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首页> 美国卫生研究院文献>Clinical Interventions in Aging >Clinical differences among the elderly admitted to the emergency department for accidental or unexplained falls and syncope
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Clinical differences among the elderly admitted to the emergency department for accidental or unexplained falls and syncope

机译：因意外或无法解释的跌倒和晕厥入急诊科的老年人的临床差异

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It is difficult to distinguish unexplained falls (UFs) from accidental falls (AFs) or syncope in older people. This study was designed to compare patients referred to the emergency department (ED) for AFs, UFs or syncope. Data from a longitudinal study on adverse drug events diagnosed at the ED (ANCESTRAL-ED) in older people were analyzed in order to select cases of AF, syncope, or UF. A total of 724 patients (median age: 81.0 [65–105] years, 66.3% female) were consecutively admitted to the ED (403 AF, 210 syncope, and 111 UF). The number of psychotropic drugs was the only significant difference in patients with AF versus those with UF (odds ratio [OR] 1.44; 95% confidence interval 1.17–1.77). When comparing AF with syncope, female gender, musculoskeletal diseases, dementia, and systolic blood pressure >110 mmHg emerged as significantly associated with AF (OR 0.40 [0.27–0.58], 0.40 [0.24–0.68], 0.35 [0.14–0.82], and 0.31 [0.20–0.49], respectively), while valvulopathy and the number of antihypertensive drugs were significantly related to syncope (OR 2.51 [1.07–5.90] and 1.24 [1.07–1.44], respectively). Upon comparison of UF and syncope, the number of central nervous system drugs, female gender, musculoskeletal diseases, and SBP >110 mmHg were associated with UF (OR 0.65 [0.50–0.84], 0.52 [0.30–0.89], 0.40 [0.20–0.77], and 0.26 [0.13–0.55]), respectively. These results indicate specific differences, in terms of demographics, medical/pharmacological history, and vital signs, among older patients admitted to the ED for AF and syncope. UF was associated with higher use of psychotropic drugs than AF. Our findings could be helpful in supporting a proper diagnostic process when evaluating older patients after a fall.
机译：很难将老年人的意外跌倒（UFs）与意外跌倒（AFs）或晕厥区分开。本研究旨在比较转诊至急诊科（ED）的房颤，超滤或晕厥患者。为了选择AF，晕厥或UF的病例，对来自在ED（ANCESTRAL-ED）中诊断出的老年人不良药物事件进行纵向研究的数据进行了分析。共有724例患者（中位年龄：81.0 [65-105]岁，女性占66.3％）被连续接受ED（403 AF，210晕厥和111 UF）。房颤患者和超滤患者的精神药物数量是唯一显着差异（几率[OR] 1.44； 95％置信区间1.17–1.77）。将房颤与晕厥进行比较时，女性，肌肉骨骼疾病，痴呆和收缩压> 110 mmHg与房颤显着相关（OR 0.40 [0.27-0.58]，0.40 [0.24-0.68]，0.35 [0.14-0.82]，和瓣膜病和降压药的数量与晕厥显着相关（OR分别为OR 2.51 [1.07–5.90]和1.24 [1.07–1.44]）和0.31 [0.20–0.49]）。在比较超滤和晕厥后，中枢神经系统药物的数量，女性，肌肉骨骼疾病和SBP> 110 mmHg与超滤相关（OR 0.65 [0.50–0.84]，0.52 [0.30–0.89]，0.40 [0.20– 0.77]和0.26 [0.13-0.55]）。这些结果表明，因房颤和晕厥入院急诊的老年患者在人口统计学，医学/药理史和生命体征方面存在特定差异。与AF相比，UF与精神药物的使用更高。我们的发现可能有助于在跌倒后评估老年患者时支持正确的诊断过程。

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