Estado nutricional e sua influência na recuperação funcional após Acidente Vascular Cerebral / Nutritional status and its influence on functional recovery after stroke

A desnutrição associada à doença é um grave problema que pode influenciar o prognóstico, aumentar os tempos de internamento, os custos e os resultados em saúde. No doente vítima de AVC, onde são frequentes as alterações do estado de consciência, a presença de disfagia orofaríngea e outras comorbidades, as consequências clínicas da desnutrição poderão afetar os processos de reabilitação e a funcionalidade. Objetivos: O presente estudo teve como objetivo principal avaliar o o risco nutricional em doentes com AVC, aquando da admissão no internamento e aos três meses após a alta hospitalar, e procurar associações entre o estado nutricional e outras variáveis referentes ao estado funcional. Métodos: Foram avaliados 70 doentes ingressados consecutivamente numa Unidade de AVC, na admissão, alta e 3 meses após a alta. Do formulário faziam parte variáveis sociodemográficas e clínicas. Nos 3 momentos de avaliação foi aplicada a Mini Avaliação Nutricional (MNA) para aferir o estado nutricional e a Escala de Rankin Modificada (ERM) e Índice de Barthel (IB) para avaliação da funcionalidade. Resultados: Dos doentes avaliados (76,1±11,2 anos) (80%) apresentavam AVC isquémico e 20% AVC hemorrágico. Os dados relativos ao estado funcional (ERM, IB) e ao estado nutricional (MNA) variaram significativamente de acordo com os vários momentos de avaliação (p<0,05). Observou-se uma correlação entre o estado nutricional e a funcionalidade em todos os momentos de avaliação (p< 0,05). Conclusão: Pela análise estatística realizada conclui-se que um bom estado nutricional prognostica uma melhor funcionalidade, analisando esta última variável quer através da ERM quer através do IB.

Malnutrition associated with the disease is a serious problem that can influence the prognosis, increase hospitalization times, costs and health outcomes. In a stroke victim, where changes in the state of consciousness are frequent, the presence of oropharyngeal dysphagia and other comorbidities, the clinical consequences of malnutrition may affect the rehabilitation processes and functionality. Aim: The main objective of this study was to assess the nutritional risk in stroke patients, upon admission to hospital and three months after hospital discharge, and to look for associations between nutritional status and other variables related to functional status. Methods: Seventy patients admitted consecutively to a stroke unit were evaluated on admission, discharge and 3 months after discharge. The form included sociodemographic and clinical variables. In the 3 assessment moments, the Mini Nutritional Assessment (MNA) was applied to assess the nutritional status and the Modified Rankin Scale (mRS) and Barthel Index (BI) to assess functionality. Results: Of the patients evaluated (76.1 ± 11.2 years) 80% had ischemic stroke and 20% hemorrhagic stroke. The data related to functional status (mRS, BI) and nutritional status (MNA) varied significantly according to the various moments of assessment (p <0.05). There was a correlation between nutritional status and functionality at all times of assessment (p <0.05). Conclusion: From the statistical analysis performed, we concluded that a good nutritional status predicts a better functionality, analyzing this last variable either through the mRS or through the BI.

Perfil de fragilidade em idosos institucionalizados num lar do concelho de Macedo de Cavaleiros / Frailty profile of elderly people institutionalised in a nursing home in the municipality of Macedo de Cavaleiros

A fragilidade em idosos institucionalizados é uma temática pouco estudada no nosso país e a sua melhor compreensão poderá ajudar nos cuidados à pessoa idosa. Objetivo: Avaliar a prevalência de fragilidade e os factores a ela associados (sociodemográficos, clínicos, estado nutricional e capacidade funcional), em idosos institucionalizados em lar. Métodos: Estudo transversal realizado numa amostra de 40 idosos institucionalizados. Utilizámos questionário sociodemográfico e clínico, o Índice de Barthel e a Escala de Lawton & Brody para avaliar as atividades básicas e instrumentais de vida diária, o Índice de Comorbilidade de Charlson (ICC) e o Mini Nutritional Assessment (MNA) para avaliar o estado nutricional. Resultados: A média de idade dos idosos rondou os 85 anos e a maioria (75%) eram mulheres. A insuficiência cardíaca (27,5%), a doença vascular periférica (25,0%) e a diabetes (15,0%) foram as comorbilidades mais prevalentes. A prevalência de fragilidade foi de 32,5%, apresentavam pré-fragilidade 60,0% e robustez 7,5%. A fragilidade obteve correlação com a idade, estado de saúde auto-percebido, Índice de Massa Corporal, score do ICC, Barthel e Lawton & Brody. Os idosos frágeis eram aqueles que apresentavam pior estado nutricional (p <0,01). Conclusão: A detecção e o tratamento precoce da fragilidade podem prevenir a dependência funcional e melhorar a qualidade de vida do idoso institucionalizado.

