Factors associated with hip fracture-related falls among patients with a history of recurrent falling
Factors associated with hip fracture-related falls among patients with a history of recurrent falling
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DOI：
10.1016/j.bone.2008.06.014
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发表时间：
2008-11-01
期刊：
影响因子：
4.1
通讯作者：
Pujol, Ramon
中科院分区：
文献类型：
--
作者：
Formiga, Francesc;Navarro, Margarita;Pujol, Ramon
背景：曾经跌倒过的人再次跌倒的风险更大。我们研究了有复发性跌倒史的人跌倒导致髋部骨折的特点，并将其与有零星跌倒史的人进行了比较。材料与方法：分析6家医院连续收治的1225例因跌倒（指数跌倒）髋部骨折的患者样本特征，确定指数跌倒特征（地点、时间和可能的跌倒原因：内在、外在或综合危险因素）。在指数下降前一年内有三次或三次以上跌倒史（复发性跌倒）的患者被确定为高危填充者；跌倒少于三次的患者被认为是散发性跌倒者。结果：指数下降前一年平均补牙次数为1.7 +/- 6.5次；227名患者（22%）在此期间经历了三次或三次以上的跌倒。大多数指数下降（880例，71.8%）发生在患者家中，232例（18.95%）发生在街头，113例（9.2%）发生在其他地方；大多数（892例，72.9%）发生在白天。多元逐步逻辑回归分析显示，复发性跌倒者的特点是日常生活活动的基线独立性较差，先前诊断为痴呆，更多地使用处方药和更多地使用抗精神病药物。对于频繁的填充物，指数的下降往往与内在因素有关，而不是零星的填充物。结论：在经历跌倒后髋部骨折的患者中，有很大比例的患者在跌倒相关髋部骨折前一年有复发性心力衰竭史。较差的功能和认知状态、多种药物和使用抗精神病药在该亚组患者中更为普遍，而内在因素作为导致跌倒的原因在该亚组中更为常见。由于经常性跌倒是造成这种内在的、非意外的跌倒的较高流行率的原因，应前瞻性地加以解决，以便实施预防战略。(c) 2008爱思唯尔公司版权所有。
Background: People who have Suffered falls are at greater risk of falling again. We Study the characteristics of falls leading to hip fracture in people with a history of recurrent falls, comparing them with those of people with a history of sporadic falling.Materials and methods: Analysis of the characteristics of a sample of 1225 patients consecutively admitted to six hospitals because of a hip fracture secondary to a fall (index fall) - index fall characteristics (location, time and the possible cause of the fall: intrinsic, extrinsic or combined risk factors) were also determined. Patients with a history of three or more falls (recurrent fallers) in the year prior to the index fall were identified as high-risk fillers: those with less than three falls were considered to be sporadic fallers.Results: The Mean number of fills in the year prior to the index fall was 1.7 +/- 6.5; 227 patients (22%) had experienced three or more falls within that period. Most index falls (880, 71.8%) took place at the patient's home, 232 (18.95%) in the street and 113 (9.2%) elsewhere; most (892, 72.9%) took place during daytime. Multiple stepwise logistic regression analysis showed that recurrent fallers were characterized by poorer baseline independence for activities of the daily living, a prior diagnosis of dementia, greater use of prescription drugs and a greater use of neuroleptics. For frequent fillers, the index fall was more often associated with an intrinsic factor than for sporadic fallers.Conclusions: A significant percentage of patients experiencing a fall followed by hip fracture have a history of recurrent failing in the year prior to a fall-related hip fracture. Poorer functional and cognitive status, polypharmacy and the use of neuroleptics are more prevalent in this Subgroup of patients, and intrinsic factors as a cause of the fall are more common in this group Whether these circumstances associated. with recurrent falling are responsible for this higher prevalence of intrinsic, non-accidental falls should be addressed prospectively in order to implement preventive strategies. (c) 2008 Elsevier Inc. All rights ieserved.