Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia; Department of Physiotherapy, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil.
Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia; Department of Applied Physiotherapy, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil.
Respir Med. 2021 Jan;176:106284. doi: 10.1016/j.rmed.2020.106284. Epub 2020 Dec 10.
Falls are frequent in people with chronic obstructive pulmonary disease (COPD) and related to increased morbidity, mortality, and health care costs in older adults. This systematic review aims to synthesise the falls outcomes and to examine risk factors for falls in the COPD literature.
The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO: CRD42015017257). Searches were updated and operated in five electronic databases in December 2019 for studies reporting falls outcomes and risk factors in people with COPD. Meta-analyses were conducted on the prevalence of fallers and frequent fallers. Quality assessment appraised the risk of bias of included articles.
Twenty-three studies met the eligibility criteria and were retained after the full-text review. In the meta-analyses, the pooled prevalence of COPD fallers was 30% (95%CI 19%-42%), and the pooled prevalence of frequent fallers (≥2 falls in the analysed period of occurrence) was 24% (95%CI 2%-56%). The falls incidence rate in stable COPD varied from 1.17 to 1.49 falls/person-year. Different study methodologies were identified. Age, female gender, falls history, the number of medications, comorbidities, coronary heart disease, use of supplemental oxygen, impaired balance performance and smoking history were risk factors for falls identified in stable COPD.
Prevalence of fallers, frequent fallers, and falls incidence rate have been reported in the COPD literature using a varying methodology. People with stable COPD present with ageing and disease-related risk factors for falls. Further research using the recommended prospective recording is needed in COPD.
慢性阻塞性肺疾病（COPD）患者经常跌倒，与老年人发病率、死亡率和医疗保健费用增加有关。本系统评价旨在综合 COPD 文献中的跌倒结局，并探讨跌倒的危险因素。
该方案已在系统评价前瞻性登记处（PROSPERO：CRD42015017257）中注册。2019 年 12 月，对报告 COPD 患者跌倒结局和危险因素的研究进行了五项电子数据库的更新和检索。对跌倒者和频繁跌倒者的患病率进行了荟萃分析。质量评估评估了纳入文章的偏倚风险。
23 项研究符合入选标准，并在全文审查后保留。荟萃分析中，COPD 跌倒者的总体患病率为 30%（95%CI 19%-42%），频繁跌倒者（分析期间发生≥2 次跌倒）的总体患病率为 24%（95%CI 2%-56%）。稳定期 COPD 的跌倒发生率为 1.17-1.49 次/人/年。确定了不同的研究方法。年龄、女性、跌倒史、用药数量、合并症、冠心病、使用补充氧气、平衡功能受损和吸烟史是稳定期 COPD 跌倒的危险因素。
COPD 文献中使用了不同的方法报告了跌倒者、频繁跌倒者和跌倒发生率。稳定期 COPD 患者存在与年龄和疾病相关的跌倒风险因素。需要在 COPD 中进一步使用推荐的前瞻性记录进行研究。
