Department of Nephrology and Hypertension, University Medical Center Utrecht, Heidelberglaan 100, the Netherlands.
Department of Internal Medicine, Division of Medicine for the Elderly, Maastricht University Medical Center, Maastricht, the Netherlands.
Arch Gerontol Geriatr. 2019 Jul-Aug;83:285-291. doi: 10.1016/j.archger.2019.05.015. Epub 2019 May 18.
As the numbers of older patients on dialysis rise, geriatric problems such as falling become more prevalent. We aimed to assess the prevalence of falls and the impact on mortality and quality of life in frail elderly patients on assisted PD (aPD) and hemodialysis (HD) from the FEPOD Study.
Data on falls and quality of life were collected with questionnaires at baseline and every six months during 2-year follow-up. Multiple regression analysis was used to evaluate factors associated with falls. Additionally, we performed a review of literature concerning the relation between falls and poor outcome.
Baseline fall data were available for 203 patients and follow-up data for 114 patients. Dialysis modality was equally distributed (49% HD and 51% aPD). Mean (SD) age was 75 ± 7 years. Fall rate was 1.00 falls/patient year, comparable in HD and aPD. Falls led to fear of falling, resulting in less activities in 68% vs 42% (p < 0.01) and leaving the house less in 59% vs 31% (p < 0.01) of patients. Patients with diabetes mellitus were twice as likely to report falls at baseline (OR 1.91 [95%CI 1.00-3.63], p = 0.05) and falls at baseline were associated with falls during follow-up (OR 2.53 [95%CI 1.06-6.04] p = 0.03). Literature revealed frailty was a strong risk factor for falling and falling results in a higher mortality and hospitalization rate.
Falls were frequent in older dialysis patients and have a negative impact on quality of life. Fall incidence is comparable between aPD and HD.
随着透析老年患者人数的增加，跌倒等老年问题变得更加普遍。我们旨在评估脆弱的老年接受辅助 PD（aPD）和血液透析（HD）的患者跌倒的发生率及其对死亡率和生活质量的影响，该研究来自 FEPOD 研究。
使用问卷在基线和 2 年随访期间每 6 个月收集跌倒和生活质量数据。多因素回归分析用于评估与跌倒相关的因素。此外，我们还对有关跌倒与不良结局之间关系的文献进行了综述。
203 名患者有基线跌倒数据，114 名患者有随访数据。透析方式分布均匀（49%为 HD，51%为 aPD）。平均（SD）年龄为 75±7 岁。跌倒率为 1.00 例/患者年，HD 和 aPD 之间相当。跌倒导致患者害怕跌倒，从而导致 68%的患者活动量减少，而 42%的患者（p<0.01）和 59%的患者离开家的次数减少，而 31%（p<0.01）。患有糖尿病的患者在基线时跌倒的可能性是其他患者的两倍（OR 1.91[95%CI 1.00-3.63]，p=0.05），且基线时跌倒与随访期间的跌倒相关（OR 2.53[95%CI 1.06-6.04]，p=0.03）。文献表明虚弱是跌倒的一个强烈危险因素，跌倒会导致更高的死亡率和住院率。
老年透析患者跌倒较为频繁，对生活质量有负面影响。aPD 和 HD 患者的跌倒发生率相当。
