Development and validation of a Fall Risk Assessment Index for dialysis patients
Development and validation of a Fall Risk Assessment Index for dialysis patients
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DOI：
10.1007/s10157-017-1431-8
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发表时间：
2018-02-01
影响因子：
2.3
通讯作者：
Sato, Takashi
中科院分区：
文献类型：
--
作者：
Kono, Kenichi;Nishida, Yusuke;Sato, Takashi
透析患者通常由于尿毒症性肌肉减少症、蛋白质能量消耗（PEW）和分析性低血压（IDH）的发生率而身体机能低下，这些都是跌倒的危险因素。本研究的目的是开发一种包含症状的评估形式，以预测透析患者的高灵敏度跌倒。总共有251名接受维持性血液透析治疗的患者参加了这项研究，每周三次。记录患者的人口统计、营养不良和炎症状况、透析治疗管理情况、身体功能和表现以及有关跌倒的询问。Cox比例风险分析评估了跌倒的影响。计算出的风险比被转换为加权分数，使用近似的0.5倍，并创建了一个评估表格，我们称之为透析跌倒风险指数（DFRI）。采用Kaplan-Meier生存分析、log-rank检验和Cox比例风险分析来评价DFRI的有效性。DFRI由7个项目组成，共12分。DFRI的预测效度包括四分位数3和四分位数4的风险比分别为2.65和3.84，与四分位数1作为参考点相比。DFRI分界点在其他筛选指标中具有最高的敏感性和特异性。目前的研究包括开发一种新的评估表格，包括终末期肾脏疾病的症状，以预测透析患者的跌倒。
Dialysis patients often have low physical performance due to uremic sarcopenia, protein energy wasting (PEW), and incidence intradialytic hypotension (IDH), which are indicated as risk factors for falling. The objective of this study was to develop a symptom-encompassing evaluation form to predict falls with high sensitivity for dialysis patients.A total of 251 patients who had been receiving maintenance hemodialysis therapy three times a week were enrolled in the study. Demographics, malnutrition and inflammatory status, dialytic therapeutic management situation, physical function and performance, and inquiries about falling were recorded. The Cox proportional hazards analysis evaluated the impact of falls. Calculated hazard ratios were converted to weighted scores, using approximate multiples of 0.5 and an evaluation form was created, which we called the Dialysis Fall Risk Index (DFRI). Kaplan-Meier survival analyses with the log-rank test and the Cox proportional hazard analysis were performed to evaluate the validity of the DFRI.The DFRI consisted of seven items and a total of 12 points. The predictive validity of DFRI included hazard ratios for quartile 3 and 4 of 2.65 and 3.84, respectively, compared with quartile 1 as a reference point. The cut-off point of the DFRI showed the highest sensitivity and specificity among other screening indices.The present study included the development of a new evaluation form that encompasses symptoms of end-stage kidney disease to predict falls in dialysis patients.