Hirata Risa, Tago Masaki, Katsuki Naoko E, Oda Yoshimasa, Tokushima Midori, Tokushima Yoshinori, Hirakawa Yuka, Yamashita Shun, Aihara Hidetoshi, Fujiwara Motoshi, Yamashita Shu-Ichi
Department of General Medicine, Saga University Hospital, Saga, Japan.
Department of General Medicine, Yuai-Kai Foundation and Oda Hospital, Saga, Japan.
Int J Gen Med. 2022 Nov 9;15:8121-8131. doi: 10.2147/IJGM.S385168. eCollection 2022.
In our former study, we had validated the previously developed predictive model for in-hospital falls (Saga fall risk model) using eight simple factors (age, sex, emergency admission, department of admission, use of hypnotic medications, history of falls, independence of eating, and Bedriddenness ranks [BRs]), proving its high reliability. We found that only admission to the neurosurgery department, history of falls, and BRs had significant relationships with falls. In the present study, we aimed to clarify whether each of these three items had a significant relationship with falls in a different group of patients.
This was a single-center based, retrospective study in an acute care hospital in a rural city of Japan. We enrolled all inpatients aged 20 years or older admitted from April 2015 to March 2018. We randomly selected patients to fulfill the required sample size. We performed multivariable logistic regression analysis using forced entry on the association between falls and each of the eight items in the Saga fall risk model 2.
A total of 2932 patients were randomly selected, of whom 95 (3.2%) fell. The median age was 79 years, and 49.9% were men. Multivariable analysis showed that female sex (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.39-0.93, p = 0.022), having a history of falls (OR 1.9, 95% CI 1.16-2.99, p = 0.010), requiring help with eating (OR 1.9, 95% CI 1.12-3.35, p = 0.019), BR of A (OR 6.6, 95% CI 2.82-15.30, p < 0.001), BR of B (OR 7.5, 95% CI 2.95-19.06, p < 0.001), and BR of C (OR 4.1, 95% CI 1.53-11.04, p = 0.005) were significantly associated with falls.
History of falls and BRs were independently associated with in-hospital falls.
在我们之前的研究中，我们使用八个简单因素（年龄、性别、急诊入院、入院科室、使用催眠药物、跌倒史、进食独立性和卧床等级[BRs]）验证了先前开发的院内跌倒预测模型（佐贺跌倒风险模型），证明了其高可靠性。我们发现只有神经外科入院、跌倒史和BRs与跌倒有显著关系。在本研究中，我们旨在阐明这三个项目中的每一个在不同患者组中与跌倒是否有显著关系。
这是一项基于日本农村城市一家急性护理医院的单中心回顾性研究。我们纳入了2015年4月至2018年3月期间入院的所有20岁及以上的住院患者。我们随机选择患者以满足所需的样本量。我们使用强制进入法对佐贺跌倒风险模型2中的跌倒与八个项目中的每一个之间的关联进行多变量逻辑回归分析。
总共随机选择了2932名患者，其中95名（3.2%）跌倒。中位年龄为79岁，49.9%为男性。多变量分析显示，女性（比值比[OR]0.6，95%置信区间[CI]0.39 - 0.93，p = 0.022）、有跌倒史（OR 1.9，95% CI 1.16 - 2.99，p = 0.010）、进食需要帮助（OR 1.9，95% CI 1.12 - 3.35，p = 0.019）、A等级的BR（OR 6.6，95% CI 2.82 - 15.30，p < 0.001）、B等级的BR（OR 7.5，95% CI 2.95 - 19.06，p < 0.001）和C等级的BR（OR 4.1，95% CI 1.53 - 11.04，p = 0.005）与跌倒显著相关。
跌倒史和BRs与院内跌倒独立相关。
