Istituto Romagnolo Per Lo Studio Dei Tumori "Dino Amadori" IRST IRCCS, via Maroncelli 40, 47014, Meldola, Italy.
Support Care Cancer. 2022 Oct;30(10):7835-7843. doi: 10.1007/s00520-022-07208-x. Epub 2022 Jun 16.
To identify fall predictors and develop an assessment tool to be used for screening hospitalized cancer patients at risk for fall.
A retrospective case-control study was conducted in 2018 at a cancer center in Northern Italy. The study participants were 448 adult cancer patients admitted to the oncology ward from 2009 to 2013. The case group consisted of 112 patients presenting at least one fall, while controls were randomly chosen by matching each case for age, sex, and admission period with three patients who did not fall. Data for the fall predictors were extracted from the electronic medical records. Conditional logistic regression was used to evaluate the association between patient's characteristics and fall risk.
The overall prevalence of patients having at least one candidate fall predictor was high (98%). Seven of the studied variables showed an independent association with fall risk at multivariate analysis. These were tumor site, the presence of neurologic diseases, gait imbalance disorders, fatigue, and the assumption of certain medications such as diuretics, hypnotics, and opioids (odds ratios and 95% confidence intervals in brackets were 3.78 (1.78-8.13), 2.26 (1.08-4.77), 4.22 (1.87-9.52), 2.76 (1.45-5.26), 2.66 (1.52-4.66), 2.41 (1.20-4.85), and 3.03 (1.68-5.45), respectively).
In this study, we identified falling risk factors in an Italian population of hospitalized cancer patients and developed a new risk assessment tool. An external validation is necessary before implementing our screening tool in clinical practice.
确定跌倒预测因素,并开发一种评估工具,用于筛选住院癌症患者中存在跌倒风险的患者。
2018 年在意大利北部的一家癌症中心进行了一项回顾性病例对照研究。研究参与者为 2009 年至 2013 年期间入住肿瘤病房的 448 名成年癌症患者。病例组由 112 名至少发生一次跌倒的患者组成,对照组通过年龄、性别和入院时期与未跌倒的 3 名患者匹配随机选择。从电子病历中提取跌倒预测因素的数据。使用条件逻辑回归评估患者特征与跌倒风险之间的关联。
总体而言,具有至少一个候选跌倒预测因素的患者的患病率很高(98%)。在多变量分析中,有 7 个研究变量与跌倒风险独立相关。这些变量是肿瘤部位、神经系统疾病、步态平衡障碍、疲劳以及使用某些药物,如利尿剂、催眠药和阿片类药物(比值比和 95%置信区间在括号内)分别为 3.78(1.78-8.13)、2.26(1.08-4.77)、4.22(1.87-9.52)、2.76(1.45-5.26)、2.66(1.52-4.66)、2.41(1.20-4.85)和 3.03(1.68-5.45)。
在这项研究中,我们确定了意大利住院癌症患者的跌倒风险因素,并开发了一种新的风险评估工具。在将我们的筛查工具应用于临床实践之前,需要进行外部验证。