老年人跌倒风险评估模型的构建

Construction of a risk assessment model for falls in the elderly

目的探讨构建适用于中国老年人跌倒风险综合评估模型。方法利用Me⁃ta分析再评价结合结构式专家咨询筛选出跌倒危险因素和OR值纳入模型,建立lo⁃gistic回归综合评估模型。结果模型最终纳入32个指标:年龄、跌倒史、运动、使用助行器、步态异常、平衡异常、睡眠障碍、认知障碍、衰弱、尿/便失禁、头晕眩晕、视力障碍、听力障碍、下肢关节炎、脑卒中史、糖尿病、体位性低血压、帕金森、痴呆、贫血、心律失常、抑郁、足部问题、抗精神病药、抗抑郁药、催眠镇静类药物、抗癫痫药、阿片类药物、髓袢利尿剂、强心苷类、降糖药、泻药。结论本研究以Meta分析为基础,结合专家意见建立了中国老年人跌倒风险评估模型,有效避免了样本量偏少的问题,模型基于循证医学依据,为跌倒高危人群筛查与干预实施提供了依据和指导。

Objective To explore the establishment of a comprehensive risk assessment mod⁃el for falls in the elderly people in China.Methods Meta-analysis reappraisal combined with structured expert consultation were used to screen out risk factors for falls and OR values into the model,and established a logistic regression comprehensive evaluation model.Results The mod⁃el finally included 32 indicators:age,history of falls,exercise,use of walking aids,Abnormal gait,abnormal balance,sleep disturbance,cognitive impairment,frailty,urinary/fecal inconti⁃nence,dizziness/vertigo,visual impairment,hearing impairment,lower extremity arthritis,His⁃tory of stroke,diabetes,orthostatic hypotension,Parkinson's,dementia,anemia,arrhythmia,depression,foot diseases,antipsychotics,antidepressants,hypnotic sedatives,antiepileptics,opioids,loop diuretics,cardiac glycosides,hypoglycemic agents,laxatives.Conclusion Based on meta-analysis and experts'opinions,this study established a risk assessment model for falls in elderly people in China,which effectively avoided the problem of small sample size.The model was based on evidence-based medicine,and provided a basis and guidance for the screening and intervention of high-risk groups.