Accidental Falls

意外跌倒
  • 文章类型: Journal Article
    关于老年人跌倒的社会因素的研究有限。这项研究评估了过去一年跌倒与社会参与之间的关系,儿童的支持,与孩子的关系,社会脆弱。
    参与者是来自SABE的17,687名社区居住的老年人(健康,幸福,和衰老,2015)哥伦比亚调查。协变量包括社会人口统计学特征,环境障碍,精神药物摄入量,视力问题,记忆丧失,多浊度,害怕跌倒。
    在多变量逻辑回归分析中,社交脆弱(与不虚弱)与较高的跌倒几率相关(OR=1.20;95%置信区间[CI],1.10-1.32)。参与组(OR=1.07;95%CI,1.03-1.11),帮助他人(OR=1.04;95%CI,1.02-1.06),或志愿服务(OR=1.09;95%CI,1.01-1.17)也与较高的跌倒几率相关.这些发现得到了部分解释,因为大多数团体参与者居住在城市,他们更容易受到环境障碍的影响。相比之下,接受帮助,感情,和来自儿童的陪伴(OR=0.95;95%CI,0.93-0.97)与较低的跌倒几率相关。此外,与不令人满意的关系相比,与儿童良好的关系与较低的跌倒几率相关(OR=0.75;95%CI,0.66-0.85).
    儿童的支持和与他们的良好关系与较少的跌倒有关;然而,社会脆弱和参与社会群体与更多的跌倒有关。
    UNASSIGNED: There is limited research on social factors related to falls among older adults. This study assessed the association between falls during the past year with social participation, children\'s support, relationship with children, and social frailty.
    UNASSIGNED: Participants were 17,687 community-dwelling older adults from the SABE (Health, Well-being, and Aging, 2015) Colombia survey. Covariates included sociodemographic characteristics, environmental barriers, psychotropic intake, vision problems, memory loss, multimorbidity, and fear of falling.
    UNASSIGNED: In multivariate logistic regression analyses, being socially frail (vs. no-frail) was associated with higher odds of falls (OR=1.20; 95% confidence interval [CI], 1.10-1.32). Participating in groups (OR=1.07; 95% CI, 1.03-1.11), helping others (OR=1.04; 95% CI, 1.02-1.06), or volunteering (OR=1.09; 95% CI, 1.01-1.17) were also associated with higher odds of falls. These findings were partly explained because most group participants reside in cities where they are more exposed to environmental barriers. In contrast, receiving help, affection, and company from children (OR=0.95; 95% CI, 0.93-0.97) was associated with lower fall odds than not receiving it. Moreover, having a good relationship with children was associated with lower odds of falls (OR=0.75; 95% CI, 0.66-0.85) compared to an unsatisfactory relationship.
    UNASSIGNED: Support from children and having a good relationship with them were associated with fewer falls; however, social frailty and participation in social groups were associated with more falls.
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  • 文章类型: Systematic Review
    背景:《世界跌倒预防和管理指南》推荐多因素跌倒风险评估和多领域干预措施。为了成功实施这些干预措施,重要的是要了解影响实施的决定因素。
    方法:在2021年12月3日对该系统综述进行了文献检索,并于2023年4月3日在五个数据库中进行了更新:PubMed(包括MEDLINE),EMBASE(通过Embase.com),Cochrane中央对照试验登记册(通过Cochrane图书馆),WebofScience核心合集和CINAHL(通过EBSCO)。如果研究报告了影响社区老年人实施多因素跌倒风险评估和/或多领域干预措施的决定因素,则包括研究。社论,意见文件,针对一个人群(如帕金森)的系统评价和研究被排除.两名研究人员独立筛选了标题上的文章,摘要和全文。基于敏感性分析评价质量。“实践决定因素综合综合清单”用于对决定因素进行分类。
    结果:纳入29项研究。决定因素分为障碍(n=40)和促进因素(n=35)。必要资源的可用性是报告最多的决定因素。其他通常报告的决定因素是知识,老年人和医疗保健专业人员的意图/信念和动机,将干预措施融入当前的实践,通信,团队和推荐流程以及财务(DIS)激励。
    结论:确定障碍和促进因素对于选择适合具体情况的实施策略至关重要,并提高多因素跌倒风险评估和/或多领域干预措施的吸收和有效性。
    BACKGROUND: Multifactorial falls risk assessment and multidomain interventions are recommended by the World guidelines for falls prevention and management. To successfully implement these interventions, it is important to understand determinants influencing the implementation.
