Systematic review of the association of diuretics with falls in the elderly / 中华护理杂志

ABSTRACT

Objective To systematically evaluate the association of diuretics with falls in the elderly. Methods Data of case-control studies and cohort studies of diuretics with falls in the elderly were collected by searching eleven electronic databases:MEDLINE,Embase,CENTRAL,AMED,CINAHL,Web of Science,Wiley online library, CBM,CNKI,VIP and WanFang Data from inception to July 2017. Study quality was assessed by the NOS scale. Meta-analysis was conducted by RevMan 5.3 software. Results A total of 17 studies involving 78284 patients were included(seven case-control studies and ten cohort studies). Meta-analysis showed that:①Case-control studies:crude OR showed that diuretics would not increase the risk of falls in elderly patients [OR=0.95,95%CI (0.66,1.38),P=0.80];adjusted OR showed that diuretics would increase the risk of falls in elderly patients[adjusted OR=1.25,95%CI (1.15,1.36),P<0.05]. ②Cohort studies:crude OR showed that diuretics would increase the risk of falls in elderly patients[OR=1.16,95%CI(1.02,1.32),P=0.03];adjusted OR showed that diuretics would not increase the risk of falls in elderly patients[adjusted OR=1.06,95%CI(0.92,1.22),P=0.43]. ③There was no statistically sig-nificant difference in the risk of falls among the elderly at different places,and there was no significant difference in the risk of falls among various diuretics (P>0.05). Conclusion Based on meta-analysis results of cohort studies that controlled confounders,and the results of diuretics in different places and different kinds,diuretics will not in-crease the risk of falls in older adults. Due to limited quantity and quality of included studies,the results need to be further confirmed by more rigorous clinical trials in the future.