Hall Rasheeda K, Landerman Lawrence R, O'Hare Ann M, Anderson Ruth A, Colón-Emeric Cathleen S
Duke University Medical Center, Division of Nephrology, Department of Medicine, Box DUMC 2747, 2424 Erwin Road Suite 605, Durham, NC 27710, USA; Durham VA Geriatric Research, Education and Clinical Center, 508 Fulton Street, Durham, NC 27705, USA.
Duke University Medical Center, Division of Geriatrics, Department of Medicine, Box DUMC 3003, Durham, NC 27710, USA; Duke University School of Nursing, DUMC Box 3322, 307 Trent Drive, Durham, NC 27710, USA.
Geriatr Nurs. 2015 Mar-Apr;36(2):136-41. doi: 10.1016/j.gerinurse.2014.12.012. Epub 2015 Jan 20.
This study examined whether chronic kidney disease (CKD) is associated with recurrent falls in older adults in nursing homes (NHs). We used data abstracted over a six month period from 510 NH residents with a history of falls. Thirty-five percent of the NH residents had CKD. In adjusted analyses, the incidence of recurrent falls was similar in those with and without CKD [fall rate ratio (FRR) 1.00, 95% confidence interval (CI) 0.97-1.02]. Orthostatic hypotension (FRR 1.52, 95% CI 1.12-2.05), history of falls during the prior six month period (FRR 1.25, 95% CI 1.05-1.49), cane or walker use (FRR 1.64, 95% CI 1.16-2.33), and ambulatory dysfunction (FRR 1.47, 95% CI 1.23-1.75) were independently associated with increased fall rate. CKD was not an important predictor of falls in this cohort of nursing home residents with prior falls. Instead, traditional fall risk factors were much more strongly associated with recurrent falls.
本研究调查了慢性肾脏病(CKD)是否与养老院(NHs)老年人反复跌倒有关。我们使用了从510名有跌倒史的NH居民中在六个月期间提取的数据。35%的NH居民患有CKD。在调整分析中,有CKD和无CKD者反复跌倒的发生率相似[跌倒率比(FRR)1.00,95%置信区间(CI)0.97 - 1.02]。体位性低血压(FRR 1.52,95% CI 1.12 - 2.05)、前六个月期间的跌倒史(FRR 1.25,95% CI 1.05 - 1.49)、使用手杖或助行器(FRR 1.64,95% CI 1.16 - 2.33)以及行走功能障碍(FRR 1.47,95% CI 1.23 - 1.75)与跌倒率增加独立相关。在这个有跌倒史的养老院居民队列中,CKD不是跌倒的重要预测因素。相反,传统的跌倒风险因素与反复跌倒的关联要强得多。