Córcoles-Jiménez María Pilar, Villada-Munera Ascensión, Moreno-Moreno Mónica, Jiménez-Sánchez María Delirio, Candel-Parra Eduardo, Del Egido Fernández María Ángeles, Piña-Martínez Antonio Javier
Complejo Hospitalario Universitario de Albacete, España.
Rev Esp Geriatr Gerontol. 2011 Nov-Dec;46(6):289-96. doi: 10.1016/j.regg.2011.05.008. Epub 2011 Oct 19.
Recurrent falls affect between 14.8% and 19% of the elderly population, and are associated with an increased risk of fracture. We know little about the influence the history of recurrent falls may have on recovery after hip fracture.
Cohort study. The patients included were, over 65 years admitted during a 1 year period to the General University Hospital of Albacete with a hip fracture due to a fall. Recurrent falls were defined as a history of two or more falls within the 6 months prior to the fracture.
demographic data, circumstances of fall, number of falls in the previous 6 months, type of fracture and its repair, comorbidity and drug treatment, cognitive status at admission (Pfeiffer test) and independence for activities of daily living (Barthel Index - BI) were collected. A subsample of patients with pre-fracture BI ≥ 60 and Pfeiffer at admission ≤ 4 was followed up at 3, 6 and 12 months.
A total of 335 patients were admitted. Data were collected on 279 of them, 19.4% of whom had previously suffered two or more falls. The recurrent fallers had a worse mental status on admission, a higher number of associated diseases, a lower percentage of independence in dressing and in bed-chair transferring than patients without history of recurrent falls, all statistically significant. In the 201 patients followed up, the impairment on the BI after 12 months compared to the BI previous to fracture was higher in recurrent fallers (-20.8 ± 31.54 vs -10.73 ± 20.21, P=.04), focusing more on independence in eating (76% vs 91.9%, P<.05), grooming (72% vs 91,9%, P<.01), faecal continence (60% vs 78.7%, p<.05) and walking indoors (80% vs 93.3%, P<.05).
The recovery of independence after hip fracture is significantly lower in the group of recurrent fallers in patients without moderate or severe functional impairment previous to fracture and cognitively stable.
反复跌倒影响14.8%至19%的老年人口，且与骨折风险增加相关。我们对反复跌倒史可能对髋部骨折后恢复产生的影响了解甚少。
队列研究。纳入的患者为65岁以上，在1年期间因跌倒导致髋部骨折入住阿尔巴塞特大学综合医院的患者。反复跌倒定义为骨折前6个月内有两次或更多次跌倒史。
收集人口统计学数据、跌倒情况、前6个月的跌倒次数、骨折类型及其修复情况、合并症和药物治疗、入院时的认知状态（ Pfeiffer测试）以及日常生活活动的独立性（ Barthel指数 - BI）。对骨折前BI≥60且入院时Pfeiffer≤4的患者亚组在3、6和12个月时进行随访。
共收治335例患者。收集了其中279例的数据，其中19.4%此前曾有两次或更多次跌倒。与无反复跌倒史的患者相比，反复跌倒者入院时精神状态较差，相关疾病数量较多，穿衣和从床到椅转移的独立百分比更低，所有这些均具有统计学意义。在随访的201例患者中，反复跌倒者骨折后12个月时BI的损伤程度高于骨折前BI（-20.8±31.54对-10.73±20.21，P = 0.04），在进食独立性（76%对91.9%，P < 0.05）、修饰（72%对91.9%，P < 0.01）、大便失禁（60%对78.7%，P < 0.05）和室内行走（80%对93.3%，P < 0.05）方面表现更为明显。
在骨折前无中度或重度功能障碍且认知稳定的患者中，反复跌倒者髋部骨折后独立性的恢复明显较低。
Zotero 插件