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评估常见步态测量指标在疑似正常压力脑积水患者中预测跌倒的预测价值。

Assessing the predictive value of common gait measure for predicting falls in patients presenting with suspected normal pressure hydrocephalus.

机构信息

Department of Neurology, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Center Tower, STE 5100, Baltimore, MD, 21224, USA.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

BMC Neurol. 2021 Feb 8;21(1):60. doi: 10.1186/s12883-021-02068-0.

Abstract

OBJECTIVE

To assess the predictive value of common measures validated to predict falls in other geriatric populations in patients presenting with suspected Normal Pressure Hydrocephalus (NPH).

METHODS

One hundred ninety-five patients over the age of 60 who received the Fall Risk Questionnaire were retrospectively recruited from the CSF Disorders clinic within the departments of Neurosurgery and Neurology. Multiple logistic regression was used to create a model to predict falls for patients with suspected NPH using common measures: Timed Up & Go, Dual Timed Up & Go, 10 Meter Walk, MiniBESTest, 6-Minute Walk, Lower Extremity Function (Mobility), Fall Risk Questionnaire, and Functional Activities Questionnaire.

RESULTS

The Fall Risk Questionnaire and age were shown to be the best predictors of falls. The model was 95.92% (Positive predictive value: 83.93%) sensitive and 47.92% specific (Negative predictive value: 77.78%).

CONCLUSION

Patients presenting with suspected NPH are at an increased fall risk, 75% of the total patients and 89% of patients who responded to a temporary drain of CSF had at least one fall in the past 6 months. The Fall Risk Questionnaire and age were shown to be predictive of falls for patients with suspected NPH. The preliminary evidence indicates measures that have been validated to assess fall risk in other populations may not be valid for patients presenting with suspected NPH.

摘要

目的

评估在疑似正常压力脑积水(NPH)患者中,经其他老年人群验证可预测跌倒的常用指标的预测价值。

方法

从神经外科和神经内科的 CSF 疾病诊所回顾性招募了 195 名年龄在 60 岁以上接受跌倒风险问卷的患者。使用多元逻辑回归创建了一个模型,使用常见的测量指标来预测疑似 NPH 患者的跌倒情况:计时起立行走测试、双计时起立行走测试、10 米步行测试、MiniBESTest、6 分钟步行测试、下肢功能(移动能力)、跌倒风险问卷和功能活动问卷。

结果

跌倒风险问卷和年龄被证明是预测跌倒的最佳指标。该模型的敏感性为 95.92%(阳性预测值:83.93%),特异性为 47.92%(阴性预测值:77.78%)。

结论

疑似 NPH 的患者跌倒风险增加,75%的患者和 89%对临时脑脊液引流有反应的患者在过去 6 个月内至少跌倒过一次。跌倒风险问卷和年龄被证明可预测疑似 NPH 患者的跌倒情况。初步证据表明,在其他人群中验证过的评估跌倒风险的措施可能不适用于疑似 NPH 的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296e/7869204/cacef5c046ff/12883_2021_2068_Fig1_HTML.jpg

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