The weakness in institutionalized elderly people is a theme that is not well studied in our country and his best understanding could help us to provide care to elderly people. Aim: To evaluate the prevalence of weakness and the associated factors (sociodemographic, clinical, nutritional status and the functional capacity) in institutionalized elderly people. Methods: Cross-sectional study conducted on a sample of 40 institutionalized elderly people. We used a sociodemographic and clinical questionnaire, the Barte Index and the Lawton & Brody Scale to evaluate the basic and instrumental activities of daily living, the Charlson Comorbidity Index (ICC) and the Mini Nutritional Assessment to assess nutritional status. Results: The mean age of elderly people who participated in this study was around 85 years and the majority were female (75%). Heart failure (27.5%), peripherical vascular disease (25.0%) and diabetes (15.0%) were the most prevalent comorbidities. The prevalence of frailty was 32.5%, with a pre-frailty of 60.0% and robustness of 7.5%. Frailty was correlated with age, health status self-perceived, Body Mass Index (BMI), ICC score, Barthel and Lawton&Brody. The weak elderly people were those who presented worst nutritional status (p<0. 01). Conclusion: The detection and early treatment of weakness can prevent functional dependence and improve the quality of life of the institutionalized of elderly people.

Estudo transversal da capacidade funcional e força muscular em setuagenários institucionalizados / Transversal study of functional capacity and muscle strength in institutionalized elderly

Introdução: As pessoas estão envelhecendo cada vez mais no Brasil e no mundo. Estudos apontam que o processo de envelhecimento populacional é acompanhado com o aumento de ocorrência de morbidade e incapacidade. Diferentes condições podem ser apresentadas pelo envelhecimento, como: diminuição da capacidade funcional, diminuição da força e da massa muscular, entre outros. Objetivo: Investigar a redução da capacidade funcional, secundária a redução de força muscular de membros inferiores em idosos institucionalizados em duas instituições de longa permanência (ILPI) no município de Nova Iguaçu (RJ/Brasil). Métodos: Trata-se de um estudo transversal, exploratório de caráter quantitativo em duas IAPI em Nova Iguaçu/RJ/ no período do mês de julho e agosto de 2017, em que foram selecionados 60 idosos de ambos os sexos (34 homens e 26 mulheres), com faixa etária ≥ 60 anos. Os voluntários foram avaliados quanto a capacidade funcional e a força muscular. Para a capacidade funcional, foi utilizado a escala de Barthel. Para o teste de força, o presente estudo usou para forma de avaliação a escala de Medical Research Council (MRC). Resultados: Os resultados mostraram que 61,7% dos idosos são classificados como independentes pelo índice de Barthel. Na escala de MRC, 95% dos idosos apresentaram fraqueza muscular. Conclusão: Concluímos que a maior proporção de idosos institucionalizados foram considerados independentes, porém, apresentaram quadro de fraqueza muscular. (AU)

Introduction: People are aging more and more in Brazil and worldwide. Studies show that the process of population aging is accompanied by increased occurrence of morbidity and disability. Different conditions can be presented by aging, such as: decreased functional capacity, decreased strength and muscle mass, among others. Objective: To investigate the reduction of functional capacity, secondary to the reduction of muscular strength of lower limbs in elderly institutionalized in two institutions in the municipality of Nova Iguaçu/RJ Brazil. Methods: This is a quantitative exploratory study in two elderly institutions at Nova Iguaçu during the period of July and August 2017, with 60 elderly men and women (34 males and 26 females), age range ≥ 60 years. The volunteers were assessed for functional capacity and muscle strength. For functional capacity, the Barthel scale was used. For strength testing, the present study used the Medical Research Council (MRC) scale for evaluation. Results: The results of the present study showed that 61.7% of the elderly are classified as independent by the Barthel index. In the MRC scale, 95% of the elderly presented muscular weakness. Conclusion: We concluded that the most proportion of institutionalized elderly was considered independent but presented a picture of muscular weakness. (AU)

Severidad de la afasia y condición funcional en pacientes con ictus / Ictus phasia severity and functional status in patients with stroke

