Morse跌倒风险评估模型对预测足踝外科手术后跌倒的风险度分级探讨及跌倒危险因素分析  

Discussion on Morse Fall Risk Assessment Model for Predicting Fall Risk Classification after Foot and Ankle Surgery and Analysis of Fall Risk Factors

作　　者：王欣[1] 王宏[1] 许蕊凤[2] 张晓乐[1] 李蕊[1] 毕桂娟 焦晨[1] Wang Xin;Wang Hong;Xu Ruifeng;Zhang Xiaole;Li Rui;Bi Guijuan;Jiao Chen(Department of Sports Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Orthopedics,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院运动医学科,北京100191 [2]北京大学第三医院骨科,北京100191

出　　处：《足踝外科电子杂志》2021年第1期11-15,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：北京大学第三医院护理基金(Y79463-04);北大医学交叉研究种子基金和中央高校基本科研业务费资助(BMU2020MX020)。

摘　　要：目的回顾性验证Morse跌倒风险评估模型预测足踝外科手术后患者跌倒风险的有效性,探讨预防足踝外科手术后患者发生跌倒的风险度分级。方法采用病例对照研究设计,连续性收集2010年1月—2018年5月北京大学第三医院骨科和运动医学科收治的足踝外科手术后发生跌倒的30例患者作为跌倒组,随机选择同时期入院的30例未发生跌倒的足踝外科手术后患者作为对照组。按照Morse风险跌倒评估量表对两组患者进行跌倒风险评估、危险度分级,探讨危险度分级与跌倒风险的关系。结果跌倒组Morse评分为(38.33±21.79)分,明显高于对照组的(23.50±22.48)分,差异有统计学意义。跌倒组患者的风险评级中高度风险所占比例最高,而中度风险以上的患者合计占73.33%。对照组患者中低度风险比例最高,两组的跌倒分级差异有统计学意义(P<0.05)。logistic回归分析显示跌倒的发生还与高龄、麻醉方式相关(P<0.05)。敏感度与特异度分析显示:Morse评分的敏感度和特异度在诊断界值为20分和37.5分时比在25分和45分时有更好的区分度。结论Morse跌倒风险评估模型可以有效预测跌倒风险,但可能存在其他危险因素,需纳入评估,且危险度分级的分值划分有待进一步验证。Objective To retrospectively verify the effectiveness of the Morse fall risk assessment model in predicting the risk of falls in patients after foot and ankle surgery,and to explore the risk classification for preventing patients from falling after foot and ankle surgery.Methods A case-control study design was adopted.From January 2010 to May 2018,30 patients who fell after foot and ankle surgery in the Department of Orthopedics and Sports Medicine of Peking University Third Hospital were continuously collected as the case group.Thirty patients admitted to the hospital who did not fall after ankle surgery served as a control group.According to the Morse Risk Fall Assessment Scale,the two groups of patients were evaluated for fall risk and risk level,and the relationship between risk level and fall risk was explored.Results The Morse score of the fall group was significantly different from that of the control group,and the Morse score of the fall group(38.33±21.79)was significantly higher than that of the control group(23.50±22.48).The high risk accounted for the highest proportion of the risk rating of the fall group,while the patients with moderate risk or higher accounted for 73.3%.The proportion of low-risk patients in the control group was the highest,and the two groups had statistically different levels of falls(P<0.05).Logistic regression analysis showed that the occurrence of falls was also related to advanced age and anesthesia(P<0.05).Sensitivity and specificity analysis showed that the sensitivity and specificity of Morse score were better at the diagnostic cutoff value of 20 points and 37.5 points than at 25 points and 37.5 points.Conclusion It is suggested that the fall risk assessment model based on Morse can effectively predict the risk of fall,but there may be other risk factors that need to be included in the assessment,and the score division of risk classification needs further verification.

关 键 词：足踝外科手术 跌倒 危险因素 跌倒风险 评估量表 

分 类 号：R587.2[医药卫生—内分泌]