Discussion
Although the present study was conducted
in 1999, these results and their applications are still
valid because there has been no major change of
health-related vital statistics in Thailand. With the nine
independent predictors of hospitalization for older
Thai people, four groups of health problems could
be established as significant issues. First, due to its
highest adjusted odds ratio, histories of chronic lung
disease and former smokers could be linked together.
As smoking causes chronic obstructive airway disease,
those who once smoked and had adverse effects such
as an intractable productive cough and dyspnea might
have to be admitted to hospital. Chronic obstruction
to airflow was a risk factor of hospitalization (OR: 1.57)
in older persons(7). They had to quit smoking, otherwise
they could not survive to be included in the
survey. Although Miller JE et al found that risk of
hospitalization was higher for current but not former
smokers, their sample subjects were those aged 45
years and older; they were much younger and,
therefore, healthier than the presented subjects(8).
Subgroup analysis also supported this concept that
there was a significant association between histories
of chronic lung disease and former smokers (p < 0.001).
Preventive strategies of hospitalization for former Thai
smokers can be achieved by early diagnosis e.g. by a
screening questionnaire or screening mini-peak
expiratory flow(9,10) and influenza vaccination(11).
Secondly, history of falls, taking calcium
tablets and poor mobility index could be considered
together. The present results showed that those who
had a history of falls and those who were taking
calcium tablets had significantly worse mobility
indices compared to those who did not and were not.
Since those who had poor walking ability probably
had poor balance with subsequent falls. Meanwhile,
the prevalence of falls inducing body injury, according
to the present results, also corresponded with the
common sites of osteoporosis-related fractures i.e.
neck of the femur, vertebrae and distal end of the
radius. 3.5-6% of falls gave rise to osteoporosisrelated
fractures(12). As a result, calcium tablets, a weak
and cheap anti-resorptive agent, would have been
prescribed for older fallers to prevent further possible
fracture. Limited physical independence requiring the
help of a person or mechanical aid to get around was
seen as an independent predictor of hospitalization
in other studies.[3] A preventive strategy of hospitalization
due to falls among the Thai elderly could be
simply achieved by repeated campaigns to alert them
to the risk of falling(13).
Discussion
Although the present study was conducted
in 1999, these results and their applications are still
valid because there has been no major change of
health-related vital statistics in Thailand. With the nine
independent predictors of hospitalization for older
Thai people, four groups of health problems could
be established as significant issues. First, due to its
highest adjusted odds ratio, histories of chronic lung
disease and former smokers could be linked together.
As smoking causes chronic obstructive airway disease,
those who once smoked and had adverse effects such
as an intractable productive cough and dyspnea might
have to be admitted to hospital. Chronic obstruction
to airflow was a risk factor of hospitalization (OR: 1.57)
in older persons(7). They had to quit smoking, otherwise
they could not survive to be included in the
survey. Although Miller JE et al found that risk of
hospitalization was higher for current but not former
smokers, their sample subjects were those aged 45
years and older; they were much younger and,
therefore, healthier than the presented subjects(8).
Subgroup analysis also supported this concept that
there was a significant association between histories
of chronic lung disease and former smokers (p < 0.001).
Preventive strategies of hospitalization for former Thai
smokers can be achieved by early diagnosis e.g. by a
screening questionnaire or screening mini-peak
expiratory flow(9,10) and influenza vaccination(11).
Secondly, history of falls, taking calcium
tablets and poor mobility index could be considered
together. The present results showed that those who
had a history of falls and those who were taking
calcium tablets had significantly worse mobility
indices compared to those who did not and were not.
Since those who had poor walking ability probably
had poor balance with subsequent falls. Meanwhile,
the prevalence of falls inducing body injury, according
to the present results, also corresponded with the
common sites of osteoporosis-related fractures i.e.
neck of the femur, vertebrae and distal end of the
radius. 3.5-6% of falls gave rise to osteoporosisrelated
fractures(12). As a result, calcium tablets, a weak
and cheap anti-resorptive agent, would have been
prescribed for older fallers to prevent further possible
fracture. Limited physical independence requiring the
help of a person or mechanical aid to get around was
seen as an independent predictor of hospitalization
in other studies.[3] A preventive strategy of hospitalization
due to falls among the Thai elderly could be
simply achieved by repeated campaigns to alert them
to the risk of falling(13).
การแปล กรุณารอสักครู่..
