Analysis Of Fall Risk Factors And Build A Prediction Model For Patients With Chronic Obstructive Pulmonary Disease

Purpose To study the risk factors for falls in COPD patients and construct a predictive model for the fall risk of COPD patients.Method Using convenience sampling,from September 2016 to August 2017,455 patients with COPD admitted to the respiratory and gerontology departments of a top-level hospital were selected for the study.Through questionnaires for patients with COPD within 3 days of admission and testing of patient's balance ability,taking the survey as the starting point,followed up after 6months,the subjects were counted for falling within 6 months.SPSS 22.0 was used for data analysis.Measured data were expressed as the mean plus or minus standard deviation,and count data were used as the number of cases and percentages.The influencing factors of the fall in COPD patients and the establishment of the model were analyzed using univariate and multivariate Logistic regression.The regression of variables was gradually backwards,with ? in=0.05 and ? out= 0.10.Logistic regression multicollinearity problem,based on experience highly correlated variables only put a representative or higher overall index.Result 1)a total of 460 questionnaires were issued,the recovery rate was 100%,5 invalid questionnaires,and the effective rate was 98.9%.In the last 455 cases of COPD patients completed the test,of which 73 cases fell and the incidence of falls was 16%.2)In this study,univariate analysis was used to determine the gender(p=0.044),age(p<0.01),marital status(p<0.01),nationality(p<0.01),assistive devices(p<0.01),history of falls in the past 6months(p<0.01),hearing(p<0.01),visual acuity(p<0.01),nocturnal urinary frequency(p<0.01),presence or absence of care(p<0.01),Complications(p<0.01),education(p<0.01),self-care ability(ADL)p<0.01),balance(p<0.01),depression(p<0.01),anxiety(p< 0.01)and the degree of hypoxia(p<0.01),p values were less than 0.05,there was a statistically significant difference between fall and non-fall COPD patients,which was the influencing factor of COPD fall;smoking(p=0.146)was no statistically significant difference between fall and non-fall COPD patients.3)Logistic regression showed that age,history of recent fall in 6 months,the degree of hypoxia,self-care ability(ADL),balance ability(Brief-BESTest)and depression were the influencing factors for the fall of COPD patients.At the same time,a model for predicting falls in patients with COPD was constructed.Conclusion The study found that the risk factors for COPD fall are multiple,including: age,history of fall in recent 6 months,ability to take care of themselves(ADL),balance ability(Brief-BESTest),hypoxia and depression;The predictive model needed to be used together with the Morse Assessment Form to assess the risk of falling in patients with COPD.Future research hopes to study the ability of the degree of hypoxia and the ability of balance(Brief-BESTest)to predict the fall of COPD patients;informations such as the degree of hypoxia can be integrated into the Morse assessment form and reorganized.Targeted fall risk assessment tools for patients with COPD provide a basis for clinical implementation,provide a practical and detailed assessment of the risk of falls in COPD patients,and develop targeted fall prevention measures to reduce adverse events of COPD fall.