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美国 65 岁及以上慢性肾脏病患者的跌倒和与跌倒相关的伤害。

Falls and Fall-Related Injuries Among US Adults Aged 65 or Older With Chronic Kidney Disease.

机构信息

Department of Nutrition and Health Science, 2000 W University Ave, Ball State University, Muncie, IN 47304. Email:

Department of Nutrition and Health Science, Ball State University, Muncie, Indiana.

出版信息

Prev Chronic Dis. 2018 Jun 21;15:E82. doi: 10.5888/pcd15.170518.

Abstract

INTRODUCTION

Falls are among the leading causes of injury and death among adults aged 65 or older. People with chronic kidney disease (CKD) are at increased risk of falling and of having a serious injury from falls. However, information is limited about risk factors for falls and fall-related injuries among people with CKD.

METHODS

We performed a secondary analysis of 157,753 adults (6.1% with CKD) aged 65 or older surveyed in the 2014 Behavioral Risk Factor Surveillance System.

RESULTS

People with CKD were at increased risk of falls (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.63-2.01) and fall-related injuries (OR = 1.50; 95% CI, 1.27-1.78) even after adjusting for differences in demographic characteristics, health conditions, and lifestyle factors (P < .05 for all). Among people with CKD, women, people diagnosed with diabetes, diabetes duration, and arthritis were all significant predictors of falls and fall-related injuries (P < .05 for all). Lifestyle factors, such as engaging in recent exercise (adjusted odds ratio [AOR] = 0.68; 95% CI, 0.56-0.81) and limited physical function (assessed as difficulty in climbing stairs) (AOR = 2.84; 95% CI, 2.30-3.44), were most closely associated with falls and fall-related injuries.

CONCLUSION

Adults aged 65 or older with CKD were at increased risk of falling and of suffering an injury as a result of a fall compared with adults in the same age range without CKD. Potentially modifiable factors such as physical function and recent exercise were most closely related to reduced risk for falls and fall-related injuries and may be an appropriate target for fall prevention and rehabilitation programs in people with CKD.

摘要

简介

跌倒位列 65 岁及以上成年人受伤和致死的首要原因之列。患有慢性肾脏病(CKD)的人群更易跌倒,且跌倒后更易受重伤。然而,有关 CKD 患者跌倒和与跌倒相关损伤的风险因素的信息有限。

方法

我们对 2014 年行为风险因素监测系统中调查的 157753 名 65 岁及以上成年人(6.1%患有 CKD)进行了二次分析。

结果

即使在调整了人口统计学特征、健康状况和生活方式因素的差异后,患有 CKD 的人群跌倒(优势比[OR] = 1.81;95%置信区间[CI],1.63-2.01)和与跌倒相关损伤(OR = 1.50;95%CI,1.27-1.78)的风险仍更高(所有 P 值均<.05)。在患有 CKD 的人群中,女性、诊断患有糖尿病、糖尿病病程和关节炎均是跌倒和与跌倒相关损伤的显著预测因素(所有 P 值均<.05)。生活方式因素,如最近进行锻炼(调整后的优势比[AOR] = 0.68;95%CI,0.56-0.81)和有限的身体功能(评估为爬楼梯困难)(AOR = 2.84;95%CI,2.30-3.44),与跌倒和与跌倒相关损伤最密切相关。

结论

与同年龄段无 CKD 的成年人相比,65 岁及以上患有 CKD 的成年人跌倒和因跌倒而受伤的风险更高。身体功能和最近锻炼等潜在可改变的因素与降低跌倒和与跌倒相关损伤的风险最密切相关,可能是 CKD 患者跌倒预防和康复计划的适当目标。

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