Kasuga Toshimitsu, Aruga Fumiko, Ono Koichi, Hiratsuka Yoshimune, Murakami Akira
Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan..
Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
Can J Ophthalmol. 2017 Dec;52(6):559-563. doi: 10.1016/j.jcjo.2017.04.010. Epub 2017 Jun 23.
To investigate the association between visual impairment and the risk of falls in hospitalized patients.
Individually matched case-control study.
The medical records of patients who fell while hospitalized at Juntendo Tokyo Koto Geriatric Medical Center (JTKGMC) from January to December 2014 were reviewed retrospectively. Among them, 36 patients who were recorded as visiting the Ophthalmology Outpatient Clinic from 1 year before to 1 year after the fall were included as cases. As the control subjects, 36 individually matched patients were chosen who were hospitalized in the same beds in the same hospital wards. Visual impairment and blindness were defined according to U.S. criteria. Conditional logistic regression analysis was used for both univariate and multivariate analyses. Based on previous reports, multivariate analysis was performed with adjustment for age, sex, a history of falls, and use of walking aids. This study was approved by the institutional review board of JTKGMC and was performed according to the tenets of the Declaration of Helsinki.
The crude odds ratio (OR) for visual impairment was 6.0 (95% confidence interval [CI]: 0.72-49.83). For a history of falls and use of walking aids, the crude OR (95% CI) was 2.5 (0.97-6.44) and 2.8 (0.88-8.64), respectively. After adjustment for age, sex, a history of falls, and use of walking aids, the association between falls and visual impairment was significant (OR: 13.9; 95% CI: 1.0004-194.41).
These findings suggest that visual impairment could be an independent risk factor for falls among hospitalized patients.
探讨住院患者视力障碍与跌倒风险之间的关联。
个体匹配病例对照研究。
回顾性分析2014年1月至12月在东京慈惠会医科大学江东老年医学中心（JTKGMC）住院期间跌倒患者的病历。其中，36例在跌倒前1年至跌倒后1年期间有眼科门诊就诊记录的患者被纳入病例组。作为对照组，选择36例在同一医院病房同一床位住院的个体匹配患者。视力障碍和失明根据美国标准定义。采用条件逻辑回归分析进行单因素和多因素分析。根据既往报告，多因素分析对年龄、性别、跌倒史和使用助行器进行了调整。本研究经JTKGMC机构审查委员会批准，并按照《赫尔辛基宣言》的原则进行。
视力障碍的粗比值比（OR）为6.0（95%置信区间[CI]：0.72 - 49.83）。跌倒史和使用助行器的粗OR（95%CI）分别为2.5（0.97 - 6.44）和2.8（0.88 - 8.64）。在对年龄、性别、跌倒史和使用助行器进行调整后，跌倒与视力障碍之间的关联具有统计学意义（OR：13.9；95%CI：1.0004 - 194.41）。
这些发现表明视力障碍可能是住院患者跌倒的独立危险因素。
