Metabolic Disease and Diabetes, Multimedica IRCCS, Milan, Sesto San Giovanni, Italy.
Quality Monitoring Office, Humanitas Clinical and Research Hospital, Milan, Rozzano, Italy.
Acta Diabetol. 2019 Aug;56(8):931-938. doi: 10.1007/s00592-019-01323-8. Epub 2019 Mar 30.
To determine the role of hypoglycemia, hyperglycemia or the combination of both as independent risk factors for falls in a hospital population. Secondary objectives included evaluation of other risk factors for falling and their relationships with glucose levels.
Retrospective cohort study over 2 years on hospitalized subjects (N = 57411) analyzing in-hospital-falls and capillary glucose values. Bivariate analysis (χ test) and multivariate analysis (logistic regression) were performed to test for correlation of glucose values, age, sex, Charlson index, service of care, diagnosis at discharge and diabetes treatment with risk of in-hospital-falls.
The comparison of patients who experienced a fall (fall population) with the non-fall population suggested that: glucose determinations were significantly more frequent in the fall population (OR 3.45; CI 2.98-3.99; p < 0.0001); values of glucose below 70 mg/dl and over 200 mg/dl were significantly associated to falls during hospitalization (OR 1.76; CI 1.42-2.19; p < 0.001) as compared to glycemic values between 70 and 200 mg/dl; diabetes treatment was significantly correlated to risk of fall (OR 2.97; CI 2.54-3.49; p < 0.001); the frequency of glycemia measurements below 70 mg/dl and over 200 mg/dl in the same subject was significantly associated to falls during hospitalization (OR 1.01; CI 1.01-1.02; p < 0.001).
Hypoglycemia and hyperglycemia during hospital stays are correlated with an increased risk for falls in the hospitalized population. Presence of diabetes, use of insulin or glucose variability could potentially constitute risk factors for falls inside the hospital as well.
确定低血糖、高血糖或两者的组合作为医院人群跌倒的独立危险因素的作用。次要目标包括评估其他跌倒危险因素及其与血糖水平的关系。
对住院患者（N=57411）进行了为期 2 年的回顾性队列研究，分析了住院期间的跌倒和毛细血管血糖值。进行了双变量分析（χ 检验）和多变量分析（logistic 回归），以测试血糖值、年龄、性别、Charlson 指数、护理服务、出院诊断和糖尿病治疗与住院期间跌倒风险的相关性。
与非跌倒人群相比，经历跌倒的患者（跌倒人群）的比较表明：跌倒人群的血糖测定明显更频繁（OR 3.45；95%CI 2.98-3.99；p<0.0001）；血糖值低于 70mg/dl 和高于 200mg/dl 与住院期间跌倒显著相关（OR 1.76；95%CI 1.42-2.19；p<0.001），而血糖值在 70 至 200mg/dl 之间；糖尿病治疗与跌倒风险显著相关（OR 2.97；95%CI 2.54-3.49；p<0.001）；同一患者血糖值低于 70mg/dl 和高于 200mg/dl 的频率与住院期间的跌倒显著相关（OR 1.01；95%CI 1.01-1.02；p<0.001）。
住院期间的低血糖和高血糖与住院人群跌倒风险增加相关。糖尿病的存在、胰岛素的使用或血糖变异性可能是医院内跌倒的潜在危险因素。
