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慢性共病对越南医院跌倒老年患者健康相关生活质量的影响。

Effects of Chronic Comorbidities on the Health-Related Quality of Life among Older Patients after Falls in Vietnamese Hospitals.

机构信息

Department of Trauma and Orthopaedic, Thai Binh Medical University Hospital, Thai Binh 410000, Vietnam.

Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.

出版信息

Int J Environ Res Public Health. 2019 Sep 27;16(19):3623. doi: 10.3390/ijerph16193623.

Abstract

Although comorbidities are prevalent in older people experiencing falls, there is a lack of studies examining their influence on health-related quality of life (HRQOL) in this population. This study examines the prevalence of comorbidities and associations between comorbidities and HRQOL in older patients after falls in Vietnamese hospitals. A cross-sectional design was employed among 405 older patients admitted to seven hospitals due to fall injuries in Thai Binh province, Vietnam. The EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) was used to measure HRQOL. Socio-demographic characteristics were collected using a structured questionnaire, while comorbidities and other clinical characteristics were examined by physicians and extracted from medical records. Multivariate Tobit regression was used to determine the associations between comorbidities and HRQOL. Among 405 patients, 75.6% had comorbidities, of which hypertension and osteoarthritis were the most common. Lumbar spine/cervical spine diseases (Coefficient (Coef.) = -0.10; 95%CI = -0.18; 0.03) and stroke (Coef. = -0.36; 95%CI = -0.61; -0.10) were found to be associated with a significantly decreased EQ-5D index. Participants with three comorbidities had EQ-5D indexes 0.20 points lower (Coef. = -0.20; 95%CI = -0.31; -0.09) in comparison with those without comorbidities. This study underlined a significantly high proportion of comorbidities in older patients hospitalized due to fall injuries in Vietnam. In addition, the existence of comorbidities was associated with deteriorating HRQOL. Frequent monitoring and screening comorbidities are critical to determining which individuals are most in need of HRQOL enhancement.

摘要

尽管合并症在经历跌倒的老年人中很常见,但缺乏研究检查这些合并症对越南医院跌倒老年人健康相关生活质量(HRQOL)的影响。本研究检查了越南泰平省 7 家医院因跌倒受伤而住院的 405 名老年患者合并症的患病率以及合并症与 HRQOL 之间的关联。采用病例交叉设计,对 405 名因跌倒受伤而在越南泰平省 7 家医院住院的老年患者进行研究。使用欧洲五维健康量表(EQ-5D-5L)来衡量 HRQOL。使用结构化问卷收集社会人口统计学特征,而合并症和其他临床特征则由医生检查并从病历中提取。采用多变量 Tobit 回归来确定合并症与 HRQOL 之间的关联。在 405 名患者中,75.6%患有合并症,其中高血压和骨关节炎最常见。腰椎/颈椎疾病(系数(Coef.)=-0.10;95%CI=-0.18;0.03)和中风(Coef.=-0.36;95%CI=-0.61;-0.10)与 EQ-5D 指数显著降低相关。与无合并症患者相比,患有三种合并症的患者的 EQ-5D 指数低 0.20 分(Coef.=-0.20;95%CI=-0.31;-0.09)。本研究强调了越南因跌倒受伤而住院的老年患者中合并症的比例非常高。此外,合并症的存在与 HRQOL 恶化有关。频繁监测和筛查合并症对于确定哪些患者最需要提高 HRQOL 至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9df8/6801440/19a0f0b1f079/ijerph-16-03623-g001.jpg

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