PREDICTORS OF FALLS AMONG ELDERLY PEOPLE - RESULTS OF 2 POPULATION-BASED STUDIES
PREDICTORS OF FALLS AMONG ELDERLY PEOPLE - RESULTS OF 2 POPULATION-BASED STUDIES
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DOI：
10.1001/archinte.149.7.1628
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发表时间：
1989-07-01
影响因子：
--
通讯作者：
FINE, G
中科院分区：
文献类型：
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作者：
ROBBINS, AS;RUBENSTEIN, LZ;FINE, G
进行了一项研究，以确定住院老年人（跌倒者，N= 79，非跌倒者，N=70）和非住院老年人（跌倒者，N=34，非跌倒者，N=34）跌倒的危险因素并对其进行排名。根据年龄、性别和居住地点将跌倒者与非跌倒者对照。一名执业护士使用标准化方案和医生咨询对所有受试者进行了全面的身体评估。这两个人群中的跌倒者在身体和功能上的受损程度都明显高于对照组。Logistic回归发现，在住院患者中，髋关节无力、平衡能力差和处方药数量是与跌倒最密切相关的因素。根据这些发现建立了跌倒预测模型，总体预测准确率为76%（灵敏度89%，特异性60%）。使用该模型，预测1年内跌倒的风险范围从没有三种风险因素的人的12%到所有三种风险因素的人的100%。在非机构的研究对象中也有类似的发现。这些数据支持进行起因性跌倒风险评估以识别有跌倒高风险的老年患者的概念。
A study was performed to identify and rank risk factors for falling among populations of institutionalized (fallers, N = 79, nonfallers, N=70) and noninstitutionalized (fallers, N=34, nonfallers, N = 34) elderly persons. Fallers were matched by age, sex, and living location to nonfaller control subjects. A nurse practitioner performed a comprehensive physical assessment in all subjects using a standardized protocol and physician consultation. Fallers in both populations were significantly more physically and functionally impaired than control subjects. Logistic regression identified hip weakness, poor balance, and number of prescribed medications as factors most strongly associated with falling among institutionalized subjects. A fall prediction model was developed from these findings yielding 76% overall predictive accuracy (89% sensitivity, 60% specificity). Using the model, the predicted 1-year risk of falling ranged from 12% for persons with none of the three risk factors to 100% for persons with all three risk factors. Findings among noninstitutional subjects were similar. These data support the concept of performing for cused fall risk assessments to identify elderly patients at high risk for falling.