Paul S S, Harvey L, Canning C G, Boufous S, Lord S R, Close J C T, Sherrington C
The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Neuroscience Research Australia, Randwick, NSW, Australia.
Eur J Neurol. 2017 Mar;24(3):523-529. doi: 10.1111/ene.13238. Epub 2017 Jan 24.
Falls are common in people with Parkinson's disease (PD) but few data exist on fall-related hospitalizations in this group. This population-based study compared fall-related hospital admissions, injury rates and consequences in people with and without PD, and determined whether PD was an independent predictor of fall-related hospital length of stay.
This was a retrospective study using probabilistic linkage of hospital data in people aged ≥65 years hospitalized for a fall between 1 July 2005 and 31 December 2013 in New South Wales, Australia. Rates of hospital admissions and injuries per person admitted over the study period were compared between people with and without PD using Poisson or negative binomial regression. Multilevel linear modelling was used to analyse length of stay by clustering individuals and adjusting for possible confounders.
There were 342 265 fall-related hospital admissions in people aged ≥65 years during the study period, of which 8487 (2.5%) were for people with PD. Sixty-seven per cent of fall-related PD admissions were associated with injury and 35% were associated with fracture. People with PD had higher rate ratios for fall admissions (1.63, 95% confidence interval 1.59-1.67) and injury (1.47, 95% confidence interval 1.43-1.51) and longer median length of stay [9 (interquartile range 1-27) vs. 6 (interquartile range 1-20) days in people without PD; P < 0.001]. PD remained associated with increased length of stay after controlling for comorbidity, age, sex and injury (P < 0.001).
This study provides important benchmark data for hospitalizations for falls and fall injuries for older people with PD, which may be used to monitor the effect of fall prevention programmes.
跌倒在帕金森病（PD）患者中很常见，但关于该群体因跌倒导致住院治疗的数据较少。这项基于人群的研究比较了有和没有PD的人群因跌倒导致的住院情况、受伤率及后果，并确定PD是否是与跌倒相关住院时长的独立预测因素。
这是一项回顾性研究，利用澳大利亚新南威尔士州2005年7月1日至2013年12月31日期间因跌倒住院的≥65岁人群的医院数据进行概率性关联分析。使用泊松或负二项回归比较有和没有PD的人群在研究期间每人的住院率和受伤率。采用多水平线性模型，通过对个体进行聚类并调整可能的混杂因素来分析住院时长。
在研究期间，≥65岁人群中有342265例因跌倒导致的住院治疗，其中8487例（2.5%）是PD患者。67%的与跌倒相关的PD住院与受伤有关，35%与骨折有关。PD患者的跌倒住院率（1.63，95%置信区间1.59 - 1.67）和受伤率（1.47，95%置信区间1.43 - 1.51）更高，中位住院时长更长[无PD患者为6（四分位间距1 - 20）天，PD患者为9（四分位间距1 - 27）天；P < 0.001]。在控制了合并症、年龄、性别和受伤情况后，PD仍与住院时长增加相关（P < 0.001）。
本研究为老年PD患者因跌倒及跌倒损伤导致的住院治疗提供了重要的基准数据，可用于监测跌倒预防项目的效果。
