Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study.
Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study.
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DOI：
10.3390/ijerph19053123
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发表时间：
2022-03-07
影响因子：
--
通讯作者：
Narumoto J
中科院分区：
文献类型：
--
作者：
Oya N;Ayani N;Kuwahara A;Kitaoka R;Omichi C;Sakuma M;Morimoto T;Narumoto J
药物的使用会增加疗养院中福尔斯跌倒和受伤的风险，给居民带来重大风险。我们进行了一项为期一年的回顾性队列研究，以确定在四家日本疗养院（280张床位）中药物相关性福尔斯损伤和非损伤的发生率。我们评估了福尔斯和跌倒相关损伤的潜在危险因素之间的关系，同时考虑了众所周知的风险，如ADL和慢性合并症。通过合作回顾护理记录，我们招募了459名住院医师（平均年龄87岁），并确定了645例福尔斯，包括146例损伤性福尔斯和16例需要住院治疗的严重损伤性福尔斯，发病率分别为：19.5、4.4、0.5/100住院医师月。药物影响了大约四分之三的福尔斯跌倒，其中超过80%是精神药物。定期服用≥5种药物是初次福尔斯（HR 1.33：CI 1.00-1.77，p = 0.0048）和福尔斯后损伤（OR 2.41：CI 1.30-4.50，p = 0.006）的风险因素。我们对有损伤和无损伤的福尔斯跌倒发生率的研究结果与西方国家相似，在西方国家，精神药物的使用影响了>50%的福尔斯跌倒。停止不必要的药物使用，同时与医生和药剂师评估患者的ADL和合并症，可能有助于避免在疗养院福尔斯。
Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We evaluated the relationship between potential risk factors for falls and fall-related injuries while considering well-known risks such as ADLs and chronic comorbidities. By collaboratively reviewing care records, we enrolled 459 residents (mean age, 87) and identified 645 falls, including 146 injurious falls and 16 severe injurious falls requiring inpatient care, incidence: 19.5, 4.4, 0.5 per 100 resident-months, respectively. Medication influenced around three-quarters of all falls, >80% of which were psychotropic drugs. Regularly taking ≥5 medications was a risk factor for the initial falls (HR 1.33: CI 1.00–1.77, p = 0.0048) and injuries after falls (OR 2.41: CI 1.30–4.50, p = 0.006). Our findings on the incidence of falls with and without injury were similar to those in Western countries, where the use of psychotropic medication influenced >50% of falls. Discontinuing unnecessary medication use while simultaneously assessing patient ADLs and comorbidities with physicians and pharmacists may help to avoid falls in nursing homes.
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影响因子：
4.4
作者：
Ayani N;Sakuma M;Morimoto T;Kikuchi T;Watanabe K;Narumoto J;Fukui K
通讯作者：
Fukui K
影响因子：
39.2
作者：
RUBENSTEIN, LZ;JOSEPHSON, KR;ROBBINS, AS
通讯作者：
ROBBINS, AS
DOI：
10.1016/j.jamda.2016.07.004
发表时间：
2016-12-01
影响因子：
7.6
作者：
Cox, Claudia A.;van Jaarsveld, Heike J.;van der Linden, Carolien M. J.
通讯作者：
van der Linden, Carolien M. J.
影响因子：
6.7
作者：
NARANJO, CA;BUSTO, U;GREENBLATT, DJ
通讯作者：
GREENBLATT, DJ
影响因子：
6.3
作者：
Rawle, Mark James;Cooper, Rachel;Richards, Marcus
通讯作者：
Richards, Marcus