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老年癌症患者跌倒的风险因素。

Risk factors for falls in older patients with cancer.

作者信息

Zhang Xiaotao, Sun Ming, Liu Suyu, Leung Cheuk Hong, Pang Linda, Popat Uday R, Champlin Richard, Holmes Holly M, Valero Vicente, Dinney Colin P, Tripathy Debu, Edwards Beatrice J

机构信息

Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA.

Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA.

出版信息

BMJ Support Palliat Care. 2018 Mar;8(1):34-37. doi: 10.1136/bmjspcare-2017-001388. Epub 2017 Aug 31.

Abstract

OBJECTIVES

A rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer.

METHODS

This is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment. Vitamin D and bone densitometry were performed.

ANALYSIS

Descriptive statistics and multivariable logistic regression.

RESULTS

A total of 304 patients aged 65 or above were enrolled in this study. The mean age was 78.4±6.9 years. They had haematological, gastrointestinal, urological, breast, lung and gynaecological cancers. A total of 215 patients with available information about falls within the past 6 months were included for final analysis. Seventy-seven (35.8%) patients had at least one fall in the preceding 6 months. Functional impairment (p=0.048), frailty (p<0.001), dementia (p=0.021), major depression (p=0.010) and low social support (p=0.045) were significantly associated with the fall status in the univariate analysis. Multivariate logistic regression analysis identified frailty and functional impairment to be independent risk factors for falls.

CONCLUSIONS

Falls are common in older patients with cancer and lead to adverse clinical outcomes. Major depression, functional impairment, frailty, dementia and low social support were risk factors for falls. Heightened awareness and targeted interventions can prevent falls in older patients with cancer.

摘要

目的

癌症患者中老年人(65岁及以上)的数量不断增加,到2020年这一比例将增至70%。跌倒在老年人中是一种常见情况。我们旨在评估老年癌症患者跌倒的患病率及危险因素。

方法

这是一项单中心回顾性队列研究。接受癌症治疗的患者接受了全面的老年综合评估,包括认知、功能、营养、身体状况、过去6个月内的跌倒情况及合并症评估。检测了维生素D和骨密度。

分析

描述性统计和多变量逻辑回归分析。

结果

本研究共纳入304例65岁及以上患者。平均年龄为78.4±6.9岁。他们患有血液系统、胃肠道、泌尿系统、乳腺、肺部和妇科癌症。最终分析纳入了215例有过去6个月内跌倒相关信息的患者。77例(35.8%)患者在之前6个月内至少跌倒过一次。单因素分析中,功能障碍(p=0.048)、衰弱(p<0.001)、痴呆(p=0.021)、重度抑郁(p=0.010)和社会支持低(p=0.045)与跌倒状况显著相关。多变量逻辑回归分析确定衰弱和功能障碍是跌倒的独立危险因素。

结论

跌倒在老年癌症患者中很常见,并会导致不良临床后果。重度抑郁、功能障碍、衰弱、痴呆和社会支持低是跌倒的危险因素。提高认识和针对性干预可预防老年癌症患者跌倒。

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