Falls in frequent neurological diseases - Prevalence, risk factors and aetiology
Falls in frequent neurological diseases - Prevalence, risk factors and aetiology
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DOI：
10.1007/s00415-004-0276-8
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发表时间：
2004-01-01
影响因子：
6
通讯作者：
Deuschl, G
中科院分区：
文献类型：
--
作者：
Stolze, H;Klebe, S;Deuschl, G
福尔斯在神经系统患者中的患病率尚不清楚，尽管步态和姿势障碍很常见。福尔斯可能会给患者、护理人员和卫生系统带来负担。我们设计了一项前瞻性研究，调查了所有在100天内入住神经科医院的患者的福尔斯病史。进行了临床调查，并应用了几种疾病特异性评分量表。共调查了548名患者。在所有患者中，34%在过去12个月内跌倒一次或多次。55%的跌倒归因于步态障碍，12%归因于癫痫发作，10%归因于晕厥，7%归因于中风。福尔斯的内在危险因素是高龄、步态紊乱、平衡差和害怕摔倒。作为外在因素，我们确定了抗抑郁药，抗精神病药和不同的心血管药物治疗，患者家中的不良环境因素和助行器的使用。在诊断中，福尔斯在帕金森病（62%）、晕厥（57%）和多发性神经病（48%）中最常见。根据这些发现，神经科住院患者的福尔斯跌倒频率是社区中年龄匹配人群的两倍。神经系统患者的福尔斯与影响步态和平衡的药物和疾病特别相关。
The prevalence of falls among neurological patients is unknown, although disturbances of gait and posture are common. Falls may lead to burdens for the patient, the caregivers and the health system. We designed a prospective study and investigated all patients for a history of falls admitted to a neurological hospital during a 100-day period. Clinical investigation was carried out and several disease specific rating scales were applied. A total of 548 patients were investigated. Of all patients 34% had fallen once or more often during the last twelve months. A disturbance of gait was blamed for the fall in 55%, epileptic seizures in 12%, syncope in 10% and stroke in 7%. Intrinsic risk factors for falls were high age, disturbed gait, poor balance and a fear of falling. As extrinsic factors we identified the treatment with antidepressants, neuroleptics and different cardiovascular medications, adverse environmental factors in the patients' home and the use of walking aids. Within the diagnoses, falls were most frequent in Parkinson's disease (62%), syncope (57%) and polyneuropathy (48%). According to these findings falls in neurological in-patients are twice as frequent as in an age-matched population living in the community. Falls in neurological patients are particularly linked to medication and disorders affecting gait and balance.