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目的探索城市社区居住的老年脑卒中患者跌倒的危险因素,为相关部门制定有针对性的干预措施提供依据。方法采用随机抽样的方法,选择居住在上海市长宁区的60岁及以上脑卒中患者1 498例,应用自行设计的调查表对过去1年的跌倒发生情况和可能与跌倒有关的危险因素进行入户调查。对危险因素分别进行单因素和二分类多因素logistic回归分析。结果 60岁及以上脑卒中患者过去1年的跌倒发生率为28.9%,非卒中发作跌倒发生率为27.8%。以非卒中发作跌倒为因变量,单因素分析发现,年龄增加(OR=1.045)、有后遗症(OR=1.747)、服用镇静安眠药(OR=1.599)、视力不良(OR=1.732)、听力不良(OR=1.846)、睡眠质量不良(OR=1.775)、使用拐杖(OR=2.297)、使用轮椅(OR=2.284)、经常感觉心情不好(OR=1.888)等25个危险因素,经χ2检验后差异均有统计学意义(P<0.01)。多因素logistic回归分析显示,进入模型的危险因素有年龄、睡眠质量、使用拐杖、担心跌倒而限制活动和平衡能力或日常生活能力,认为跌倒可以预防是保护因素。结论社区脑卒中患者跌倒发生率高,多种因素均能增加患者的跌倒风险,可根据危险因素采取针对性干预措施。
Objective To explore the risk factors of falls in elderly stroke patients living in urban communities and provide evidences for relevant departments to make targeted interventions. Methods A total of 1 498 stroke patients aged 60 years and above living in Changning District of Shanghai were selected by random sampling. The self-designed questionnaires were used to investigate the incidence of falls and possible risk factors associated with falls in the past year Household survey. Univariate and dichotomous multivariate logistic regression analyzes were performed on risk factors. Results The incidence of falls in the 60-year-old and above stroke patients was 28.9% in the past year and 27.8% in non-stroke patients. Unilateral stroke was the independent variable. Univariate analysis showed that age (OR = 1.045), sequelae (OR = 1.747), sedative hypnotics (OR = 1.599), poor vision (OR = 1.732) OR = 1.846), poor sleep quality (OR = 1.775), crutches (OR = 2.297), wheelchair (OR = 2.284), and other 25 risk factors such as poor mood (OR = 1.888) The differences were statistically significant (P <0.01). Multivariate logistic regression analysis showed that the risk factors for entering the model were age, quality of sleep, use of crutches, fear of falls and limitation of activity and balance ability or daily living ability, and that the fall could prevent as a protective factor. Conclusion The incidence of falls in community stroke patients is high. Many factors can increase the risk of falls in patients. Targeted interventions can be taken according to risk factors.