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老年人在老年评估和管理单元住院期间餐后低血压的患病率和危险因素:一项观察性研究。

Prevalence and Risk Factors of Postprandial Hypotension among Elderly People Admitted in a Geriatric Evaluation and Management Unit : An Observational Study.

机构信息

Prof Didier Schoevaerdts, CHU UCL Namur, site Godinne ; Avenue Dr. Gaston Thérasse, 1 ; B-5530 Yvoir, Belgium, Office: +32/81423435, E-mail:

出版信息

J Nutr Health Aging. 2019;23(10):1026-1033. doi: 10.1007/s12603-019-1271-1.

Abstract

OBJECTIVES

To explore the prevalence and potential risk factors of postprandial hypotension (PPH) among elderly patients in an acute geriatric ward.

DESIGN

A prospective observational study.

SETTING

Geriatric Unit in a Belgian tertiary-care University Hospital.

PARTICIPANTS

Seventy-six hospitalized elderly patients after stabilization of their acute conditions.

MEASUREMENTS

PPH and orthostatic hypotension (OH) measured by a non-invasive automated blood pressure device, demographic data, Katz's Basic Activities of Daily Living (ADL) and Lawton's instrumental ADL, Short Physical Performance Battery, Charlson Comorbidity Index, Mini Nutritional Assessment-Short Form, Timed Up and Go test, Get-up Early test, grip strength and 7 classes of drugs.

RESULTS

Overall, the prevalence of PPH was 46% (n=35/76), and it was symptomatic in 31% of the patients (n=11/35). PPH is associated with OH in one-third of the cases (n=12/35). Two-thirds of the patients with HPP had a significant drop in systolic blood pressure within the first 75 minutes after a meal. In univariate analyses, risk factors of PPH were nursing home residence, alpha-blocker consumption, help needed for eating and a good level of global functional status. However, patients with a good functional status were at increased risk of alpha-blocker exposure. In multivariate analyses, only alpha-blocker consumption and help needed for eating remained statistically significant.

CONCLUSION

PPH is frequent among hospitalized elderly people in a Geriatric Evaluation and Management Unit, affecting nearly one out of two people. The use of alpha-blockers is an important risk factor and may alert clinicians to the risk of PPH.

摘要

目的

探讨老年患者在急性老年病房中餐后低血压(PPH)的患病率和潜在危险因素。

设计

前瞻性观察研究。

地点

比利时三级保健大学医院老年病房。

参与者

76 名急性病情稳定后住院的老年患者。

测量

使用非侵入性自动血压装置测量 PPH 和直立性低血压(OH)、人口统计学数据、Katz 的基本日常生活活动(ADL)和 Lawton 的工具性 ADL、简短体能表现电池、Charlson 合并症指数、迷你营养评估-简短形式、起立和行走测试、早起测试、握力和 7 类药物。

结果

总体而言,PPH 的患病率为 46%(n=35/76),其中 31%(n=11/35)的患者出现症状。PPH 与 OH 相关的占三分之一(n=12/35)。三分之二的 HPP 患者在餐后 75 分钟内收缩压显著下降。单因素分析中,PPH 的危险因素包括居住在养老院、使用α-受体阻滞剂、进食需要帮助和整体功能状态良好。然而,功能状态良好的患者因使用α-受体阻滞剂而增加了风险。多因素分析中,只有使用α-受体阻滞剂和进食需要帮助仍然具有统计学意义。

结论

在老年评估和管理病房中,住院老年人群中 PPH 很常见,近二分之一的人受到影响。使用α-受体阻滞剂是一个重要的危险因素,可能会提醒临床医生注意 PPH 的风险。

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