Analysis Of Postural Control Ability And Construction And Application Of Fall Risk Prediction Model In The Elderly With Hearing Loss

ObjectivesBy investigating the status quo of postural control ability of elderly people with hearing loss,in-depth analysis of the risk factors that lead to falls in this group is carried out using evidence-based methods,and a fall risk prediction model for elderly people with hearing loss is preliminarily constructed.The aim is to alert grassroots community medical staff and family caregivers,enhance the accurate identification rate of elderly people at high risk of hearing loss from falls,take preventive measures as early as possible,and carry out targeted intervention on risk factors,avoid or reduce the occurrence of falls as far as possible,ensure their life safety.Methods1.Based on the evidence-based method,relevant literatures published at home and abroad on factors affecting falls in the elderly with hearing loss were retrieved for systematic evaluation and meta-analysis.At the same time,based on the actual clinical situation in China,the Questionnaire of General Conditions and Diseases of the elderly with hearing loss was designed.2.A total of 406 patients who underwent audiology tests and met the inclusion and exclusion criteria in the ear,nose,throat,head and neck surgery Department of a third-class A hospital in Henan Province from November 2021 to July 2022 were selected as the study subjects.IBM SPSS Statistics23.0 software was used for statistical analysis.（1）Describe the data statistically.Description of frequency（%）of classification variable data;Objective test results for continuous data to normality test,accord with normal distribution data using mean standard deviation（X+S）said,on the other hand,do not accord with the adoption of the interquartile range P₅₀(P₂₅,P₇₅)description.（2）To hearing loss to the old position control ability on correlation analysis of the classification variables using t test,analysis of variance or nonparametric rank and inspection,continuous variables using Pearson correlation analysis,P（27）0.05 think correlation between variables;Collinearity diagnosis to P（27）0.05variables;Put P（27）0.05 variables in a multiple linear regression analysis,the effects of hearing loss the elderly posture control factors.（3）Analysis of influencing factors of fall in the elderly with hearing loss:（1）Binary classification variables and disorderly classification data using thex²inspection analysis,more orderly classification data analysis using nonparametric rank and inspection,measurement data using normality and F test,multiple sets of comparison between using t test and variance analysis,the results of the analysis above if P（27）0.05,statistically significant differences.（2）Multi-factor analysis.First of all,the argument of P（27）0.05 linear analysis;Second,there will be a statistically significant variable into binary Logistic regression analysis,get is an independent predictor of hearing loss the elderly fall and Logistic regression equation.Finally,Hosmer-Lemeshow was used to test the goodness of fit of the prediction model.ROC curve was used to evaluate the prediction efficiency of the model,and finally the fall risk prediction model of the elderly with hearing loss was obtained.3.Effect verification of fall risk prediction model for elderly people with hearing loss:The study was conducted in the ear,nose,throat,Head and neck Surgery Clinic of a third-class Class A general hospital in Henan Province from July 2022 to October 2022.The audiology test showed that the inclusion and exclusion criteria were met（consistent with the inclusion and exclusion criteria of the modeling group）.Older adults with hearing loss who had never participated in the study between November 2021 and July 2022 were surveyed.The fall risk was predicted by the model and compared with the actual fall occurrence.The area under the ROC curve was used to evaluate the differentiation of the model,and the accuracy,sensitivity and specificity of the fall risk prediction model for the elderly with hearing loss were obtained according to the four-cell table data.Results1.Through systematic literature review and meta-integration,this study designed the Questionnaire of General Conditions and Diseases of the elderly with hearing loss,which mainly included（1）the general conditions of the patients（7 items）:gender,age,BMI,number of chronic diseases,marital status,residence and education;（2）Hearing related factors（8 items）:degree of hearing Loss,nature of hearing loss,duration of hearing loss,pure tone hearing threshold（left ear/right ear）,difference between left and right ears,whether it is Asymmetrical Hearing Loss（AHL）,poor hearing,and hearing aid use history.（3）Other factors（2 items）:step speed and step length.2.Analyze the hearing loss in the elderly posture control ability,found that the position control ability to the Mini-BESTest scored an average of（15.20+2.07）points,below the truncation is worth points,as well as the different dimensions also scored in a relatively low level.To hearing loss to the old position control ability scores and main variables,correlation analysis and multiple linear regression analysis results show that the hearing loss time,PTA right ear,and fall,the pace is hearing loss to the old position control factors（P（27）0.05）.3.Univariate and multivariate analyses were performed on data from 406 patients in the modeling group,the results showed that the age（P（27）0.001,OR=1.258,95%CI:1.188～1.333）,female（P（27）0.001,OR=3.822,95%CI:2.212～6.602）,sensorineural hearing loss（P=0.005,OR=2.378,95%CI:1.300～4.350）,poor hearing（P=0.004,OR=2.316,95%CI:1.316～4.076）,AHL（P=0.037,OR=1.772,95%CI:1.036～3.032）are independent predictors of fall risk in the elderly with hearing loss.（3）According to the results of multivariate analysis,the fall risk prediction model of elderly people with hearing loss was preliminatively determined as:Logit P=﹣18.747+0.230*age+1.341*female+0.866*sensorineural hearing loss+0.840*hearing poor ear was right ear+0.572*AHL.In addition to the actual value assigned by age,The above argument is assigned as（no=0,yes=1）.4.（1）modeling group（406 cases）and validation group（123 cases）to the baseline data consistency analysis,two groups of comparable（P（29）0.05）baseline data.（2）Verification of fall risk prediction model for elderly people with hearing loss:modeling group Homser-Lemeshow test analysis results show that thex²=11.642,v=8,P=0.168,proved that prediction model has a better goodness-of-fit,had no significant difference between predicted values and the observed values,the model can accurately predict the probability of hearing loss the elderly fall.Area under the ROC curve was 0.875（95%CI:0.841～0.908,P（27）0.001）,the prediction model has better identification of validity,and can accurately identify hearing loss falls the elderly people at high risk.The area under ROC curve of the verification group was 0.861（95%CI:0.795～0.927）.Conclusions1.The score of postural control ability of the elderly with hearing loss was low in each dimension,and the total score was lower than the cut-off value.Hearing loss time,PTA right ear,fall and walking speed were the influencing factors of postural control ability.2.Age,female,SNHL,hearing loss in the right ear and AHL are risk factors for falls in the elderly with hearing loss,and the prediction model of fall risk in the elderly with hearing loss established has high consistency and discriminant validity.3.After external verification,the prediction model has a high degree of consistency with the actual fall probability,and can accurately identify elderly people with hearing loss who are at high risk of falling.