Predictors of falls in patients during the first year after total hip arthroplasty: A prospective cohort study
Predictors of falls in patients during the first year after total hip arthroplasty: A prospective cohort study
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DOI：
10.1002/hsr2.184
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发表时间：
2020-09-01
影响因子：
2
通讯作者：
Hirakawa, Kazuo
中科院分区：
文献类型：
--
作者：
Ninomiya, Kazunari;Takahira, Naonobu;Hirakawa, Kazuo
背景和目的由于全髋关节置换术(THA)后跌倒会导致严重的并发症，如股骨柄周围的脱位和骨折，因此研究哪些因素可以预测跌倒是非常重要的。因此，调查等待全髋关节置换术患者跌倒的预测因素将是有价值的，因为这将导致更多的战略性干预措施来预防这些问题。本研究的目的是评估THA术后第一年患者跌倒的预测因素。对157例单侧髋关节骨性关节炎行全髋关节置换术的患者进行了分析。监测全髋关节置换术后第一年内跌倒的发生率，并将患者分为“跌倒”组和“不跌倒”组。比较两组的人口学资料(年龄、性别、体重指数、腿长差、住院时间和跌倒病史)、术前髋外展肌力量、功能表现(单腿站立和最大步行速度)、行走时疼痛和体力活动。结果多因素Logistic回归分析显示，术前患侧髋外展肌力量和跌倒病史是术后1年内跌倒的预测因素。在后续的受试者操作特征曲线分析中，术前患侧髋外展肌力量仍是一个显著的预测因素，其截止值为0.46 Nm/kg，区分跌倒组和非跌倒组的特异度为73.6%，特异度为50.0%，曲线下面积为70.2%。结论本研究结果提示，临床医生应重点关注患侧髋外展肌力量较低和术后1年有跌倒史以防止跌倒。
Background and PurposeSince falls after total hip arthroplasty (THA) cause severe complications such as dislocation and fractures around the femoral stem, it is important to investigate what factors predict of falls. Thus, investigating predictors of falls in patients waiting for THA would be valuable as it lead to more strategic interventions to prevent these problems. The purpose of this study was to evaluate the predictors of falls in patients during the first year after THA.MethodsThis is a prospective cohort study. A total of 157 patients who underwent THA for unilateral hip osteoarthritis were analyzed. The incidence of falls during the first year after THA was monitored, and patients were classified into a "faller" and "non-faller" group. The following factors were compared between the two groups: demographic data (age, sex, body mass index, leg length discrepancy, length of hospital stay, and history of falling), preoperative hip abductor muscle strength, functional performance (single leg stance and maximum walking speed), pain during walking, and physical activity.ResultsOn multivariate logistic regression analysis, preoperative hip abductor muscle strength on the affected side and a history of falling were predictors of falls during the first year after THA. On subsequent receiver operating characteristic curve analysis, preoperative hip abductor muscle strength on the affected side was retained as a significant predictor, with a cut-off strength of 0.46Nm/kg differentiating the faller and non-faller groups with a specificity of 73.6%, specificity of 50.0%, and area under the curve of 70.2%.ConclusionsFinding from the present study suggested that clinicians should focus on low preoperative hip abductor muscle strength on the affected side and a history of falling to prevent falls during the first year after THA.