Allogeneic haematopoietic stem cell transplantation and patient falls: impact of lower extremity muscle strength
Allogeneic haematopoietic stem cell transplantation and patient falls: impact of lower extremity muscle strength
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异体造血干细胞移植与患者跌倒：下肢肌力的影响
DOI：
10.1136/bmjspcare-2022-003582
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发表时间：
2022
影响因子：
2.7
通讯作者：
Katoh
中科院分区：
文献类型：
--
作者：
Kondo Shin;Inoue Tatsuro;Saito Takashi;Kawamura Yuka;Katayama Ayane;Nakamura Masafumi;Sumitani Ryohei;Takahashi Mamiko;Oura Masahiro;Sogabe Kimiko;Harada Takeshi;Fujii Shiro;Nakamura Shingen;Miki Hirokazu;Kagawa Kumiko;Sato Nori;Ono Rei;Abe Masahiro;Katoh
目的 接受同种异体造血干细胞移植 (allo-HSCT) 的患者比接受其他血液疾病治疗的患者跌倒的风险更高。本研究旨在探讨移植前下肢肌力（LEMS）对移植后跌倒的影响。方法在这项回顾性队列研究中，纳入了年龄≥18岁接受allo-HSCT的患者。所有数据均从医疗记录中提取。 LEMS 被定义为手持式测力计测量的膝关节伸展力除以患者体重。使用受试者工作特征 (ROC) 曲线来计算预测跌倒的最佳 LEMS 截止值。根据截止值将患者分为低 LEMS 组和正常 LEMS 组。使用 Cox 比例风险模型分析移植前 LEMS 对移植后跌倒的影响。结果总共分析了 101 名患者。观察期间，有32名患者（31.7%）发生跌倒。 ROC曲线分析结果表明，预测跌倒的最佳LEMS截止值为单位体重的45.4%。在多变量分析中，移植前低 LEMS 分别是模型 1（以患者特征为混杂因素）和模型 2（以药物诱导跌倒为混杂因素）跌倒的显着预测因子（模型 1：HR 3.23，95% CI 1.37 至 7.64；模型 2：HR 2.82，95% CI 1.20 至 6.59）。移植后跌倒的重要预测因素。这项研究的结果可能有助于预防接受异基因造血干细胞移植的患者跌倒。
ObjectivesPatients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) have a higher risk of falls than those receiving other therapies for haematological disorders. This study aimed to investigate the impact of pretransplant lower extremity muscle strength (LEMS) on post-transplant falls.MethodsIn this retrospective cohort study, patients aged ≥18 years who underwent allo-HSCT were included. All data were extracted from medical records. LEMS was defined as the knee extension force measured by a handheld dynamometer divided by the patient’s weight. The receiver operating characteristic (ROC) curve was used to calculate the optimal LEMS cut-off value for prediction of falls. Patients were categorised into low and normal LEMS groups based on the cut-off value. The impact of pretransplant LEMS on post-transplant falls was analysed using a Cox proportional hazards model.ResultsIn total, 101 patients were analysed. During the observation period, falls occurred in 32 patients (31.7%). The ROC curve analysis results showed that the optimal LEMS cut-off value for prediction of falls was 45.4% per body weight. In multivariate analysis, pretransplant low LEMS was a significant predictor of falls in model 1 with patient characteristics as a confounding factor and model 2 with medications-inducing falls as a confounding factor, respectively (model 1: HR 3.23, 95% CI 1.37 to 7.64; model 2: HR 2.82, 95% CI 1.20 to 6.59).ConclusionsPretransplant LEMS was a significant predictor of post-transplant falls. The results of this study may help to prevent falls in patients undergoing allo-HSCT.