摘要
目的:探索导致老年患者住院期间反复跌倒的相关因素,焦点在其认知损伤的特点,目的是探索可借鉴的管理经验。方法:回顾性地研究了在澳大利亚新南威尔士州Bankstown-Lidcombe医院老年科住院治疗期间发生跌倒的患者,其中住院期间跌倒1次以上的70例、1次的269例,并随机抽取没发生过跌倒的70例为对照组。同时,分析了部分患者的简易智能检查量表(MMSE)总分和各亚项目分数。结果:住院老年患者反复跌倒的独立危险因素是痴呆、脑卒中、房颤和住院时间>5周,保护性因素有英语背景。反复跌倒的患者的MMSE分值明显低于单次跌倒和未发生跌倒的患者(分别为17.3±6.7,20.2±6.2,24.0±5.1,P<0.01),反复跌倒患者在"瞬间记忆"、"注意力和计算力"和"视空间结构"方面分值明显低于单次跌倒患者。结论:认知功能障碍是住院老年患者反复跌倒的主要原因,尤其是在瞬间记忆、延时记忆和视空间结构方面。老年人住院期间跌倒应规范管理,预防为主,尤其是认知功能损伤的患者。
Objective：To determine the factors associated with recurrent falls in aged inpatients at a tertiary hospital in Australia, with a focus on the cognitive domains of recurrent fallers and to explore the management experience for reference.Method：A retrospective study was proceeded on the characteristics of 70 aged inpatients who sustained≥1 falls, 269 patients who sustained once fall; and 70 non-fallers during their hospital admission.The available mini-mental state examination （MMSE） scores were analyzed.Result：The independent risk factors for recurrent falls were the history of dementia, stroke, or atrial fibrillation, and the lengths of patients staying in hospital were 5 weeks.The protective factor for falls were the patients＇ a-bility of speaking English.Recurrent fallers had significantly lower MMSE scores compared with once fallers and non-fallers （17.3±6.7, 20.2±6.2, 24.0±5.1 respectively, P0.01）; and the proportion of recurrent fallers who had MMSE18 was larger than that in the other two groups （54.1%, 34.4% and 10.8% respectively, P0.01）.In addition, patients with recurrent falls were more likely to have significantly lower scores in the ＇registration＇, ＇attention and calculation＇, ＇recall＇ and ＇praxis＇ domains of MMSE than the once fallers.Conclusion：Cognitive impairment particularly in short-term memory, recall and visuospatial perception domains, may contribute to recurrent falls in the inpatient population.
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2010年第8期740-743,共4页
Chinese Journal of Rehabilitation Medicine
关键词
住院患者
老年人
反复跌倒
认知障碍
inpatient
the elderly
recurrent fall
cognitive impairment
