Fernández M, Valbuena C, Natal C
Centro de Salud de Sotrondio, Área sanitaria VIII, Servicio de Salud del Principado de Asturias, Sotondrio, Asturias, España.
Gerencia del Área sanitaria VIII, Servicio de Salud del Principado de Asturias, La Felguera, Asturias, España.
J Healthc Qual Res. 2018 Mar-Apr;33(2):105-108. doi: 10.1016/j.cali.2017.12.007. Epub 2018 Mar 9.
To describe the risk factors and the effect of medication use on the risk of falls in a population of 65 years or older.
Descriptive study of falls in the elderly population. The risk factors and consequences of the fall were recorded. Hypnotic and sedative risk drugs, opioids, and the simultaneous consumption of six or more drugs were considered. Diuretics were also included. The cumulative incidence for each group and the corresponding relative risks of falls were analysed from the cases registered between June and November 2016.
During the study period, 60 falls were reported, of which 66% were by women and 34% by men. The cumulative incidence of falls was 3 per thousand women (95% CI: 2.22-4.08), and 2 per thousand men (95% CI: 1.44-3.41). The majority (71%) had consumed risk medication. Six or more medications were taken by 40% of the men and 62.5% of the women, and 97.6% was risk medication. The relative risk of falls in people using hypnotics, sedatives and opioids compared to non-users was 8.7 in men and 7.1 in women. In people who took diuretics, the relative risk was 4.6 for both genders. In women on multiple medications the relative risk was 3.7 compared to 1.7 in men.
Polypharmacy and the use of hypnotic and sedative drugs and opioids and diuretics are an important public health problem, due to being risk factors for falls in this population, with a greater impact for women.
描述65岁及以上人群中跌倒的风险因素以及药物使用对跌倒风险的影响。
对老年人群跌倒情况进行描述性研究。记录跌倒的风险因素和后果。考虑使用催眠和镇静类风险药物、阿片类药物以及同时服用六种或更多药物的情况。还纳入了利尿剂。对2016年6月至11月登记的病例分析了每组的累积发病率以及相应的跌倒相对风险。
在研究期间，报告了60例跌倒事件，其中66%为女性，34%为男性。女性跌倒的累积发病率为千分之三（95%可信区间：2.22 - 4.08），男性为千分之二（95%可信区间：1.44 - 3.41）。大多数（71%）曾使用过风险药物。40%的男性和62.5%的女性服用了六种或更多药物，且97.6%为风险药物。与未使用者相比，使用催眠药、镇静药和阿片类药物的男性跌倒相对风险为8.7，女性为7.1。服用利尿剂的人群中，男女的相对风险均为4.6。在服用多种药物的女性中，相对风险为3.7，而男性为1.7。
多重用药以及使用催眠和镇静药物、阿片类药物和利尿剂是一个重要的公共卫生问题，因为它们是该人群跌倒的风险因素，对女性的影响更大。
