[Changes in the incidence of falls in an intermediate and long-term care center]. / Evolución de la incidencia de caídas en un centro hospitalario de media y larga estancia.

INTRODUCTION: The characteristics of falls in older patients admitted to an institution in 2 different periods. MATERIAL AND METHODS: We performed a prospective study of falls among inpatients admitted to an intermediate and long-term care center. Age, sex, Barthel index, main diagnoses, medication at the time of the fall, place, the shift when the fall occurred, lighting, characteristics of the floor, the use of walking aids and/or restraints, the kind of shoes worn, and activity at the moment of the fall were registered. During the first 2-year study period (period A), there were 332 beds (intermediate care and rehabilitation unit, long-term care unit, palliative care unit, psychogeriatric unit and assisted residential home). During the second 2-year period (period B), the palliative and intermediate care units were moved to another center (255 beds remaining). RESULTS: Period A: there were 647 falls in 227 patients; the total number of patients admitted was 1387 (accumulated incidence of falls: 46.6%). Period B: there were 539 falls in 191 patients; the total number of patients admitted was 908 (accumulated incidence of falls: 59.3%). Significant differences between the two periods were found in age (79.8+/-10.6 versus 81.3 10.2) (p<0.02), the percentage of women (55.2% versus 66.4%) (p<0.001), neurological diagnoses (26.7% versus 36.1%) (p< 0.001), antidepressants (12.6% versus 16.4%), neuroleptics (10.3% versus 15.2%) (p<0.001), falls in the bedroom (39.7% versus 41.6%) (p<0.001), falls when moving from bed to chair (41.3% versus 30.8%) (p<0.001), and the use of walking aids (65.8% versus 40.5%) (p<0.001). CONCLUSIONS: a) the incidence of falls increased in the second period of the study; b) in period A, risk factors for falls related to rehabilitation (moving from bed to chair, use of walking aids) were more frequent. In period B, risk factors related to the characteristics of psychogeriatric patients were predominant (neurological illness, use of psychotropic drugs, and c) the difference in the incidence of falls between the two study periods may be related to the distinct characteristics of the patients (case mix).

Evolución de la incidencia de caídas en un centro hospitalario de media y larga estancia / Changes in the incidence of falls in an intermediate and long-term care center

IntroducciónEl objetivo de este estudio es analizar características de caídas en los ancianos institucionalizados durante 2 períodos de estudio.Material y métodosRegistro prospectivo de caídas en un centro sociosanitario. Las variables recogidas fueron: edad, sexo, índice de Barthel, diagnósticos principales, fármacos en el momento de la caída, lugar, turno en el que aconteció, iluminación, características del suelo, uso de ayudas técnicas y/o sujeción, calzado y actividad al caer. En el primer período de estudio de dos años (período A) había 332 camas (convalecencia, larga estancia, paliativos, psicogeriatría y residencia asistida). En el segundo período, también de dos años (período B), las unidades de cuidados paliativos y de convalecencia fueron trasladadas a otro centro (quedando 255 camas).ResultadosPeríodo A: 647 caídas en 227 pacientes; número total de pacientes ingresados: 1.387 (incidencia acumulada de caídas del 46,6%). Período B: 539 caídas en 191 pacientes; número total de pacientes ingresados: 908 (incidencia acumulada de caídas del 59,3%). Diferencias significativas entre períodos: edad (79,8±10,6 frente a 81,3±10,2) (p<0,02); porcentaje de mujeres (el 55,2 frente al 66,4%) (p<0,001); diagnóstico neurológico (el 26,7 frente al 36,1%) (p<0,001); fármacos: antidepresivos (el 12,6 frente al 16,4%) y neurolépticos (el 10,3 frente al 15,2%) (p<0,001); caída en la habitación (el 39,7 frente al 41,6%) (p<0,001); transferencias (el 41,3 frente al 30,8%) (p<0,001), y uso de ayuda técnica (el 65,8 frente al 40,5%) (p<0,001).Conclusionesa) la incidencia de caídas se incrementó en el segundo período del estudio; b) en el período A predominaron factores de riesgo relacionados con la actividad rehabilitadora (transferencias o uso de ayudas técnicas)...(AU)

IntroductionThe characteristics of falls in older patients admitted to an institution in 2 different periods.Material and methodsWe performed a prospective study of falls among inpatients admitted to an intermediate and long-term care center. Age, sex, Barthel index, main diagnoses, medication at the time of the fall, place, the shift when the fall occurred, lighting, characteristics of the floor, the use of walking aids and/or restraints, the kind of shoes worn, and activity at the moment of the fall were registered. During the first 2-year study period (period A), there were 332 beds (intermediate care and rehabilitation unit, long-term care unit, palliative care unit, psychogeriatric unit and assisted residential home). During the second 2-year period (period B), the palliative and intermediate care units were moved to another center (255 beds remaining).ResultsPeriod A: there were 647 falls in 227 patients; the total number of patients admitted was 1387 (accumulated incidence of falls: 46.6%). Period B: there were 539 falls in 191 patients; the total number of patients admitted was 908 (accumulated incidence of falls: 59.3%). Significant differences between the two periods were found in age (79.8±10.6 versus 81.3 10.2) (p<0.02), the percentage of women (55.2% versus 66.4%) (p<0.001), neurological diagnoses (26.7% versus 36.1%) (p< 0.001), antidepressants (12.6% versus 16.4%), neuroleptics (10.3% versus 15.2%) (p<0.001), falls in the bedroom (39.7% versus 41.6%) (p<0.001), falls when moving from bed to chair (41.3% versus 30.8%) (p<0.001), and the use of walking aids (65.8% versus 40.5%) (p<0.001).Conclusionsa) the incidence of falls increased in the second period of the study; b) in period A, risk factors for falls related to rehabilitation (moving from bed to chair, use of walking aids) were more frequent...(AU)