Risk Factors And Related Analysis Of Falls In Elderly Patients With Chronic Diseases

Objective: The elderly are a high-risk group of falls,and death due to falls is one of the main causes of death for the elderly.The elderly with chronic diseases have a higher incidence of falls and are more harmful.This article aims to study the risk factors of falls in elderly patients with chronic diseases,identify the predictive value of different factors for the occurrence of falls,and provide a theoretical basis for preventing falls in elderly patients with chronic diseases,thereby improving the quality of life of elderly patients with chronic diseases.Methods:(1)Research objects: 182 patients who were admitted to the cadre ward of the First Hospital of Jilin University from January 2020 to June 2020 who were ?65 years old and had at least one chronic disease.(2)Research method: According to whether the patients had a history of falls in the past year,they were divided into fall group and non-fall group.Collect the patient's general data,biochemical indicators,visceral fat area,fat-free body weight,skeletal muscle mass,bone mineral content,limb and trunk muscle content and other body composition data,and measure the ultrasound bone density value to perform daily activities(ADL),Cognitive Function(MMSE),Geriatric Depression(GDS),Nutrition(MNA),Charson Comorbidity Index(a CCI)scale assessment.(3)Statistical method: Use SPSS 22.0 software for data processing and statistical analysis.If measurement data obey a normal distribution,it is expressed as mean ± standard deviation,and independent sample t test is used for comparison between groups;otherwise,median(M,(P25,P75)))means that the Wilcoxon rank sum test is used for comparison between groups.Count data is expressed by frequency and percentage,and comparison between groups is performed by chi-square test.Based on the univariate test results,binary Logistic regression analysis was performed on the statistically significant variables.Draw the receiver operating characteristic(ROC)curve to obtain the best cut-off value of the factors affecting falls in elderly patients with chronic diseases.P<0.05 is considered statistically significant.Results: A total of 182 patients were enrolled in this study,with an average age of(78.86±8.98)years,including 117 cases(64.3%)in the non-fall group and 65 cases(35.7%)in the fall group.(1)The age of the fall group is higher than that of the non-fall group(P<0.05),and the incidence of falls in elderly patients with chronic diseases increases with age.(2)Gender,number of chronic diseases,multiple medications,ability of daily living scale(ADL),mini-mental state examination(MMSE),geriatric depresion scale(GDS),mini nutritionaal assessment(MNA),age-adjusted Charson's comorbidity index(a CCI),hemoglobin,albumin The skeletal muscle mass,bone mineral content,limb and trunk muscle content are related risk factors affecting the occurrence of falls in elderly patients with chronic diseases(P<0.05),and the non-fall group has higher body muscle content than the fall group.(3)Comparison of the types of chronic diseases between the two groups.Hypertension is a related risk factor affecting the occurrence of falls in elderly patients with chronic diseases(P=0.036),coronary heart disease,diabetes,chronic obstructive pulmonary disease,chronic renal insufficiency,cerebrovascular disease,malignant tumors,There was no statistical significance in the comparison of blood system diseases,gastritis/peptic ulcer between the two groups(P>0.05).(4)The number of chronic diseases(OR=5.972,95%CI[0.252-5.194],P<0.001),GDS(OR=1.087,95%CI[1.005-1.176],P=0.037)are chronic diseases of the elderly The independent risk factors for the patient to fall were skeletal muscle mass(OR=0.542,95%CI[0.352-0.835],P=0.005),albumin(OR=0.791,95%CI[0.6679-0.922],P=0.003)Is an independent protective factor that affects the occurrence of falls in elderly people with chronic diseases.(5)The results of drawing the ROC curve showed that the area under the curve of chronic diseases(AUC)was 0.783,P<0.001;the cut-off value was 2.5(the actual integer was 3),the sensitivity was 0.646,and the specificity was 0.761;the AUC of GDS was 0.607,P=0.016 The cut-off value is 19.5,the sensitivity is 0.554,and the specificity is 0.684;the albumin content AUC is 0.743,P<0.001;the cut-off value is 33.75g/l,the sensitivity is 0.607,and the specificity is 0.862.The AUC of skeletal muscle mass was 0.745,P<0.001;the cut-off value was 22.05 kg,the sensitivity was 0.786,and the specificity was 0.569.Conclusion:(1)The fall rate of elderly patients with chronic diseases has age-related changes,and the incidence of falls in elderly patients with 3 or more chronic diseases increases.(2)Skeletal muscle mass and depression score are related to the occurrence of falls in elderly patients with chronic diseases,and have certain predictive value.