Frequency and Predictors of Falls Among Adults With Heart Failure: A Prospective Study
Frequency and Predictors of Falls Among Adults With Heart Failure: A Prospective Study
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DOI：
10.1016/j.cardfail.2022.09.011
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发表时间：
2023-03-14
影响因子：
6
通讯作者：
Winters-Stone, Kerri
中科院分区：
文献类型：
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作者：
Denfeld, Quin E.;Goodlin, Sarah;Winters-Stone, Kerri
目的：由于年龄、合并症和虚弱，心力衰竭（HF）成人患者跌倒的风险较高;然而，很少有研究检查HF患者的福尔斯。本研究的目的是量化的频率和预测的福尔斯超过1年的成人HF.Methods：我们进行了一项前瞻性研究的成年人与纽约心脏协会（NYHA）功能等级I-IV HF。在对身体虚弱和临床特征进行基线评估后，参与者在1年内每3个月自我报告一次福尔斯。使用比较统计来确定跌倒者与未跌倒者之间的基线差异。采用逐步负二项回归模型确定1年以上跌倒率的预测因子。结果：样本（n = 111）为63.4 +/- 15.7岁，48%为女性，28%为射血分数正常的HF，41%为体弱。1年内，43例（39%）受试者报告至少1次跌倒，28例（25%）受试者报告2次以上福尔斯跌倒。在跌倒的人中，29人（67%）报告了受伤的福尔斯。跌倒者的体重指数明显高于未跌倒者，更有可能患有NYHA III/IV级、2型糖尿病和射血分数保留的HF，并符合缓慢和体力衰竭标准。下降率升高与2型糖尿病和那些满足缓慢和体力衰竭的标准为physicalfraughty.Conclusions：近40%的成人HF经历了下降1年内。筛查合并症、行动迟缓和疲惫可能有助于识别那些有跌倒风险的人。
Objective: Adults with heart failure (HF) may be at high risk for falling due to age, comorbid-ities and frailty; however, few studies have examined falls in HF. The purpose of this study was to quantify the frequency and predictors of falls over 1 year among adults with HF.Methods: We conducted a prospective study of adults with New York Heart Association (NYHA) functional class I -IV HF. After baseline assessment of physical frailty and clinical char-acteristics, participants self-reported falls every 3 months during 1 year. Comparative statistics were used to identify baseline differences between those who fell vs those who did not. A stepwise negative binomial regression model was used to identify predictors of fall rate over 1 year.Results: The sample (n = 111) was 63.4 +/- 15.7 years old, 48% were women, 28% had HF with preserved ejection fraction, and 41% were frail. Over 1 year, 43 (39%) of participants reported at least 1 fall and 28 (25%) of participants reported 2+ falls. Among those who fell, 29 (67%) reported injurious falls. Those who fell had significantly higher body mass indexes and were more likely to have NYHA class III/IV, type 2 diabetes and HF with preserved ejection fraction and to meet slowness and physical exhaustion criteria than those who did not fall. The fall rate was elevated among those with type 2 diabetes and those meeting the slowness and physical exhaustion criteria for physical frailty.Conclusions: Nearly 40% of adults with HF experienced a fall within 1 year. Screening for comorbidities, slowness and exhaustion may help to identify those at risk for a fall.