    METHODS: A literature search was conducted for this systematic review on the 3 December 2021 and updated on the 3 April 2023 in five databases: PubMed (including MEDLINE), EMBASE (via Embase.com), Cochrane Central Register of Controlled Trials (via Cochrane Library), Web of Science Core Collection and CINAHL (via EBSCO). Studies were included if they reported on determinants influencing the implementation of a multifactorial falls risk assessment and/or multidomain interventions in community-dwelling older people. Editorials, opinion papers, systematic reviews and studies focusing on one population (e.g. Parkinson) were excluded. Two researchers independently screened the articles on title, abstract and full text. The quality was evaluated based on a sensitivity analysis. \'The Comprehensive Integrated Checklist of Determinants of practice\' was used to categorise the determinants.
    RESULTS: Twenty-nine studies were included. Determinants were classified as barriers (n = 40) and facilitators (n = 35). The availability of necessary resources is the most reported determinant. Other commonly reported determinants are knowledge, intention/beliefs and motivation at the levels of older people and healthcare professionals, fitting of the intervention into current practice, communication, team and referral processes and financial (dis)incentives.
    CONCLUSIONS: Mapping of the barriers and facilitators is essential to choose implementation strategies tailored to the context, and to enhance the uptake and effectiveness of a multifactorial falls risk assessment and/or multidomain interventions.
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  • 文章类型: Journal Article
    这篇综述文章评估了减少衰弱和痴呆住院老年人跌倒的策略的有效性和局限性。它探讨了现有的跌倒预防策略对急性容易跌倒和跌倒相关后果的队列的有效性。在MEDLINE进行了系统的文献检索,Embase,CINAHL,和PsycINFO,采用医学主题词(MeSH)确定2013年至2023年发表的关于患有痴呆和虚弱的住院老年人跌倒预防策略的研究.最初的643条记录被提炼成八篇文章,结构化跨学科床边回合(SIBR)作为一种值得注意的干预措施。SIBR通过促进改进的跨学科交流和护理计划,证明了跌倒的减少。然而,连续会议期间家庭参与的下降表明需要采取策略来维持家庭参与.研究结果提倡以患者为中心的干预措施,以解决该老年人群面临的认知和功能挑战。这篇综述提倡在医院环境中进行全面和包容性的研究,以改善虚弱的老年痴呆症患者的跌倒预防策略。
    This review article assesses the effectiveness and limitations of strategies to reduce falls among hospitalized older adults with frailty and dementia. It explores the efficacy of existing fall prevention strategies for a cohort that is acutely susceptible to falls and fall-related consequences. A systematic literature search was conducted across MEDLINE, Embase, CINAHL, and PsycINFO, employing Medical Subject Headings (MeSH) to identify studies on fall prevention strategies in hospitalized older adults with both dementia and frailty published from 2013 to 2023. The initial 643 records were distilled to eight articles, with Structured Interdisciplinary Bedside Rounds (SIBR) emerging as a notable intervention. SIBR demonstrated a reduction in falls by fostering improved interdisciplinary communication and care planning. However, a decline in family engagement during consecutive sessions suggests a need for strategies to sustain familial involvement. The findings advocate for patient-centered interventions that address the cognitive and functional challenges faced by this cohort of older adults. This review advocates for comprehensive and inclusive research in hospital environments to improve fall prevention strategies for frail older adults with dementia.
