Risk factors in falls among the elderly according to extrinsic and intrinsic precipitating causes
Risk factors in falls among the elderly according to extrinsic and intrinsic precipitating causes
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DOI：
10.1023/a:1007636531965
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发表时间：
2000-01-01
影响因子：
13.6
通讯作者：
G치lvez-Vargas, R
中科院分区：
文献类型：
--
作者：
Bueno-Cavanillas, A;Padilla-Ruiz, F;G치lvez-Vargas, R
这项前瞻性队列研究的目的是确定格拉纳达（安达卢西亚，西班牙）两个老年中心的190名老年居民跌倒的危险因素。由于不同类型的瀑布可能与不同的因素有关，因此根据瀑布的沉淀原因进行了分类，分为外在原因和内在原因。计算了入射密度以及粗密度和调整密度的比值。采用Cox比例风险分析计算调整后的发病率密度比。在121个确定的瀑布中，63个（52.1%）有外部沉淀原因，43个（35.5%）有内在沉淀原因，15个瀑布没有确定沉淀原因。外因诱发的跌倒率为每人每年0.39次，而内因诱发的跌倒率为每人每年0.27次。对于外因诱发的跌倒，最重要的危险因素是：年龄、糖尿病、跌倒史、接受过抗精神病药或口服支气管扩张剂的治疗。疾病的数量是一个保护因素。对于有内在诱发原因的跌倒，独立的危险因素是：年龄、糖尿病、痴呆、步态和平衡的改变、以前的跌倒、用过数字黄素、抗精神病药或抗抑郁药的治疗。这些结果表明，对具有内在沉淀原因的跌倒的易感性更容易识别，并且具有更大的控制潜力。
The aim of this prospective cohort study was to identify the risk factors involved in falls in 190 elderly residents of two geriatric centres in Granada (Andalusia, Spain). Because different types of falls may be associated with different factors, falls were classified according to the precipitating cause, either extrinsic or intrinsic. The incidence density and the ratios for crude and adjusted density were calculated. Cox proportional risk analysis was used to calculate adjusted incidence density ratios. Of the 121 falls identified, 63 (52.1%) had a extrinsic precipitating cause, 43 (35.5%) had an intrinsic precipitating cause, and no precipitating cause was determined in 15 falls. The rate of falls with an extrinsic precipitating cause was 0.39 per person per year, while falls with an intrinsic precipitating cause showed a frequency of 0.27 per person per year. For falls with an extrinsic precipitating cause, the most significant risk factors were: age, diabetes mellitus, a history of falling, and treatment with neuroleptics or oral bronchodilators. The number of illnesses acted as a protective factor. For falls with an intrinsic precipitating cause, the independent risk factors were: age, diabetes, dementia, alterations of gait and balance, previous falls, and treatment with digitalins, neuroleptics or antidepressants. These results suggest that the susceptibility to a fall with an intrinsic precipitating cause is easier to identify and has a greater potential for being controlled.