入院时 SARC-F 评分可预测老年人住院期间的跌倒。
The SARC-F Score on Admission Predicts Falls during Hospitalization in Older Adults.
机构信息
Keisuke Maeda, M.D., Ph.D., Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan, Phone: +81-562-46-2311; FAX: +81-562-44-8518, E-mail:
出版信息
J Nutr Health Aging. 2021;25(3):399-404. doi: 10.1007/s12603-021-1597-3.
OBJECTIVES
Community-dwelling older adults with sarcopenia are likely to fall. However, few studies have investigated whether sarcopenia is associated with falls during hospitalization in older adults. The purpose of this study was to determine whether the SARC-F when used as a simple screening tool for sarcopenia at the time of admission, predicts in-hospital falls.
DESIGN
A retrospective, observational study.
SETTING
A 900-bed university hospital.
PARTICIPANTS
A total of 9,927 patients aged 65 years and older were hospitalized at the hospital between April 2019 and March 2020.
MEASUREMENTS
The SARC-F contains five items: strength, assistance in walking, rise from a chair, climb stairs, and falls were evaluated at hospital admission. To investigate the relationship between the SARC-F score and falls, a ROC curve analysis was performed. Multivariate analysis adjusted for fall-related confounding factors such as age, gender, ADL, and disease were performed.
RESULTS
Mean age: 75.9±6.7 years; male: 56.2% were analyzed, and 159 patients (1.6%) fell during hospitalization. SARC-F scores at admission were significantly higher in the fall group than in the control group (3 [1-6] points vs. 0 [¬0-2] point, p<0.001). Statistical association was observed between the SARC-F and in-hospital fall (area under the curve = 0.721 [0.678-0.764], p < 0.001). The cut-off value for the highest sensitivity and specificity of the SARC-F score for in-hospital falls was two (sensitivity = 0.679, specificity = 0.715). Among the subitem of the SARC-F, the hazard ratios for climbing stairs were significantly higher (HR = 1.52 [1.10-2.09], p = 0.011) and for a history of fall was significantly higher (HR = 1.41 [1.02-1.95], p = 0.036). A SARC-F score ≥ 2 had a significantly higher incidence of in-hospital falls compared to a SARC-F score <2 (3.7% vs. 0.7%, p < 0.001). Also, a SARC-F score ≥ 2 had a significantly higher hazard ratio for falls (2.11 [1.37-3.26], p < 0.001).
CONCLUSION
SARC-F can help predict falls among hospitalized older adults.
目的
社区居住的患有肌少症的老年人更容易摔倒。然而，很少有研究调查肌少症是否与老年人住院期间的跌倒有关。本研究的目的是确定 SARC-F 是否可以作为入院时肌少症的简单筛查工具，预测住院期间的跌倒。
设计
回顾性观察性研究。
地点
一家 900 张床位的大学医院。
参与者
2019 年 4 月至 2020 年 3 月期间，共有 9927 名 65 岁及以上的患者在该医院住院。
测量方法
SARC-F 包含 5 个项目：入院时评估力量、行走辅助、从椅子上起身、爬楼梯和跌倒。为了研究 SARC-F 评分与跌倒之间的关系，进行了 ROC 曲线分析。进行了多变量分析，调整了年龄、性别、ADL 和疾病等与跌倒相关的混杂因素。
结果
平均年龄：75.9±6.7 岁；男性：56.2%进行了分析，159 名患者（1.6%）在住院期间跌倒。与对照组相比，跌倒组的 SARC-F 评分在入院时明显更高（3[1-6]分比 0[¬0-2]分，p<0.001）。SARC-F 与住院期间跌倒之间存在统计学关联（曲线下面积=0.721[0.678-0.764]，p<0.001）。SARC-F 评分预测住院期间跌倒的最佳截断值为 2 分（灵敏度=0.679，特异性=0.715）。在 SARC-F 的子项目中，爬楼梯的危险比显著更高（HR=1.52[1.10-2.09]，p=0.011），跌倒史的危险比显著更高（HR=1.41[1.02-1.95]，p=0.036）。与 SARC-F 评分<2 相比，SARC-F 评分≥2 的患者住院期间跌倒的发生率显著更高（3.7%比 0.7%，p<0.001）。此外，SARC-F 评分≥2 的跌倒风险比也显著更高（2.11[1.37-3.26]，p<0.001）。
结论
SARC-F 可帮助预测住院老年患者的跌倒。
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