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  • 文章类型: Journal Article
    本研究探讨了老年认知障碍患者跌倒的相关因素,与一般老年人群相比,提供不同的证据来预防有认知障碍的老年人跌倒。
    这项研究基于横断面调查,包括124,124名老年人口。数据来源于上海市长期护理保险老年护理统一需求评估。对跌倒的相关因素依次进行二元和多变量logistic回归分析。对有意义的变量进行多变量逻辑回归,按认知功能水平分层。
    在本研究中,过去90天内跌倒的发生率为17.67%。具体变量,如性别(男性),高龄(≥80岁),带电梯(或电梯)的住宅,轻度或中度残疾,睡眠质量(可接受/较差)与跌倒呈负相关,虽然教育水平较高,独自生活,住宅与室内步骤,不整洁的生活环境,MCI或痴呆症,慢性疾病,限制接头,视力受损,尿布的使用是跌倒的正相关因素。与认知功能正常的老年人相比,由于住宅中的无障碍障碍,老年痴呆症患者面临更高的跌倒风险。对于一般老年人来说,外出频率较低和社会交往不良与跌倒呈正相关,而对于有认知障碍的老年人,适度(有时)外出与跌倒呈正相关。患有认知障碍的老年人与慢性病相关的跌倒风险增加,限制接头,和尿布的使用。随着慢性疾病的增加,下降的风险也在上升。
    对于有认知障碍的老年人,和别人一起生活是明智的。此外,创造无障碍的生活环境,保持整洁,可以有效降低跌倒的风险,特别是对于患有MCI或痴呆症的人。最佳户外活动计划应根据老年人的认知功能单独制定。与一般的老年人群相比,有合并症的老年痴呆症患者在预防跌倒时应特别注意。
    UNASSIGNED: This study explored the correlative factors of falls among the older adult with cognitive impairment, to provide distinct evidence for preventing falls in the older adult with cognitive impairment compared with the general older adult population.
    UNASSIGNED: This study was based on a cross-sectional survey, with an older adult population of 124,124 was included. The data was sourced from the Elderly Care Unified Needs Assessment for Long-Term Care Insurance in Shanghai. Binary and multivariable logistic regression analyses were conducted sequentially on the correlative factors of falls. Multivariable logistic regression was performed on variables that were significant, stratified by cognitive function levels.
    UNASSIGNED: The incidence of fall in the past 90 days was 17.67% in this study. Specific variables such as gender (male), advanced age (≥80), residence with a elevator (or lift), mild or moderate disability, quality of sleep (acceptable/poor) were negatively correlated with falls, while higher education level, living alone, residence with indoor steps, unclean and untidy living environment, MCI or dementia, chronic diseases, restricted joints, impaired vision, and the use of diaper were positively correlative factors of falls. Comparing with older adult with normal cognitive functions, older adult with dementia faced a higher risk of falling due to accessibility barrier in the residence. For general older adults, less frequency of going outside and poor social interactions were positively correlated with falls, while for older adult with cognitive impairments, going outside moderately (sometimes) was found positively correlated with falls. Older adults with cognitive impairments have increased fall risks associated with chronic diseases, restricted joints, and the use of diaper. The risk of falling escalated with the greater number of chronic diseases.
    UNASSIGNED: For older adult with cognitive impairments, it is advisable to live with others. Additionally, creating an accessible living environment and maintaining the cleanness and tidiness can effectively reduce the risk of falls, particularly for those with MCI or dementia. Optimal outdoor activity plans should be developed separately based on the cognitive function of older adults. Older adult with dementia who have comorbidities should be paid special attention in fall prevention compared to the general older adult population.
