100 次跌倒）的 6.5 倍。我们提出的方法（基于平衡、跌倒风险和骨折风险指数）选择了一组同时具有高跌倒和跌倒相关骨折风险的老年人。在选定的居民中，骨折发生率高 144%，跌倒发生率高 31%。
该指数可帮助为虚弱老年人制定合理的骨折预防计划。
