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糖尿病老年患者意外跌倒发生率及跌倒风险预测模型的建立:一项前瞻性队列研究。

Incidence of accidental falls and development of a fall risk prediction model among elderly patients with diabetes mellitus: A prospective cohort study.

机构信息

School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.

出版信息

J Clin Nurs. 2023 Apr;32(7-8):1398-1409. doi: 10.1111/jocn.16371. Epub 2022 May 20.

Abstract

AIMS

To investigate the incidence of accidental falls and develop a fall risk prediction tool in elderly patients with diabetes mellitus.

BACKGROUND

The risk of fall in elderly patients with diabetes is higher than that in the general elderly, there is fewer fall assessment tools for elderly patients with diabetes.

DESIGN

A prospective cohort study.

METHODS

Between June and September 2019, a total of 1007 elderly patients with diabetes were enrolled from a tertiary specialist diabetes hospital in Tianjin and were prospectively followed up for 6 months to determine outcomes of accidental falls through telephone. Demographic and diseases related factors were collected at baseline. Incidence of falls was investigated, and a nomogram was developed based on logistic regression model. SPSS 21.0 and R 3.6.3 were used to analyse the data. The article was reported in accordance with STROBE guidelines.

RESULTS

Among 1007 elderly patients, 950 finished the follow-up. A total of 133 falls occurred in 93 patients during the follow-up period, with a fall rate of 9.79%. Diabetic peripheral neuropathy, walking aids, depression, fall history, fatigue and sex were independent predictors of accidental fall in diabetes elderly patients. The sensitivity and specificity of the predictive model were 73.12% and 52.63%, respectively, and a fall risk prediction nomogram was developed based on the regression model.

CONCLUSIONS

A nomogram including 6 easily available prediction factors (diabetic peripheral neuropathy, walking aids, depression, fall history within 1 year, fatigue, sex) was developed, and it can be used in safety management among Chinese elderly patients diagnosed with diabetes.

RELEVANCE TO CLINICAL PRACTICE

Nomogram can be used to identify diabetic elderly patients at high risk of accidental falls.

摘要

目的

调查老年糖尿病患者意外跌倒的发生率,并开发一种跌倒风险预测工具。

背景

老年糖尿病患者跌倒的风险高于一般老年人,针对老年糖尿病患者的跌倒评估工具较少。

设计

前瞻性队列研究。

方法

2019 年 6 月至 9 月,我们从天津市一家三级专科糖尿病医院共招募了 1007 名老年糖尿病患者,前瞻性随访 6 个月,通过电话确定意外跌倒的结局。在基线时收集人口统计学和与疾病相关的因素。调查跌倒发生率,并基于逻辑回归模型开发列线图。使用 SPSS 21.0 和 R 3.6.3 分析数据。文章按照 STROBE 指南进行报告。

结果

在 1007 名老年患者中,950 名完成了随访。在随访期间,93 名患者共发生 133 次跌倒,跌倒率为 9.79%。糖尿病周围神经病变、助行器、抑郁、跌倒史、疲劳和性别是老年糖尿病患者意外跌倒的独立预测因素。预测模型的灵敏度和特异度分别为 73.12%和 52.63%,并基于回归模型开发了跌倒风险预测列线图。

结论

我们开发了一个包含 6 个易于获得的预测因素(糖尿病周围神经病变、助行器、抑郁、1 年内跌倒史、疲劳、性别)的列线图,可用于中国诊断为糖尿病的老年患者的安全管理。

临床意义

列线图可用于识别有意外跌倒高风险的老年糖尿病患者。

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