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  • 文章类型: Journal Article
    根本原因分析(RCA)是一个系统过程,可用于以反应性方式分析跌倒发生率,以确定影响因素并提出防止未来跌倒的措施。为了更好地了解跌倒的原因和减少跌倒的有效干预措施,我们对医疗机构中住院患者的RCA和减少跌倒的策略进行了叙述性回顾。
    在这篇叙述性评论中,包括Scopus在内的数据库,ISIWebofScience,科克伦,和PubMed进行检索,以获取相关文献。从2005年1月至2023年3月底检索数据库。JoannaBriggs研究所(JBI)工具用于文章的质量评估。为了分析数据,采用五阶段框架分析方法。
    本研究确定了七篇符合纳入标准的文章。所有选定的研究本质上都是介入性的,并采用了RCA方法来确定住院患者跌倒的根本原因。发现跌倒的根本原因涉及患者相关因素(37.5%),环境因素(25%),组织和过程因素(19.6%),员工和沟通因素(17.9%)。减少跌倒的策略涉及环境措施和实物保护(29.4%),识别,并显示风险原因(23.5%),教育和文化(21.6%),标准跌倒风险评估工具(13.7%),以及监督和监测(11.8%)。
    研究结果确定了住院单位跌倒的根本原因,并为成功执行行动计划提供指导。此外,它强调了考虑医疗机构的独特特征并相应调整干预措施在不同环境中的有效性的重要性.
    UNASSIGNED: Root Cause Analysis (RCA) is a systematic process which can be applied to analyze fall incidences in reactive manner to identify contributing factors and propose actions for preventing future falls. To better understand cause of falls and effective interventions for their reduction we conducted a narrative review of RCA and Strategies for Reducing Falls among Inpatients in Healthcare Facilities.
    UNASSIGNED: In this narrative review, databases including Scopus, ISI Web of Science, Cochrane, and PubMed were searched to obtain the related literature published. Databases were searched from January 2005 until the end of March 2023. The Joanna Briggs Institute (JBI) tool was used for quality assessment of articles. To analyze the data, a five-stage framework analysis method was utilized.
    UNASSIGNED: Seven articles that fulfilled the inclusion criteria were identified for this study. All of the selected studies were interventional in nature and employed the RCA method to ascertain the underlying causes of inpatient falls. The root causes discovered for falls involved patient-related factors (37.5%), environmental factors (25%), organizational and process factors (19.6%), staff and communication factors (17.9%). Strategies to reduce falls involved environmental measures and physical protection (29.4%), identifying, and displaying the causes of risk (23.5%), education and culturalization (21.6%), standard fall risk assessment tool (13.7%), and supervision and monitoring (11.8%).
    UNASSIGNED: the findings identify the root causes of falls in inpatient units and provide guidance for successful action plan execution. Additionally, it emphasizes the importance of considering the unique characteristics of healthcare organizations and adapting interventions accordingly for effectiveness in different settings.
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  • 文章类型: Journal Article
    成人癌症幸存者意外跌倒是一个健康问题。瀑布给癌症幸存者带来经济负担和有害后果。这篇综述旨在综合已发表的研究结果,以探讨癌症幸存者中跌倒与癌症诊断和治疗之间的关系。
    使用四个数据库进行了范围审查(Medline,EMBASE,CINAHL,和Scopus)为2001-2021年。在删除重复项后,鉴定出总共425份摘要。完成了2022-2023年的第二次搜索,确定了80篇摘要。抽象筛选,全文回顾,并进行了数据提取。从全文中提取研究特征和关键发现。提出了描述性数字摘要,并进行了叙事分析。
    共有42篇文章被纳入范围审查中,这些研究表明(1)癌症幸存者中跌倒的患病率增加,(2)存在癌症特异性跌倒危险因素,(3)缺乏癌症特异性跌倒预测工具,和(4)很少有跌倒预防干预措施作为癌症幸存者常规护理的一部分。年轻的癌症幸存者人数不足。癌症幸存者应该意识到他们跌倒的风险,卫生专业人员应确保跌倒预防是日常护理的一部分。
    瀑布与癌症生存有关,随着越来越多的人与癌症一起生活,跌倒变得越来越重要。存在与癌症幸存者相关的癌症特异性跌倒风险因素,这可能导致跌倒风险增加。然而,在癌症幸存者的标准治疗中,可能无法解决跌倒预防问题.这篇评论表明,需要癌症特异性跌倒风险工具,预防跌倒应该是肿瘤治疗的一部分。
    UNASSIGNED: Accidental falls among adult cancer survivors are a health concern. Falls impose economic burdens and detrimental consequences to cancer survivors. This review aimed to synthesize findings from published research to explore the relationship between falls and cancer diagnosis and treatment among cancer survivors.
