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老年人疼痛与伤害性跌倒之间关联的性别差异:一项基于人群的纵向研究。

Sex Differences in the Association Between Pain and Injurious Falls in Older Adults: A Population-Based Longitudinal Study.

作者信息

Welmer Anna-Karin, Rizzuto Debora, Calderón-Larrañaga Amaia, Johnell Kristina

出版信息

Am J Epidemiol. 2017 Nov 1;186(9):1049-1056. doi: 10.1093/aje/kwx170.

Abstract

We investigated whether there are sex differences in the association between pain and incident injurious falls. A total of 2,934 people (ages ≥60 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen (2001-2004) participated. Participants were followed up for 3 and 10 years for falls leading to hospitalization or outpatient care. Data were analyzed with flexible parametric survival models that adjusted for potential confounders. During the first 3 years of follow-up, 67 men and 194 women experienced an injurious fall, and over 10 years of follow up, 203 men and 548 women experienced such a fall. In men, the presence of pain, having pain that was at least mild, having pain that affected several daily activities, and having daily pain all significantly increased the likelihood of incurring an injurious fall during the 3-year follow-up period. The multivariate-adjusted hazard ratios ranged from 1.78 (95% confidence interval: 1.00, 3.15) for the presence of pain to 2.89 (95% confidence interval: 1.41, 5.93) for several daily activities' being affected by pain. Results for the 10-year follow-up period were similar. No significant associations were detected in women. Although pain is less prevalent in men than in women, its impact on risk of injurious falls seems to be greater in men.

摘要

我们调查了疼痛与意外伤害性跌倒之间的关联是否存在性别差异。共有2934名来自基于人群的瑞典斯德哥尔摩 Kungsholmen 地区老龄化与护理国家研究(2001 - 2004年)的60岁及以上人群参与了研究。对参与者进行了3年和10年的随访,以了解导致住院或门诊治疗的跌倒情况。使用灵活的参数生存模型对数据进行分析,并对潜在混杂因素进行了调整。在随访的前3年中,67名男性和194名女性经历了意外伤害性跌倒;在10年的随访期间,203名男性和548名女性经历了此类跌倒。在男性中,疼痛的存在、至少有轻度疼痛、疼痛影响多项日常活动以及每天都疼痛,均显著增加了3年随访期间发生意外伤害性跌倒的可能性。多变量调整后的风险比范围从疼痛存在时的1.78(95%置信区间:1.00, 3.15)到疼痛影响多项日常活动时的2.89(95%置信区间:1.41, 5.93)。10年随访期的结果相似。在女性中未检测到显著关联。尽管疼痛在男性中的患病率低于女性,但其对意外伤害性跌倒风险的影响在男性中似乎更大。

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