【Objective】This study aimed to investigate whether the severity of cognitive impairment, as determined from the total score of Cognitive-related Behavioral Assessment（CBA）, which is based on behavioral observations, is associated with falls in patients admitted to rehabilitation wards.
【Methods】This retrospective cohort study included patients admitted to the recovery unit between April 2019 and March 2021. CBA was used to assess cognitive impairment, and falls were investigated using the records of the Falls and Falls Incident Report Form in the electronic medical record. To test the association between CBA on admission and falls early in hospitalization, falls within one month of admission were included in the tally, and those with falls within one month of admission were included in the fall group, while those without falls were included in the non-fall group. From the cross-tabulation of the two groups of falls and non-falls and CBA severity, a residual analysis was performed to identify the combination that deviated significantly from the expected values, and the adjusted residuals were calculated. Logistic regression analysis was performed with the presence of falls within one month of admission as the dependent variable and CBA severity as the independent variable.
【Results】This study included 879 patients, with a median age of 76 years（interquartile range：65-83）years. The fall group（68 patients）had a higher proportion of patients with the most severe to moderate CBA severity than the non-fall group（811 patients）. CBA severity in the fall group was as follows：most severe, 4（5.9 ％）；severe, 24（35.3 ％）；moderate, 24（35.3 ％）；mild, 11（16.2 ％）；and normal, 5（7.4 ％）. Residual analysis showed that significantly more patients in the fall group had severe CBA（p ＜0.01）and significantly more patients in the non-fall group had mild CBA（p ＜0.01）. Logistic regression analysis using the presence or absence of falls within one month of admission as the dependent variable showed that the association between falls and CBA severity was significant（odds ratio 1.92；95 ％ CI, 1.00-3.68；p ＜0.05）, even after adjustment for factors related to falls, such as age 70 years or older, as covariates.
【Conclusions】 Severe CBA severity was significantly associated with the risk of early falls in hospitalized patients in recovery units.
"},{"@language":"ja","@value":"【目的】本研究の目的は，回復期リハビリテーション病棟の入院患者に対して，行動観察から評価される認知関連行 動アセスメント（以下 CBA）の総合点から判定した認知機能障害の重症度と転倒の関連性を検討することであった。
【方法】本研究は後ろ向きコホート研究であり，対象は2019 年4 月から2021 年3 月までの期間に当院回復期リハビ リテーション病棟に入院した患者とした。認知機能障害の評価はCBA を使用し，転倒の有無は電子カルテ内の転倒・転落事故報告書の記録から調査した。入院時のCBA と入院早期の転倒との関連性を検証するため，入院1 か月以内の転倒を集計対象とし，入院1 か月以内で転倒を認めた者を転倒群，認めなかった者を非転倒群とした。転倒と非転倒の2 群とCBA 重症度とのクロス集計から，どの組み合わせが期待値から大きく乖離しているかを確認するために残差分析を行い，調整済み残差を算出した。そして，入院後1 か月以内の転倒の有無を従属変数とし，CBA 重症度を独立変数とした2 項ロジスティック回帰分析を行った。
【結果】本研究の解析対象は879 名であり，年齢の中央値は76（四分位範囲：65-83）歳であった。転倒群（68 名） は非転倒群（811 名）よりもCBA 重症度が最重度〜中等度の者の割合が多かった。また，転倒群におけるCBA 重症度の内訳では，最重度4 名（5.9 ％），重度24 名（35.3 ％），中等度24 名（35.3 ％），軽度11 名（16.2 ％），良好5 名（7.4 ％）であった。残差分析の結果，転倒群ではCBA 重度（p ＜0.01）の者が有意に多く，非転倒群ではCBA 軽度（p ＜0.01）の者が有意に多かった。入院後1 か月以内の転倒の有無を従属変数としたロジスティック回帰分析は，70 歳以上などの転倒に関連する因子を共変量として調整しても，転倒とCBA 重度の有無との関連性は有意であった（オッズ比1.92；95 ％CI, 1.00-3.68；p ＜0.05）。
【結論】回復期リハビリテーション病棟の入院患者における入院患者のCBA 重症度は，入院1 か月以内の転倒発生 と有意に関連していた。
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410866680454731908","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"牧 芳昭"},{"@language":"en","@value":"MAKI Yoshiaki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Rehabilitation, Ukai Rehabilitation Hospital"},{"@language":"ja","@value":"鵜飼リハビリテーション病院リハビリテーション部"}]},{"@id":"https://cir.nii.ac.jp/crid/1410866680454731904","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"森田 秋子"},{"@language":"en","@value":"MORITA Akiko"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Rehabilitation, Ukai Rehabilitation Hospital"},{"@language":"ja","@value":"鵜飼リハビリテーション病院リハビリテーション部"}]},{"@id":"https://cir.nii.ac.jp/crid/1410866680454731905","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"山田 将成"},{"@language":"en","@value":"YAMADA Masanari"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Rehabilitation, Ukai Rehabilitation Hospital"},{"@language":"ja","@value":"鵜飼リハビリテーション病院リハビリテーション部"}]},{"@id":"https://cir.nii.ac.jp/crid/1410866680454731907","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"加藤 涼平"},{"@language":"en","@value":"KATO Ryohei"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Rehabilitation, Ukai Rehabilitation Hospital"},{"@language":"ja","@value":"鵜飼リハビリテーション病院リハビリテーション部"}]},{"@id":"https://cir.nii.ac.jp/crid/1410866680454731906","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"牧迫 飛雄馬"},{"@language":"en","@value":"MAKIZAKO Hyuma"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University"},{"@language":"ja","@value":"鹿児島大学医学部保健学科理学療法学専攻"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"21885702"},{"@type":"LISSN","@value":"21885702"},{"@type":"EISSN","@value":"21885710"}],"prism:publicationName":[{"@language":"ja","@value":"日本転倒予防学会誌"},{"@language":"en","@value":"JapaneseJournal of Fall Prevention"},{"@language":"ja","@value":"転倒予防誌"},{"@language":"en","@value":"Jpn J Fall Prev"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society for Fall Prevention"},{"@language":"ja","@value":"日本転倒予防学会"}],"prism:publicationDate":"2025-02-14","prism:volume":"11","prism:number":"1","prism:startingPage":"31","prism:endingPage":"38"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2025239157"}],"availableAt":"2025-02-14","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E3%83%AA%E3%83%8F%E3%83%93%E3%83%AA%E3%83%86%E3%83%BC%E3%82%B7%E3%83%A7%E3%83%B3%E7%97%85%E6%A3%9F","dc:title":"リハビリテーション病棟"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%AA%8D%E7%9F%A5%E6%A9%9F%E8%83%BD%E9%9A%9C%E5%AE%B3","dc:title":"認知機能障害"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%A1%8C%E5%8B%95%E8%A6%B3%E5%AF%9F","dc:title":"行動観察"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%BB%A2%E5%80%92","dc:title":"転倒"},{"@id":"https://cir.nii.ac.jp/all?q=rehabilitation%20wards","dc:title":"rehabilitation wards"},{"@id":"https://cir.nii.ac.jp/all?q=cognitive%20dysfunction","dc:title":"cognitive dysfunction"},{"@id":"https://cir.nii.ac.jp/all?q=behavior%20observation%20technique","dc:title":"behavior observation technique"},{"@id":"https://cir.nii.ac.jp/all?q=falls","dc:title":"falls"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2013969503"}]}