Liang Junqing, Wang Ying, Zhang Weilin, Ding Hong, Gao Yanjun, Wang Rui, Sun Xiaofei, Peng Ying, Gan Liangying, Zuo Li
Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China.
Beijing Miyun Hospital, Department of Nephrology, Beijing, Miyun, People's Republic of China.
Hemodial Int. 2023 Apr;27(2):155-164. doi: 10.1111/hdi.13064. Epub 2023 Feb 6.
Patients undergoing hemodialysis (HD) are at a higher risk of falls than healthy individuals. Further knowledge regarding the risk of falls could lead to better risk prevention strategies. We designed a multicenter, prospective cohort study according to the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines to investigate the incidence and risk factors of falls in patients undergoing hemodialysis in Northern China.
Patients undergoing hemodialysis in six hemodialysis units were recruited from January 2019 to January 2020. Data on demographics and disease conditions were collected at baseline. Data on other variables, the incidence of falls, and related conditions were collected every 3 months during a 1-year follow-up. The Generalized Estimating Equation model was used to evaluate factors associated with falls.
This study included 472 patients. The incidence of falls was 0.31 per patient year. In patients aged 45-64 years (p = 0.01; odds ratio [OR]: 14.801; 95% confidence interval [CI]: 1.897-115.453) and ≥ 65 years (p = 0.007; OR: 16.562; 95% CI: 2.118-129.521), anemia (p = 0.015; OR: 2.122; 95% CI: 1.154-3.902) and moderately (p = 0.003; OR: 5.439; 95% CI: 1.791-16.516) and severely abnormal timed up and go test (TUGT) levels (p = 0.001; OR: 7.032; 95% CI: 2.226-22.216) were identified as independent risk factors of falls.
Falls are prevalent among patients undergoing in-center hemodialysis. Advanced age, anemia, and moderately and severely abnormal TUGT levels may be risk factors of falls.
接受血液透析（HD）的患者比健康个体更容易跌倒。对跌倒风险的进一步了解可能会带来更好的风险预防策略。我们根据加强流行病学观察性研究报告（STROBE）指南设计了一项多中心前瞻性队列研究，以调查中国北方接受血液透析患者的跌倒发生率及风险因素。
2019年1月至2020年1月，招募了6个血液透析单位的接受血液透析的患者。在基线时收集人口统计学和疾病状况数据。在1年的随访期间，每3个月收集一次其他变量、跌倒发生率及相关情况的数据。采用广义估计方程模型评估与跌倒相关的因素。
本研究纳入了472例患者。患者每年的跌倒发生率为0.31。年龄在45 - 64岁（p = 0.01；比值比[OR]：14.801；95%置信区间[CI]：1.897 - 115.453）和≥65岁（p = 0.007；OR：16.562；95% CI：2.118 - 129.521）的患者、贫血患者（p = 0.015；OR：2.122；95% CI：1.154 - 3.902）以及计时起立行走测试（TUGT）水平中度异常（p = 0.003；OR：5.439；95% CI：1.791 - 16.516）和严重异常（p = 0.001；OR：7.032；95% CI：2.226 - 22.216）的患者被确定为跌倒的独立风险因素。
在接受中心血液透析的患者中，跌倒情况很普遍。高龄、贫血以及TUGT水平中度和重度异常可能是跌倒的风险因素。