    UNASSIGNED: A scoping review was conducted using four databases (Medline, EMBASE, CINAHL, and Scopus) for the years 2001-2021. A total of 425 abstracts were identified after removing duplicates. A second search for the years 2022-2023 was completed where 80 abstracts were identified. Abstract screening, full-text review, and data extraction were conducted. Study characteristics and key findings were extracted from full texts. Descriptive numerical summaries were presented, and narrative analyses were performed.
    UNASSIGNED: A total of 42 articles were included in the scoping review which demonstrated (1) an increased prevalence of falls among cancer survivors, (2) the presence of cancer-specific fall risk factors, (3) a lack of cancer-specific fall prediction tools, and (4) few fall prevention interventions as part of usual care among cancer survivors. Younger cancer survivors were underrepresented. Cancer survivors should be aware of their risk of falls, and health professionals should ensure that fall prevention is part of usual care.
    Falls are associated with cancer survivorship and as there are more people living with and beyond cancer, falls are becoming more significant.There are cancer-specific fall risk factors relevant to cancer survivors which can contribute to increased fall risk.However, fall prevention may not be addressed in standard care for cancer survivors.This review suggests cancer-specific fall risk tools are needed, and that fall prevention should be part of oncologic care.
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  • 文章类型: Journal Article
    背景:台湾是一个老龄化社会,痴呆症患者的数量正在迅速增加。由于认知和身体功能的下降,患有痴呆症的老年人不仅逐渐失去了自己完成日常生活任务的能力,但也有更高的跌倒和伤害性跌倒的风险。重要的是要制定干预措施,将认知和运动训练相结合,以促进或维持老年人的认知和身体功能,并降低跌倒的风险。本研究旨在探讨基于认知的棋盘游戏和多成分运动干预对认知功能的可行性和效果。身体健康,老年痴呆症患者的跌倒风险。
    方法:这是一项准实验研究,具有单组前测和后测设计。研究参与者是41名社区居住的轻度至中度痴呆的老年人。他们接受基于认知的棋盘游戏和多成分运动干预,每周一次,持续12周。干预措施包括1小时的运动训练和1小时的认知训练。台湾版蒙特利尔认知评估(MoCA-T)的分数,身体健康,和圣托马斯老年住院患者跌倒风险评估工具(STRATIFY)作为基线和12周后的结果指标进行测量。
    结果:总体MoCA-T评分显着增加(效应大小=0.402),轻度痴呆的参与者(效应大小=0.522)比中度痴呆的参与者(效应大小=0.310)表现出更大的增加。参与者的体能表现有所改善。女性参与者在30秒的椅子站立测试(效果大小=0.483)和8英尺的起跑测试(效果大小=0.437)中表现出显着的改善。跌倒风险评分下降0.05分,变化不明显。
    结论:本研究中使用的基于认知的棋盘游戏和多成分运动干预措施有利于改善老年痴呆症患者的认知功能和身体素质。这些干预措施是可行的,适合在患有轻度认知障碍或痴呆症的社区居住和机构居住的老年人中推广,以延缓认知和身体功能的下降。
    BACKGROUND: Taiwan is an aging society, and the number of people with dementia is rapidly increasing. Due to a decline in cognitive and physical function, older adults with dementia not only gradually lose the ability to complete daily living tasks on their own, but are also at a higher risk of falls and injurious falls. It is important to develop interventions that combine cognitive and exercise training for older adults with dementia to promote or maintain their cognitive and physical functions and reduce their risk of falls. This study aimed to investigate the feasibility and effect of cognitive-based board games and multi-component exercise interventions on cognitive function, physical fitness, and fall risk in older adults with dementia.
