视野缺失和因跌倒而需住院治疗的结果：eFOVID 研究结果。

Visual field loss and falls requiring hospitalisation: results from the eFOVID study.

机构信息

School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton Street, Nedlands 6009, Australia.

Western Australian Centre for Road Safety, School of Psychology, The University of Western Australia, Nedlands, Australia.

出版信息

Age Ageing. 2024 Sep 1;53(9). doi: 10.1093/ageing/afae191.

DOI:10.1093/ageing/afae191

PMID:39228096

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11371543/

Abstract

BACKGROUND

Visual fields are important for postural stability and ability to manoeuvre around objects.

OBJECTIVE

Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +.

METHODS

Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists' practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: -2 to -6 dB, moderate: -6.01 dB to -12 dB, severe < -12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders.

RESULTS

A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <-12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0-1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39-39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38-1.60) and diabetes (IRR 1.25, 95% CI 1.14-1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81-0.95) compared with those who did not have cataract surgery.

CONCLUSION

The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss.

摘要

背景

视野对于姿势稳定性和绕障碍物移动的能力很重要。

目的

研究视野丧失与 50 岁以上成年人需要住院治疗的跌倒之间的关系。

方法

使用从西澳大利亚州（WA）眼科医生实践中获得的视野数据库，确定了有和无视野丧失的 50 岁以上老年人。将数据与医院发病率数据收集和 WA 医院死亡率系统相关联，以确定 1990 年至 2019 年期间因跌倒而需要住院治疗的参与者。基于最近一次视野测试中（跌倒前 3 年或如果不可用，则为跌倒后 2 年）最佳眼平均偏差（轻度：-2 至-6dB，中度：-6.01dB 至-12dB，严重< -12.01dB），使用广义线性负二项回归模型，根据视野丧失（无视野丧失、轻度、中度、严重）的严重程度，研究需要住院治疗的跌倒与视野丧失之间的关系，并调整了潜在混杂因素。

结果

共有 31021 名独特的个体，其中 6054 名（19.5%）在中位观察时间为 14.1 年期间经历了 11818 次需要住院治疗的跌倒。只有平均偏差指数<-12.01dB（严重）与需要住院治疗的跌倒发生率增加 14%显著相关（调整后的 IRR 1.14，95%CI 1.0-1.25），与无视野丧失相比，调整了潜在混杂因素后。其他因素包括年龄，80 岁以上者发生率增加（IRR 29.16，95%CI 21.39-39.84），其他合并症（IRR 1.49，95%CI 1.38-1.60）和糖尿病（IRR 1.25，95%CI 1.14-1.37）。与未行白内障手术者相比，既往白内障手术与需要住院治疗的跌倒发生率降低 13%相关（IRR 0.87，95%CI 0.81-0.95）。