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疗养院居民跌倒相关的血压变异性

Blood pressure variability associated with falls in nursing home residents.

作者信息

Soultan El Hassan, Hara Anjandeep, Knutson Peter, Holzwarth Elizabeth, Klug Marilyn, Basson Marc D, Dahl Lindsey, McGrath Ryan, Manocha Gunjan, Jurivich Donald A

机构信息

Department of Geriatrics, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, North Dakota, USA.

Department of Population Health, Education Resources, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, North Dakota, USA.

出版信息

Geriatr Gerontol Int. 2024 Dec;24(12):1315-1319. doi: 10.1111/ggi.15014. Epub 2024 Nov 3.

Abstract

BACKGROUND

High variations in serially measured blood pressures (BPs) portend a variety of adverse clinical events including dementia, cardiovascular sequelae and frailty. In this study, systolic blood pressure variability (BPV) was examined for its association with fall frequency and time to next fall among older adults living in nursing homes.

METHODS

BP values and falls over time were extracted from medical records of nursing home residents aged ≥65 years over a 10-month period. BPV was measured as the standard deviation of 17 to 20 systolic values, and its correlation with falls and time to next fall were evaluated according to quartile values.

RESULTS

One hundred patient charts were analyzed with nearly 2000 BP data points. All older adults had at least one fall incident. Higher BPV was related to more falls, shorter time between the first and second fall and fewer average days between falls. Subgroups of high BP and different diagnoses affected this association between BPV and falls.

CONCLUSIONS

People who fall often show a high variability in BP; as the number of falls increases, the BPV also increases. This study suggests that BPV may be marker for patients who might benefit from more aggressive application of fall reduction strategies. Geriatr Gerontol Int 2024; 24: 1315-1319.

摘要

背景

连续测量的血压(BP)存在高度变异性,预示着包括痴呆、心血管后遗症和衰弱在内的各种不良临床事件。在本研究中,对收缩压变异性(BPV)与居住在养老院的老年人跌倒频率及下次跌倒时间的关联进行了研究。

方法

从年龄≥65岁的养老院居民10个月期间的医疗记录中提取血压值和跌倒情况。BPV以17至20个收缩压值的标准差来衡量,并根据四分位数评估其与跌倒及下次跌倒时间的相关性。

结果

分析了100份患者病历,有近2000个血压数据点。所有老年人至少有一次跌倒事件。较高的BPV与更多跌倒、首次和第二次跌倒之间的时间间隔较短以及跌倒之间的平均天数较少有关。高血压亚组和不同诊断影响了BPV与跌倒之间的这种关联。

结论

经常跌倒的人血压变异性较高;随着跌倒次数增加,BPV也会增加。本研究表明,BPV可能是那些可能从更积极应用跌倒预防策略中获益的患者的一个标志物。《老年医学与老年病学国际杂志》2024年;24:1315 - 1319。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b711/11628908/4a65d842a3d5/GGI-24-1315-g001.jpg

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