    METHODS: This was a quasi-experimental study with a single-group pretest and post-test design. The study participants were 41 community-dwelling older adults with mild to moderate dementia. They received cognitive-based board games and multi-component exercise interventions once a week for 12 weeks. The interventions included 1 hour of exercise training and 1 hour of cognitive training. Scores for the Taiwan version of the Montreal Cognitive Assessment (MoCA-T), physical fitness, and the St. Thomas Risk Assessment Tool for Falling Elderly Inpatients (STRATIFY) were measured as outcome indicators at baseline and after the 12-week period.
    RESULTS: The overall MoCA-T score increased significantly (effect size = 0.402), with participants with mild dementia showing a greater increase (effect size = 0.522) than those with moderate dementia (effect size = 0.310). Participants\' physical fitness performance improved. Female participants exhibited significant improvements in the 30-second chair stand test (effect size = 0.483) and 8-foot up-and-go test (effect size = 0.437). The fall risk score decreased by 0.05 points, the change was not significant.
    CONCLUSIONS: The cognitive-based board game and multi-component exercise interventions used in this study are beneficial for improving cognitive function and physical fitness in older adults with dementia. These interventions are feasible and suitable for promotion among community-dwelling and institution-dwelling older adults with mild cognitive impairment or dementia to delay the decline in cognitive and physical function.
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  • 文章类型: Journal Article
    由学生药剂师领导的预防跌倒教育对老年人社区生活的影响的研究有限,其中包括药物审查,以确定跌倒风险增加药物(FRID)。研究目标是在参加学生药剂师主导的跌倒预防计划(FPP)后,首先评估老年人的知识和行为意图,其次是量化药物审查期间确定的FRID数量。在2022年10月至2023年4月之间,四个独立生活设施和两个高级中心作为编程地点。活动始于学生药剂师提供的以预防跌倒为重点的演讲。与会者自愿填写调查问卷,以评估他们关于预防跌倒的知识和行为意图。提供了可选的药物审查。对药物审查参与者提出了其他调查问题。如果FRID被识别,向该人提供了与开药者分享的文件。在某些活动中提供了预防跌倒宾果游戏,以审查教育内容并吸引那些等待药物审查的人。86名老年人参加了演讲;45人完成了六个地点的药物审查。调查信息可用于65名演示参与者和29名药物审查参与者。编程后,65名参与者中有64名表示,他们对与药剂师或提供者谈论跌倒和服用药物感到很自在。大多数受访者正确选择了哪些药物会增加跌倒风险。29名药物审查参与者中有22人服用了至少一种FRID。通过调查后评估,描述的FPP显示出积极的结果。参与者展示了包括药物在内的跌倒危害知识,并愿意与卫生专业人员讨论跌倒和FRID。这些因素可能导致采取具体干预措施,以避免跌倒及其对老年人的相关健康后果。
    There is limited research on the impact of fall prevention education for older community-living people led by student pharmacists, which includes a medication review to identify Fall Risk-Increasing Drugs (FRIDs). Study objectives were to first assess the knowledge and behavioral intentions of older people after attending a student pharmacist-led fall-prevention program (FPP) and secondly to quantify the number of FRIDs identified during a medication review. Between October 2022 and April 2023, four independent-living facilities and two senior centers served as programming locations. Events began with a fall prevention-focused presentation provided by student pharmacists. Attendees voluntarily filled out surveys to assess their knowledge and behavioral intentions regarding fall prevention. Optional medication reviews were offered. Additional survey questions were asked of medication review participants. If FRIDs were identified, the individual was provided documentation to share with their prescriber. Fall prevention bingo was offered at select events to review educational content and engage those waiting for a medication review. Eighty-six older people attended the presentations; 45 people completed medication reviews across six sites. Survey information was available for 65 presentation attendees and 29 medication review participants. After programming, 64 out of 65 participants stated they felt comfortable speaking to their pharmacist or provider about falls and their medications. Most survey respondents correctly selected which medications increase fall risk. Twenty-two of 29 medication review participants were taking at least one FRID. The FPP described showed positive results through a post-survey evaluation. Participants demonstrated knowledge of fall hazards including medications and a willingness to discuss falls and FRIDs with health professionals. These factors may lead to concrete interventions to avoid falls and their associated health consequences for older people.
