Background

Falls are frequent in people with chronic obstructive pulmonary disease (COPD) and related to increased morbidity, mortality, and health care costs in older adults. This systematic review aims to synthesise the falls outcomes and to examine risk factors for falls in the COPD literature.

Methods

The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO: CRD42015017257). Searches were updated and operated in five electronic databases in December 2019 for studies reporting falls outcomes and risk factors in people with COPD. Meta-analyses were conducted on the prevalence of fallers and frequent fallers. Quality assessment appraised the risk of bias of included articles.

Results

Twenty-three studies met the eligibility criteria and were retained after the full-text review. In the meta-analyses, the pooled prevalence of COPD fallers was 30% (95%CI 19%–42%), and the pooled prevalence of frequent fallers (≥2 falls in the analysed period of occurrence) was 24% (95%CI 2%–56%). The falls incidence rate in stable COPD varied from 1.17 to 1.49 falls/person-year. Different study methodologies were identified. Age, female gender, falls history, the number of medications, comorbidities, coronary heart disease, use of supplemental oxygen, impaired balance performance and smoking history were risk factors for falls identified in stable COPD.

Conclusion

Prevalence of fallers, frequent fallers, and falls incidence rate have been reported in the COPD literature using a varying methodology. People with stable COPD present with ageing and disease-related risk factors for falls. Further research using the recommended prospective recording is needed in COPD.

中文翻译：

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慢性阻塞性肺疾病患者跌倒的患病率和危险因素：系统评价

背景

慢性阻塞性肺病 (COPD) 患者经常跌倒，这与老年人的发病率、死亡率和医疗保健费用增加有关。本系统评价旨在综合跌倒结果并检查 COPD 文献中跌倒的危险因素。

方法

该方案已在前瞻性系统评价注册 (PROSPERO: CRD42015017257) 中注册。2019 年 12 月，在五个电子数据库中更新和运行了搜索报告，用于报告 COPD 患者跌倒结果和危险因素的研究。对跌倒者和频繁跌倒者的流行率进行了荟萃分析。质量评估评估纳入文章的偏倚风险。

结果

23 项研究符合资格标准，并在全文审查后保留。在荟萃分析中，COPD 跌倒者的汇总患病率为 30%（95%CI 19%–42%），频繁跌倒者（在分析的发生期间跌倒 2 次以上）的汇总患病率为 24%（95%置信区间 2%–56%）。稳定期 COPD 的跌倒发生率为 1.17 至 1.49 次跌倒/人年。确定了不同的研究方法。年龄、女性、跌倒史、用药次数、合并症、冠心病、补充氧气的使用、平衡能力受损和吸烟史是稳定型 COPD 患者跌倒的危险因素。

结论

COPD 文献中使用不同的方法报告了跌倒者、频繁跌倒者和跌倒发生率的患病率。患有稳定期 COPD 的人存在衰老和与疾病相关的跌倒危险因素。COPD 需要使用推荐的前瞻性记录进行进一步研究。