Shumway-Cook A, Baldwin M, Polissar N L, Gruber W
Department of Physical Therapy, Northwest Hospital, Seattle, WA 98133, USA.
Phys Ther. 1997 Aug;77(8):812-9. doi: 10.1093/ptj/77.8.812.
The objective of this retrospective case-control study was to develop a model for predicting the likelihood of falls among community-dwelling older adults.
Forty-four community-dwelling adults (> or = 65 years of age) with and without a history of falls participated.
Subjects completed a health status questionnaire and underwent a clinical evaluation of balance and mobility function. Variables that differed between fallers and nonfallers were identified, using t tests and cross tabulation with chi-square tests. A forward stepwise regression analysis was carried out to identify a combination of variables that effectively predicted fall status.
Five variables were found to be associated with fall history. These variables were analyzed using logistic regression. The final model combined the score on the Berg Balance Scale with a self-reported history of imbalance to predict fall risk. Sensitivity was 91%, and specificity was 82%.
A simple predictive model based on two risk factors can be used by physical therapists to quantify fall risk in community-dwelling older adults. Identification of patients with a high fall risk can lead to an appropriate referral into a fall prevention program. In addition, fall risk can be used to calculate change resulting from intervention.
这项回顾性病例对照研究的目的是建立一个模型，用于预测社区居住的老年人跌倒的可能性。
44名社区居住的成年人（年龄≥65岁）参与了研究，其中有跌倒史和无跌倒史的各占一部分。
研究对象完成一份健康状况问卷，并接受平衡和移动功能的临床评估。通过t检验和卡方检验的交叉列表，确定跌倒者和未跌倒者之间存在差异的变量。进行向前逐步回归分析，以确定有效预测跌倒状况的变量组合。
发现五个变量与跌倒史相关。使用逻辑回归对这些变量进行分析。最终模型将伯格平衡量表得分与自我报告的失衡史相结合，以预测跌倒风险。敏感性为91%，特异性为82%。
物理治疗师可以使用基于两个风险因素的简单预测模型，来量化社区居住老年人的跌倒风险。识别跌倒风险高的患者可导致将其适当地转诊至跌倒预防计划。此外，跌倒风险可用于计算干预产生的变化。
