摘要
目的 系统评价维持性血液透析(MHD)患者发生跌倒的危险因素.方法 计算机检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library 和 Embase 中关于MHD患者发生跌倒的危险因素的研究,使用RevMan 5.4软件进行meta分析.检索时限为建库至2023年7月1日.结果 最终纳入19篇研究,总样本量为107 641例.17项因素中,10项影响因素(P＜0.05),包括危险因素:年龄[OR=1.03,95％CI(1.00,1.05),P=0.002]、糖尿病[OR=1.97,95％CI(1.42,2.73),P＜0.001]、透析龄[OR=2.23,95％CI(1.68,2.98),P＜0.001]、透析相关低血压(IDH)[OR=1.93,95％CI(1.88,1.97),P＜0.001]、衰弱[OR=1.64,95％CI(1.43,1.88),P＜0.001]、跌倒史[OR=1.71,95％CI(1.43,2.05),P＜0.001]、甲状旁腺功能亢进[OR=1.31,95％CI(1.15,1.49),P＜0.001]、听力或视觉障碍[OR=1.58,95％CI(1.24,2.01),P=0.002]、平衡与步态[OR=2.23,95％CI(1.54,3.25),P＜0.001];保护因素:血清白蛋白(Alb)[OR=0.89,95％CI(0.83,0.95),P=0.001].结论 年龄、糖尿病、透析龄、IDH、衰弱、跌倒史、甲状旁腺功能亢进、听力或视觉障碍及平衡与步态均为MHD患者跌倒的危险因素,Alb为MHD患者跌倒的保护因素.
Abstract
Objective To systematically evaluate the risk factors of falls in maintenance hemodialysis(MHD)pa-tients.Methods The studies on the risk factors of falls in MHD patients from China National Knowledge Infrastruc-ture(CNKI),Wanfang,VIP,CBM,PubMed,Web of Science,Cochrane Library,and Embase were searched by computer,and RevMan 5.4 software was used for meta-analysis.The search time limit was from the establishment of the database to July 1,2023.Results A total of 19 studies were included,with a total sample size of 107,641.A-mong the 17 factors,10 influencing factors(P＜0.05)included(1)Risk factors:Age(OR=1.03,95％CI was from 1.00 to 1.05,P=0.002),diabetes(OR=1.97,95％CI was from1.42 to 2.73,P＜0.001),age of dialysis(OR=2.23,95％CI was from 1.68 to 2.98,P＜0.001),related dialysis hypotension(IDH;OR=1.93,95％CI was from 1.88 to 1.97,P＜0.001),frailty(OR=1.64,95％CI was from 1.43 to 1.88,P＜0.001),history of falls(OR=1.71,95％CI was from 1.43 to 2.05,P＜0.001),hyperparathyroidism(OR=1.31,95％CI was from 1.15 to 1.49,P＜0.001),hearing or visual impairment(OR=1.58,95％CI was from 1.24 to 2.01,P=0.002),balance and gait(OR=2.23,95％CI was from 1.54 to 3.25,P＜0.01);(2)Protective factors:serum albumin(Alb;OR=0.89,95％CI was from 0.83 to 0.95,P=0.001).Conclusion Age,diabetes,age of dialysis,IDH,frailty,history of falls,hyperparathyroidism,hearing or visual impairment,and balance and gait were all risk factors for falls in MHD patients,and Alb was a protective factor for falls in MHD patients.
基金项目
河南省中医药文化与管理研究项目(TCM2023009)
教育部学位与研究生教育研究课题(MSC8)
维普
万方数据