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探索急性中风患者首次跌倒时间和6个月跌倒发生率的潜在风险因素。

Exploring possible risk factors for time to first fall and 6-month fall incidence in persons with acute stroke.

作者信息

Sjöholm Hanna, Hägg Staffan, Nyberg Lars, Lind Jonas, Kammerlind Ann-Sofi

机构信息

Rehabilitation Center in Jönköping, Region Jönköping County, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Futurum, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

出版信息

SAGE Open Med. 2022 Mar 31;10:20503121221088093. doi: 10.1177/20503121221088093. eCollection 2022.

Abstract

OBJECTIVES

The aim was to explore how the time to the first fall and 6-month fall incidence relates to rapidly and easily collected data in persons with acute stroke.

METHODS

Out of consecutively admitted patients with stroke at three stroke units, 284 with at least one follow-up were included in this prospective cohort study. During 6 months following discharge, participants reported falls using a diary and monthly phone calls. Data about participants' characteristics, functions, and activities were collected during hospital stay and analyzed in relation to time to first fall by Cox regression and fall incidence by negative binomial regression.

RESULTS

Use of ⩾9 medications, paresis in arms, paresis in legs (National Institutes of Health Stroke Scale), impaired protective reactions in sitting (Postural Reactions Test), and limitations in self-care (Barthel Index) were decisive risk factors for time to first fall. Limitations in mobility (Step Test, 30-s Chair Stand Test) were decisive risk factors for high fall incidence (p < 0.0005).

CONCLUSION

Several easily collected participant characteristics, functions, and activities were identified as risk factors for falls. The findings emphasize the width of assessments that can be used for the identification of individuals at risk for falls and that the risk factors vary in different strata of the population. These results are important when developing multivariate risk models. The risk factors differed in part when analyzing the time to the first fall and 6-month fall incidence.

摘要

目的

本研究旨在探讨首次跌倒时间和6个月内跌倒发生率与急性卒中患者快速且易于收集的数据之间的关系。

方法

在三个卒中单元连续收治的卒中患者中,本前瞻性队列研究纳入了284例至少有一次随访的患者。出院后的6个月内,参与者通过日记和每月电话报告跌倒情况。在住院期间收集参与者的特征、功能和活动数据,并通过Cox回归分析首次跌倒时间,通过负二项回归分析跌倒发生率。

结果

使用≥9种药物、手臂轻瘫、腿部轻瘫(美国国立卫生研究院卒中量表)、坐位时保护性反应受损(姿势反应测试)以及自我护理受限(巴氏指数)是首次跌倒时间的决定性危险因素。活动能力受限(步速测试、30秒椅子站立测试)是跌倒发生率高的决定性危险因素(p < 0.0005)。

结论

确定了几个易于收集的参与者特征、功能和活动作为跌倒的危险因素。研究结果强调可用于识别跌倒风险个体的评估范围广泛,且危险因素在不同人群分层中有所不同。这些结果在开发多变量风险模型时很重要。在分析首次跌倒时间和6个月内跌倒发生率时,危险因素部分不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dffe/8977710/e96c1790a42b/10.1177_20503121221088093-fig1.jpg

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