Risk factors associated with the occurrence of fractures in US nursing homes: Resident and facility characteristics and prescription medications
Risk factors associated with the occurrence of fractures in US nursing homes: Resident and facility characteristics and prescription medications
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DOI：
10.1111/j.1532-5415.2007.01081.x
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发表时间：
2007-03-01
影响因子：
6.3
通讯作者：
Limcangco, M. Rhona
中科院分区：
文献类型：
--
作者：
Spector, William;Shaffer, Thomas;Limcangco, M. Rhona
目的：为了确定是否居民和设施的特点和处方药的影响骨折的发生率在疗养院（NHs）。设计：面板研究与1年的随访。设置：一个全国代表性的样本NHs的医疗费用面板调查（MEPS）。参与者：居民年龄65岁及以上谁是样本NHs在1996年1月1日。测量：健康状况的措施，从设施的记录和抽象使用计算机辅助个人访谈工具。骨折和药物数据每4个月更新一次，以提供全年的信息。从每月给药记录中获得药物数据。骨折的发生率来自医疗记录。使用退伍军人事务部药物分类系统对给药的药物进行分类。设施特征的基础上MEPS调查数据收集从NH sources.RESULTS：在1996年，6%的居民在一个NH在年初经历了骨折在他们的NH停留（S）。居民风险因素包括85岁及以上，从社区入院，表现出激动的行为，并使用轮椅和拐杖或步行者。使用抗惊厥药、抗抑郁药、阿片类镇痛药、铁补充剂、双膦酸盐、噻嗪类和泻药与骨折相关。一个高认证的护士助手比例呈负相关frauds.CONCLUSION：研究结果表明，骨折与居民和设施的特点和处方的做法。它重申了药物审查的重要性，特别关注阿片类镇痛药，抗抑郁药和抗惊厥药，以降低骨折的风险。
OBJECTIVES: To determine whether resident and facility characteristics and prescription medications influence the occurrence of fractures in nursing homes (NHs).DESIGN: Panel study with 1-year follow-up.SETTING: A nationally representative sample of NHs from the Medical Expenditure Panel Survey (MEPS).PARTICIPANTS: Residents aged 65 and older who were in sample NHs on January 1, 1996.MEASUREMENTS: Health status measures were collected from facility records and abstracted using a computer-assisted personal interview instrument. Fracture and drug data were updated every 4 months to provide a full year of information. Drug data were obtained from monthly medication administration records. The occurrences of fractures were obtained from medical records. Administered medications were classified using the Department of Veterans Affairs medication classification system. Facility characteristics were based on MEPS survey data collected from NH sources.RESULTS: In 1996, 6% of residents in a NH at the beginning of the year experienced a fracture during their NH stay(s). Resident risk factors included aged 85 and older, admitted from the community, exhibited agitated behaviors, and used both wheelchair and cane or walker. Use of anticonvulsants, antidepressants, opioid analgesics, iron supplements, bisphosphonates, thiazides, and laxatives were associated with fractures. A high certified nurse aide ratio was negatively associated with fractures.CONCLUSION: The findings indicate that fractures are associated with resident and facility characteristics and prescribing practices. It reaffirms the importance of medication review with special attention on opioid analgesics, antidepressants, and anticonvulsants to reduce the risk of fractures.