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寻求医疗服务的老年人群中跌倒的患病率及预测因素:一项基于门诊的研究。

Prevalence and predictors of falls in a health-seeking older population: An outpatient-based study.

作者信息

Subramanian Manicka Saravanan, Singh Vishwajeet, Chatterjee Prashun, Dwivedi Sada Nand, Dey Aparajit Ballav

机构信息

Department of Geriatric Medicine All India Institute of Medical Sciences New Delhi India.

Department of Biostatistics All India Institute of Medical Sciences New Delhi India.

出版信息

Aging Med (Milton). 2020 Jan 19;3(1):25-31. doi: 10.1002/agm2.12096. eCollection 2020 Mar.

Abstract

BACKGROUND

Falls are one of the major causes of disability in older people. A wide range of risk factors for falls are described according to setting - inpatient, nursing homes and community. The aim of this study was to identify the risk factors for falls in an outpatient setting.

METHODS

In this cross-sectional observational study, 160 consenting subjects were enrolled randomly, from the Geriatric Medicine outpatient department, All India Institute of Medical Sciences, New Delhi, India. Non-ambulatory, seriously ill subjects were excluded. The subjects underwent brief evaluation including falls and geriatric assessment. They were grouped into fallers and non-fallers. A multivariable logistic regression analysis was used to identify the factors associated with falls.

RESULTS

The prevalence of falls was 23.75% (38/160). Women were proportionately higher (26.31%) in the fallers group vis-à-vis 19.67% in the non-fallers group. After multivariate analysis, opioids (odds ratio [OR] 5.24 [95% CI, 2.0 18-13.611]), vision impairment (OR 2.71 [95% CI, 1.050-07.011]), fear of falling (OR 3.17 [95% CI, 1.167-08.629]), instrumental activity of daily living (IADL) impairment (OR 3.41 [95% CI, 1.251-09.301]), anti-anginal medications (OR 8.90 [95% CI, 0.997-79.564]) and self-employment (OR 5.37 [95% CI, 1.058-27.329]) were associated with falls. Adequate nutrition (OR 0.82 [95% CI, 0.688-00.976]) and caregiver support (OR 0.46 [95% CI, 0.275-00.801]) were protective of falls.

CONCLUSION

We identified the multi-factorial etiology of falls. Patients having any of the above risk factors should undergo detailed fall risk assessment and preventive measures afterwards.

摘要

背景

跌倒为老年人残疾的主要原因之一。根据环境(住院、养老院和社区)描述了多种跌倒风险因素。本研究旨在确定门诊环境中跌倒的风险因素。

方法

在这项横断面观察性研究中,从印度新德里全印医学科学研究所老年医学门诊部随机招募了160名同意参与的受试者。排除非卧床的重症受试者。受试者接受了包括跌倒和老年评估在内的简要评估。他们被分为跌倒者和非跌倒者。采用多变量逻辑回归分析来确定与跌倒相关的因素。

结果

跌倒的患病率为23.75%(38/160)。跌倒者组中女性比例相对较高(26.31%),而非跌倒者组中为19.67%。多变量分析后,阿片类药物(比值比[OR]5.24[95%CI,2.018 - 13.611])、视力障碍(OR 2.71[95%CI,1.050 - 7.011])、害怕跌倒(OR 3.17[95%CI,1.167 - 8.629])、日常生活工具性活动(IADL)受损(OR 3.41[95%CI,1.251 - 9.301])、抗心绞痛药物(OR 8.90[95%CI,0.997 - 79.564])和个体经营(OR 5.37[95%CI,1.058 - 27.329])与跌倒相关。充足的营养(OR 0.82[95%CI,0.688 - 0.976])和照护者支持(OR 0.46[95%CI,0.275 - 0.801])对跌倒有预防作用。

结论

我们确定了跌倒的多因素病因。有上述任何一种风险因素的患者应随后接受详细的跌倒风险评估和预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1daa/7099749/3f4c842f8b54/AGM2-3-25-g001.jpg

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