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  • 文章类型: Journal Article
    目的:膀胱过度活动症(OAB)最近被认为是跌倒和骨折的独立危险因素。本研究旨在预测有OAB症状的女性患者的骨折风险。
    方法:我们使用骨折风险评估工具(FRAX)评估并比较了新诊断的OAB女性患者与无OAB女性患者的骨折风险,并调查了骨折风险与OAB严重程度之间的关系。
    结果:目前的单中心,横断面研究包括177名女性参与者(79名OAB患者,98没有OAB)。与非OAB组相比,OAB组年龄更大(p=0.033)和更短(p=0.010)。与非OAB组相比,OAB组的高血压(p<0.001)和糖尿病(p=0.011)患者较多,以及较大骨折的风险较高(非OAB组:15.2±13.2%;OAB组:23.6±14.1%;p<0.001)和髋部骨折(非OAB组:6.3±11.0%;OAB组:10.6±10.0%;p=0.007)。此外,患有中度/重度OAB的患者发生两种主要骨折的风险最高(非OAB组:15.2±13.2%,轻度OAB:17.6±12.5%,中度/严重OAB:26.4±14.0%;p<0.001)和髋部骨折(非OAB组:6.3±11.0%,轻度OAB:6.5±7.6%,中度/严重OAB:12.5±10.4%;p<0.001)。在OAB症状中,夜尿症与骨折风险的相关性最强(严重骨折,ρ=0.534;髋部骨折,ρ=0.449;所有p<0.001)。
    结论:重度OAB患者,尤其是严重的夜尿症,应密切监测与及时和积极的症状管理;然而,需要一项纳入OAB症状治疗的介入研究,以确认OAB症状的主动治疗是否能降低老年女性骨折的风险.
    OBJECTIVE: Overactive bladder (OAB) has recently been recognized as an independent risk factor for falls and fractures. This study aimed to predict fracture risk in female patients with OAB symptoms.
    METHODS: We assessed and compared the fracture risk in newly diagnosed female patients with OAB to those without OAB using the Fracture Risk Assessment Tool (FRAX), and investigated the relationship between fracture risk and OAB severity.
    RESULTS: The present single-center, cross-sectional study included 177 female participants (79 with OAB, 98 without OAB). The OAB group was older (p=0.033) and shorter (p=0.010) compared to the non-OAB group. Compared to the non-OAB group, the OAB group had more patients with hypertension (p<0.001) and diabetes mellitus (p=0.011), as well as higher risks for major fractures (non-OAB group: 15.2±13.2%; OAB group: 23.6±14.1%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%; OAB group: 10.6±10.0%; p=0.007). In addition, those with moderate/severe OAB had the most significantly elevated risks for both major fractures (non-OAB group: 15.2±13.2%, mild-OAB: 17.6±12.5%, moderate/sever-OAB: 26.4±14.0%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%, mild-OAB: 6.5±7.6%, moderate/sever-OAB: 12.5±10.4%; p<0.001). Among the OAB symptoms, nocturia had the strongest correlation with fracture risk (major fracture, ρ=0.534; hip fracture, ρ=0.449; all p<0.001).
    CONCLUSIONS: Patients with severe OAB, and particularly severe nocturia, should be closely monitored with timely and aggressive symptom management; however, an interventional study incorporating the management of OAB symptoms is required to confirm whether the proactive management of OAB symptoms reduces the risk of fractures in older females.
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  • 文章类型: Journal Article
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