Significant fall risk factors in the personal history of in-patients with neurological dis­ease


Authors: M. Miertová 1;  I. Bóriková 1;  M. Grendár 2;  J. Madleňák 1;  M. Tomagová 1;  K. Žiaková 1
Authors‘ workplace: Ústav ošetrovateľstva, Jesseniova LF UK v Martine, Slovensko 1;  Martinské centrum pre biomedicínu (BioMed), Jesseniova LF UK v Martine, Slovensko 2
Published in: Cesk Slov Neurol N 2019; 82(6): 649-654
Category: Original Paper
doi: 10.14735/amcsnn2019649

Overview

Aim: To identify significant fall risk factors in in-patients with neurological dis­ease and to as­sess their predictive value.

Patients and methods: 298 in-patients were included into the prospective study. Fall risk factors were as­ses­sed through analysis of medical records, and fall risk score was identified through the Morse Fall Scale (MFS) screen­­ing dur­­ing admis­sion to the hospital. A multidimensional logistic regres­sion model was used to identify significant fall risk factors. The relative risk of fal­l­­ing was quantified us­­ing the odds ratio (OR). Receiver operat­­ing characteristic (ROC) curve with area under the curve (AUC) was used to as­sess the predictive value of selected fall risk factors.

Results: The most frequent fall risk factors were in the sample (N = 298): gait, balance and mobility disorders (80.9%), pharmacother­apy (57.0%), associated dis­ease (52.7%), and visual impairment (52.3%). The average fall risk score was at medium risk level (MFS score of 44.2 ± 21.2). The highest risk of fal­l­­ing was seen in risk factors: associated dis­ease (OR = 5.452; CI 1.693– 20.033; P = 0.007), medical dia­gnosis G35– G37 (OR = 4.597, CI 1.273– 17.481; P = 0.021), visual impairment (OR = 3.494; CI 1.281– 10.440; P = 0.019), and fall risk level according to the MFS at admis­sion (OR = 1.18; CI 1.135– 1.252; P < 0.001). The predictive value of risk factors expres­sed by the ROC curve was AUC = 0.934.

Conclusions: Identify­­ing fall risk factors is the first step in ef­fective prevent­­ion of this adverse event dur­­ing hospitalization. Targeted fall risk screen­­ing will al­low plan­n­­ing and implementation of interventions to minimize the risk of fal­ling.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


患有神经系统疾病的患者的个人病史中存在重要的跌倒危险因素

目的:确定患有神经系统疾病的住院患者的重大跌倒危险因素,并评估其预测价值。

患者和方法:298名住院患者纳入前瞻性研究。通过对病历的分析来评估跌倒风险因素,并在入院期间通过莫尔斯跌倒量表(MFS)筛查来确定跌倒风险评分。多维逻辑回归模型用于确定重大的跌倒风险因素。使用比值比(OR)量化跌倒的相对风险。受试者工作特征(ROC)曲线及其下的面积(AUC)用于评估所选跌倒危险因素的预测值。

结果:最常见的跌倒风险因素是样本(N = 298):步态,平衡和活动障碍(80.9%),药物治疗(57.0%),相关疾病(52.7%)和视力障碍(52.3%)。平均跌倒风险评分处于中等风险水平(MFS评分为44.2±21.2)。跌倒的最高风险发生于危险因素:相关疾病(OR = 5.452; CI 1.693-20.033; P = 0.007),医学诊断G35-G37(OR = 4.597,CI 1.273-17.481; P = 0.021),视力障碍(OR = 3.494; CI 1.281– 10.440; P = 0.019),并根据入院时的MFS下降风险水平(OR = 1.18; CI 1.135– 1.252; P <0.001)。 ROC曲线表示的危险因素的预测值为AUC = 0.934。

结论:识别跌倒危险因素是有效预防住院期间这种不良事件的第一步。有针对性的跌倒风险筛查将有助于规划和实施干预措施,以最大程度地降低跌倒的风险。

关键词:跌倒–危险因素–筛查–神经科–患者–住院

Keywords:

fall – risk factor – screening – neurology – patient – hospitalization


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