Analysis of fall risk factors and establishment of risk identification model in elderly stroke patients in Shanghai community

doi:10.16150/j.1671-2870.2021.05.011

Abstract

Abstract:

Objective: To investigate the risk for falling, and fall risk related factors by visiting elderly stroke patients in Shanghai Community Health Service Center. Methods: A total of 230 patients aged from 60 to 90 in the Service Center were randomly selected during 2019 using convenience sampling method. Biochemical indicators were detected,and Morse Fall Risk Assessment Scale was used to assess the falling risk of the subjects. According to the short-form mini-nutritional assessment (MNA-SF method), patients were divided into low-risk and high-risk groups. Multivariate Logistic regression model was used to analyze the falling risk factors, and receiver operator characteristic (ROC) curves was used to evaluate the value of risk factors in predicting falling risk in elderly stroke patients. Results: After baseline analysis, Multivariate Logistic regression analysis showed that MNA-SF (OR=0.338, 95%CI: 0.225-0.508, P<0.001), serum albumin(OR=0.513, 95%CI: 0.396-0.664, P<0.001), hemoglobin (OR=0.908, 95%CI: 0.858-0.961, P=0.001), female(OR=4.407, 95%CI: 1.006-19.311, P=0.049), older age(OR=3.464,95%CI: 1.172-10.235, P=0.025) were risk factors for falling in elderly patients. Among these factors, female,older age (≥80 years old) were the risk factors for falling in elderly stroke patients, besides high score of MNA-SF, elevated level of serum albumin were the protection factors, and elevated hemoglobin was less protective. The area under the curve of ROC curve for the model established with 5 risk factors was 0.925 (P<0.05), which has a good performance for predicting falling in elderly stroke patients. Conclusions: It indicates that female, older age (≥80 years old) are the risk factors for falling, while elevated level of serum albumin,hemogolbin, and good nutrition (MNA-SF≥11) are protective factors for falling in elderly stroke patients. Establishment of risk model will help to identify the patients with high risk of falling, which has practical value.

Key words: Elderly people, Stroke, Falling risk, Nutritional status, Risk factor

CLC Number:

R591

LIU Anping, LING Feng, SHI Chao, SUN Jing. Analysis of fall risk factors and establishment of risk identification model in elderly stroke patients in Shanghai community[J]. Journal of Diagnostics Concepts & Practice, 2021, 20(05): 475-479.

Figures/Tables 4

References 19

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参数	跌倒高风险组	跌倒低风险组	P值
性别			0.025
女	46（20）	69（30）
男	30（13）	85（37）
年龄（岁）			0.049
低龄组（60~69岁）	19（8.3）	56（24.3）
中龄组（70~79岁）	48（20.9）	91（39.6）
高龄组（80~89岁）	9（3.9）	7（3）
腰围	84.8±10.49	84.29±10.01	0.722
臀围	94.8±7.85	94.56±6.4	0.895
BMI（kg/m²）	24.22±3.77	24.18±3.29	0.932
MNA-SF评分	9.20±2.74	12.69±1.69	<0.001
慢性病
高血压	56（24.3）	83（36.1）	0.004
冠心病	14（6.1）	42（18.3）	0.141
糖尿病	18（7.8）	27（11.7）	0.269
痛风	6（2.6）	17（7.4）	0.455
慢性肾病	3（1.3）	8（3.5）	0.929
抑郁症	1（0.4）	6（2.6）	0.507

参数	跌倒高风险组	跌倒低风险组	P值
血清白蛋白（g/L）	52.2±2.65	46.41±4.49	<0.001
血清丙氨酸氨基转移酶（IU/L）	20.62±11.33	21.99±11.92	0.473
血清肌酐（μmol/L）	74.8±15.33	74.38±16.95	0.716
空腹血糖（mmol/L）	5.65±1.68	6.08±2.25	0.122
血红蛋白（%）	144.9±14.42	127.63±12.52	<0.001
糖化血红蛋白（%）	6.14±0.96	6.27±1.02	0.366
同型半胱氨酸（μmol/L）	14.52±8.33	15.01±8.46	0.339
血清高密度脂蛋白胆固醇（mmol/L）	5.18±8.81	6.17±10.9	0.956
血清低密度脂蛋白胆固醇（mmol/L）	2.81±0.9	2.92±0.9	0.353
血清总胆固醇（mmol/L）	4.89±0.98	5.09±1.09	0.156

参数	B	S.E.	Wald	OR（95%CI）	P值
MNA-SF评分	-1.084	0.208	27.231	0.338（0.225~0.508）	<0.001
血清白蛋白	-0.668	0.132	25.646	0.513（0.396~0.664）	<0.001
血红蛋白	-0.096	0.029	11.173	0.908（0.858~0.961）	0.001
女性	1.483	0.754	3.871	4.407（1.006~19.311）	0.049
高龄（≥80岁）	1.242	0.553	5.050	3.464（1.172~10.235）	0.025