The Value Institute, New York-Presbyterian Hospital, New York, New York.
Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, New York.
Am J Prev Med. 2020 Jun;58(6):839-844. doi: 10.1016/j.amepre.2020.01.019.
The objectives of this study were to investigate an association between the risk of patient falls and self-reported hearing loss and to examine whether self-reported hearing loss with versus without hearing aids predicts patient falls in an inpatient setting.
This retrospective cohort analysis was conducted in 2018 in a large, urban, academic medical center. Participants included unique inpatients (N=52,805) of adults aged >18 years between February 1, 2017, and February 1, 2018. Outcome measures were falls in the inpatient setting and hearing loss with versus without hearing aids as predictors for patient falls.
Self-reported hearing loss was associated with falls in the inpatient setting (OR=1.74, 95% CI=1.46, 2.07, p<1.43 × 10). Among patients with hearing impairment, a lack of hearing aids increased the risk for falls in the inpatient setting (OR=2.70, 95% CI=1.64, 4.69, p<1.41 × 10). After accounting for the risk of fall using the Morse Fall Scale (which does not include hearing impairment) and controlling for age and sex, patients with hearing loss and no hearing aids were significantly more likely to fall (OR=2.44, 95% CI=1.002, 5.654, p<0.042), but patients with hearing loss who did have hearing aids were not significantly more likely to fall (p<0.889). Hearing loss together with the Morse Fall Scale better predicted falls than the Morse Fall Scale alone (p<0.017).
In the inpatient setting, there was a positive association between hearing loss and falls. However, among patients with hearing loss, only those without hearing aids were significantly more likely to fall, accounting for the Morse Fall Scale score and demographics characteristics. These findings support adding hearing loss as a modifiable risk factor in risk assessment tools for falls and exploring the use of amplification devices as an intervention.
本研究旨在探讨患者跌倒风险与自我报告听力损失之间的关系，并检验在住院环境中，有无助听器的自我报告听力损失是否能预测患者跌倒。
本回顾性队列研究于 2018 年在一家大型城市学术医疗中心进行。参与者为 2017 年 2 月 1 日至 2018 年 2 月 1 日期间年龄＞18 岁的独特住院成人患者（N=52805）。主要结局指标为住院环境中发生跌倒，有无助听器的听力损失作为预测患者跌倒的指标。
自我报告听力损失与住院环境中跌倒相关（OR=1.74，95%CI=1.46，2.07，p<1.43×10）。在听力受损的患者中，缺乏助听器会增加住院环境中跌倒的风险（OR=2.70，95%CI=1.64，4.69，p<1.41×10）。在使用不包含听力障碍的 Morse 跌倒量表（Morse Fall Scale）来评估跌倒风险，并控制年龄和性别后，有听力损失且没有助听器的患者跌倒的可能性显著增加（OR=2.44，95%CI=1.002，5.654，p<0.042），但有听力损失且有助听器的患者跌倒的可能性无显著增加（p<0.889）。听力损失与 Morse 跌倒量表联合应用比单用 Morse 跌倒量表更能准确预测跌倒（p<0.017）。
在住院环境中，听力损失与跌倒之间存在正相关。然而，在听力受损的患者中，只有那些没有助听器的患者跌倒的可能性显著增加，这与 Morse 跌倒量表评分和人口统计学特征有关。这些发现支持将听力损失作为跌倒风险评估工具中的一个可修正的危险因素，并探索使用放大设备作为干预措施。
