住院老年患者跌倒危险因素的meta分析

Risk factoes of falls in hospitalized elderly patients:a meta-analysis

目的通过meta分析对住院老年患者跌倒的危险因素进行系统分析。方法通过检索中外文数据库中国学术期刊全文数据库(CNKI)、万方数据库、维普数据库,英文数据库pubmed、Embase、web of science、Cochrane Library,筛选出符合纳入标准的文献,应用Stata 12.0对研究数据进行分析,计算各危险因素的合并比值比OR值与95%CI。结果 8篇文献符合纳入标准,累计病例组1 385例,对照组22 039例,共纳入危险因素17个。住院老年患者跌倒危险因素的合并OR值和95%CI分别为:年龄1.04(0.93~1.15)、性别(女)1.02(0.53~1.50)、跌倒史5.17(3.14~7.19)、意识障碍2.49(0.20~4.77)、视力障碍1.55(0.86~2.25)、失眠9.13(-5.57~23.84)、眩晕2.04(1.22~2.86)、关节疼痛0.44(-0.02~0.90)、肢体乏力5.78(1.10~10.47)、步态不稳2.94(1.66~4.22)、体位性低血压2.82(-1.80~7.45)、抗精神病药物1.62(0.94~2.31)、降压药1.20(0.67~1.73)、苯二氮卓类药物21.20(-19.00~61.39)、利尿剂0.72(0.46~0.97)、抗心律失常药物0.81(0.32~1.30)。结论住院老年患者跌倒的危险因素包括年龄、性别、跌倒史、意识障碍、视力障碍、眩晕、肢体乏力、步态不稳、服用抗精神病药物、降压药、降糖药、利尿剂、抗心率失常药物,而失眠、关节疼痛、体位性低血压、使用苯二氮晫类药物对住院老年患者跌倒的影响仍有待进一步研究。

[Objective] To systematically analyze the risk factors of falls in hospitalized elderly patients by meta-analysis.[Methods] According to the data of CNKI,Wanfang database,VIP database,English database pubmed,Embase,web of science and Cochrane Library,the documents that met the inclusion criteria were screened,and the data were analyzed by Stata12.0.The pooled odds ratio（OR） and 95% confidence interval（95%CI） of each risk factor were calculated.[Results] Eight articles met the inclusion criteria,with a total of 1 385 cases in the case group and 22 039 cases in the control group.A total of 17 risk factors were included.The pooled OR and 95%CI of the risk factors of falls in hospitalized elderly patients were age 1.04（0.93-1.15）,gender（female） 1.02（0.53-1.50）,history of fall 5.17（3.14-7.19）,disturbance of consciousness 2.49（0.20-4.77）,visual impairment 1.55（0.86-2.25）,insomnia 9.13（-5.57-23.84）,dizziness 2.04（1.22-2.86）,joint pain 0.44（-0.02-0.90）,limb weakness5.78（1.10-10.47）,unsteady gait 2.94（1.66-4.22）,orthostatic hypotension 2.82（-1.80-7.45）,antipsychotics 1.62（0.94-2.31）,antihypertensive drugs 1.20（0.67-1.73）,benzodiazepines 21.20（-19.00-61.39）,diuretics 0.72（0.46-0.97） and antiarrhythmic drugs 0.81（0.32-1.30）.[Conclusion] The risk factors of falls in hospitalized elderly patients include age,gender,history of fall,disturbance of consciousness,visual impairment,dizziness,limb weakness,unsteady gait,antipsychotics,antihypertensive drugs,hypoglycemic drugs,diuretics,antiarrhythmic drugs.While the influence of insomnia,joint pain,orthostatic hypotension and benzodiazepines on falls of hospitalized elderly patients still need further study.