老年心房颤动患者跌倒发生率及影响因素的meta分析

doi:10.3969/j.issn.1003-9198.2026.08.007

摘要/Abstract

摘要： 目的系统评价老年心房颤动(atrial fibrillation, AF)患者跌倒发生率及其影响因素,为预防跌倒提供循证依据。方法系统检索中英文数据库(中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、Cochrane library、CINAHL)中关于老年AF患者跌倒发生率和(或)影响因素的文献。检索时限从建库至2025年1月。由2名研究者独立筛选文献、提取数据,采用Stata 16.0软件进行meta分析。结果共纳入9项研究,总样本量为228 821例。Meta分析显示,老年AF患者跌倒发生率为19%(95%CI: 15%～23%)。亚组分析表明,横断面研究报道的跌倒发生率(51%)高于队列研究(10%),随访时间≥3年的研究(22%)高于＜3年的研究(6%)。跌倒影响因素的meta分析显示,胺碘酮的使用是AF患者跌倒的独立危险因素(OR=2.84, 95%CI: 1.42～5.65,P<0.01);苯二氮?类药物、心血管疾病、肌肉骨骼疾病及高龄亦显示出增加跌倒风险的趋势,但关联性无统计学意义(P＞0.05)。结论老年AF患者跌倒发生率较高,胺碘酮为其独立危险因素。临床应加强药物管理与共病评估,将跌倒预防纳入老年AF综合管理策略。

关键词: 心房颤动, 跌倒, 老年人, 发生率, 危险因素, meta分析

Abstract: Objective To systematically evaluate the incidence and expplore the influencing factors of falls in elderly patients with atrial fibrillation (AF), providing evidence-based guidance for fall prevention. Methods Literature on the incidence and/or influencing factors of falls in elderly AF patients was systematically searched in Chinese and English databases (CNKI, Wanfang, VIP, Sinomed, PubMed, Web of Science, Cochrane Library, CINAHL). The search period spanned from database inception to January 2025. Two researchers independently screened and extracted data. Meta-analysis was performed using Stata 16.0. Results Nine studies involving 228 821 elderly AF patients were included. Meta-analysis revealed a pooled fall incidence of 19%(95%CI: 15%-23%)in the elderly AF patients. Subgroup analysis showed higher fall incidence in cross-sectional studies (51%) compared to cohort studies (10%), in studies with follow-up durations ≥3 years (22%) versus <3 years (6%). For influencing factors, meta-analysis identified amiodarone use as an independent risk factor for falls(OR =2.84, 95%CI: 1.42-5.65, P<0.01). Benzodiazepines, cardiovascular diseases, musculoskeletal diseases, and advanced age also showed trends toward increased fall risk, though these associations were not statistically significant (P>0.05). Conclusions Elderly AF patients exhibit a high incidence of falls, with amiodarone identified as an independent risk factor. Medication review and comprehensive comorbidity management should be integrated into fall prevention strategies in AF management.

Key words: atrial fibrillation, falls, aged, incidence, risk factors, meta-analysis

中图分类号:

R 541.75

王雪菲, 康圣琴, 王伟, 王洁, 蔡崔春. 老年心房颤动患者跌倒发生率及影响因素的meta分析[J]. 实用老年医学, 2026, 40(8): 787-792.

WANG Xuefei, KANG Shengqin, WANG Wei, WANG Jie, CAI Cuichun. Meta-analysis of incidence and influencing factors of falls in elderly patients with atrial fibrillation[J]. Practical Geriatrics, 2026, 40(8): 787-792.

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