慢性阻塞性肺疾病患者跌倒情况:一项为期12个月的初步前瞻性队列研究。

Falls by individuals with chronic obstructive pulmonary disease: a preliminary 12-month prospective cohort study.

作者信息

Oliveira Cristino C, Lee Annemarie L, McGinley Jennifer, Thompson Michelle, Irving Louis B, Anderson Gary P, Clark Ross A, Clarke Sandy, Denehy Linda

机构信息

Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.

Department of Respiratory and Sleep Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

出版信息

Respirology. 2015 Oct;20(7):1096-101. doi: 10.1111/resp.12600. Epub 2015 Jul 23.

Abstract

BACKGROUND AND OBJECTIVE

Despite evidence of an increased fall risk in people with chronic obstructive pulmonary disease (COPD), there is a paucity of prospective fall data in this population. This preliminary study aimed to prospectively examine the prevalence rate, incidence rate and associated risk factors for falls in a sample of community-dwelling people with COPD over 1 year.

METHODS

Forty-one participants with stable COPD (mean ± SD) aged 71 ± 8 years with a forced expiratory volume in 1 s of 45.1 ± 16.2% predicted were included. At baseline, participants' demographic, physical function and fall-related measures were documented. Falls were monitored for 12 months following initial assessments.

RESULTS

The prevalence of people having falls was 40% (95% CI: 24-56%); amongst these, 75% had frequent falls. The overall fall incidence rate was 1.17 falls/person-year. Risk factors associated with a higher fall incidence rate ratio (IRR) in COPD were: number of pack-years (IRR: 1.02; 95%CI: 1.00,1.04), comorbidities (IRR: 2.02; 95%CI: 1.42,3.06), number of medications (IRR: 1.15; 95%CI: 1.00,1.34), history of falls in the previous year (IRR: 1.89; 95%CI: 1.10,3.34), fear of falling (IRR: 1.08; 95% CI: 1.02,1.14) and higher score in a fall risk assessment questionnaire for older adults (IRR: 1.14; 95% CI: 1.05,1.25); P ≤ 0.05. When adjusted for age, only pack-years (P = 0.01), number of comorbidities (P < 0.001) and history of falls (P = 0.03) were related to an increased fall incidence.

CONCLUSIONS

These preliminary findings demonstrated the fall prevalence and incidence rate in community-dwelling people with stable COPD and identified prospective risk factors for an increased fall incidence, which suggest potential mitigation strategies.

摘要

背景与目的

尽管有证据表明慢性阻塞性肺疾病(COPD)患者跌倒风险增加,但该人群前瞻性跌倒数据匮乏。这项初步研究旨在前瞻性地调查社区居住的COPD患者样本在1年期间的跌倒患病率、发病率及相关危险因素。

方法

纳入41名稳定期COPD患者,年龄(71±8)岁,第1秒用力呼气容积占预计值百分比为45.1%±16.2%。在基线时,记录参与者的人口统计学、身体功能及跌倒相关指标。初始评估后对跌倒情况进行12个月监测。

结果

跌倒患病率为40%(95%CI:24 - 56%);其中75%为频繁跌倒。总体跌倒发病率为1.17次/人年。COPD患者中与较高跌倒发病率比(IRR)相关的危险因素为:吸烟包年数(IRR:1.02;95%CI:1.00,1.04)、合并症(IRR:2.02;95%CI:1.42,3.06)、用药数量(IRR:1.15;95%CI:1.00,1.34)、上一年跌倒史(IRR:1.89;95%CI:1.10,3.34)、害怕跌倒(IRR:1.08;95%CI:1.02,1.14)及老年人跌倒风险评估问卷得分较高(IRR:1.14;95%CI:1.05,1.25);P≤0.05。校正年龄后,仅吸烟包年数(P = 0.01)、合并症数量(P < 0.001)及跌倒史(P = 0.03)与跌倒发病率增加有关。

结论

这些初步研究结果表明了社区居住的稳定期COPD患者的跌倒患病率和发病率,并确定了跌倒发病率增加的前瞻性危险因素,提示了潜在的缓解策略。

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