Kutner Nancy G, Zhang Rebecca, Huang Yijian, Wasse Haimanot
United States Renal Data System , Rehabilitation/Quality of Life Special Studies Center , Emory University , Atlanta, GA , USA.
United States Renal Data System , Rehabilitation/Quality of Life Special Studies Center , Emory University , Atlanta, GA , USA ; Division of Nephrology , School of Medicine, Emory University , Atlanta, GA , USA.
Clin Kidney J. 2014 Jun;7(3):257-63. doi: 10.1093/ckj/sfu034. Epub 2014 Apr 15.
Falls among patients undergoing maintenance hemodialysis (HD) have significant consequences for quality of life and functional independence, morbidity, healthcare utilization and even mortality, but studies on the etiology of falls within large HD cohorts are limited.
Falls during the past 12 months were ascertained for a prevalent multi-center HD cohort (n = 762) aged 20-92 years, and associations with demographic and treatment characteristics, comorbidities, cognitive function, prescribed medications, balance tests, frailty and depressive symptoms were assessed.
Falls were sustained by 28.4% of participants. In multivariable-adjusted analyses, participants classified as frail were over two times more likely to report falls [odds ratio (OR): 2.39, 95% confidence interval (CI): 1.22-4.71, P = 0.01], and participants with a CES-D score 18+ and/or prescribed antidepressants were over 80% more likely to be fallers (OR: 1.83, 95% CI: 1.23-2.74, P = 0.003) than were participants with a CES-D score <18 and no prescribed antidepressants.
Frailty and depressed mood, factors that are potentially modifiable, are prominently associated with falls.
维持性血液透析（HD）患者跌倒对生活质量、功能独立性、发病率、医疗资源利用甚至死亡率都有重大影响，但关于大型血液透析队列中跌倒病因的研究有限。
确定了一个年龄在20 - 92岁的多中心HD现患队列（n = 762）在过去12个月内的跌倒情况，并评估了跌倒与人口统计学和治疗特征、合并症、认知功能、处方药、平衡测试、衰弱和抑郁症状之间的关联。
28.4%的参与者发生过跌倒。在多变量调整分析中，被归类为衰弱的参与者报告跌倒的可能性高出两倍多[比值比（OR）：2.39，95%置信区间（CI）：1.22 - 4.71，P = 0.01]，与CES - D评分<18且未开具抗抑郁药的参与者相比，CES - D评分≥18和/或开具抗抑郁药的参与者跌倒的可能性高出80%以上（OR：1.8- 95% CI：1.23 - 2.74，P = 0.003）。
衰弱和情绪低落是可能可改变的因素，与跌倒显著相关。