Introducción: la afasia constituye una secuela altamente incapacitante del ictus, que consta de variabilidad en su grado de severidad. Objetivo: evaluar la severidad de la afasia como secuela, y la repercusión sobre la condición funcional. Material y métodos: se realizó un estudio observacional de tipo transversal, de 60 pacientes con diagnóstico de ictus, con 1 año o más de evolución, todos con afasia. La afasia se clasificó según carácter lenguaje de la Escala Escandinava del ictus. Se conformaron tres grupos y se determinó el grado de discapacidad funcional de cada grupo utilizando la escala de Rankin y el índice de Barthel. Se utilizó estadística descriptiva para caracterizar la muestra. Se utilizó una prueba t no pareada y test de correlación de matrices para identificar asociación entre variables. Se consideró como significativo todo valor p < 0,05. Resultados: predominaron los pacientes con afasia severa. Con el uso de índice de Barthel se identificó mayor compromiso funcional para de Rankin, independientemente de la severidad de la afasia, todos los pacientes mostraron incapacidad moderada e incapacidad moderadamente severa (p<0.05). El Índice de Barthel fue la escala más sensible para determinar el grado de compromiso funcional, según severidad de la afasia. Conclusión: predominaron los pacientes con afasia severa. La severidad de la afasia constituye un factor agravante de la condición funcional en pacientes con ictus de 1 año o más tiempo de evolución.

Prevalencia de disfagia orofaríngea en ancianos institucionalizados y su relación con síndromes geriátricos / Prevalence of oropharyngeal dysphagia in institutionalized elderly patients and its relationship with geriatric syndroms

Antecedentes y objetivo. La disfagia orofaríngea es un síntoma, a menudo infravalorado, con una gran trascendencia clínica por las graves complicaciones que puede provocar. El objetivo general de este estudio es estimar la prevalencia de disfagia orofaríngea en adultos mayores institucionalizados y, específicamente, conocer su relación con síndromes geriátricos. Pacientes y método. La población de estudio estaba compuesta por 30 sujetos mayores de 80 años institucionalizados en una residencia geriátrica. Todas las variables analizadas se extrajeron de la valoración clínica multidisciplinar. Las herramientas de valoración usadas han sido el Mini-Nutritional Assessment®, el Índice de Barthel, la Escala de depresión geriátrica, el Método de exploración clínica volumen-viscosidad y el Short Portable Mental Status Questionnaire. Los datos se han gestionado con SAS® 9.4 y han sido importados desde la base de datos original en Excel mediante SAS® Enterprise 6.1. Resultados. La prevalencia de disfagia orofaríngea en esta población es de 41,5%. Existe una relación estadísticamente significativa entre el Índice de Barthel y la presencia de disfagia orofaríngea (p=.0279), al contrario del estado cognitivo (p=.8951), nutricional (p=.1470) o a la presencia de depresión (p=.999). Conclusiones. La disfagia orofaríngea es muy prevalente en ancianos institucionalizados. La situación funcional puede ser un factor de riesgo a padecer disfagia orofaríngea. La presencia de depresión no parece influir en la aparición de este síntoma. Se observa una tendencia a presentar disfagia orofaríngea cuando el estado cognitivo o nutricional es peor

Background and objective. oropharyngeal dysphagia is often an underestimated symptom, with clinical significance because of the severe complications it may cause. The main objective of this project is to estimate the prevalence of oropharyngeal dysphagia among institutionalized elderly people and, specifically, to determine its relationship with geriatric syndromes or giants. Patients and method. the study population was composed of 30 subjects older than 80 years institutionalized in a Nursing Home. All variables analyzed were obtained from a multidisciplinary clinical assessment. The assessment tools used were: the Mini-Nutritional Assessment®, the Barthel Scale, the Geriatric Depression Scale, the Volume-Viscosity Swallow Test and the Short Portable Mental Status Questionnaire. The data were managed with SAS® 9.4 and imported from the original database into Excel using SAS® Enterprise 6.1. Results. prevalence of oropharyngeal dysphagia in this population is 41.5%. There is a statistically significant relationship between the Barthel Index and the presence of oropharyngeal dysphagia (P=.0279), unlike the cognitive status (P=.8951), nutrition (P=.1470) or the presence of depression (P=.999). Conclusions. oropharyngeal dysphagia is highly prevalent among elderly institutionalized patients. Functional health status may be a risk factor for suffering oropharyngeal dysphagia. The presence of depression does not appear to influence the onset of this symptom. Worse cognitive and nutritional status is significantly related to the incidence of oropharyngeal dysphagia

Evaluación de las complicaciones clínicas de los pacientes con fractura de cadera y sus factores asociados en una Unidad de Agudos de Ortogeriatría / Assessment of clinical complications and their associated factors in hip-fracture patients in an Acute Geriatric Orthopaedic Unit

Introducción. Las complicaciones clínicas en pacientes con fractura de cadera (FC) son elevadas y variables por su heterogéneo registro. El objetivo del estudio fue evaluar las complicaciones clínicas y sus factores asociados en pacientes con FC ingresados en la Unidad de Ortogeriatría de un hospital universitario de 283 camas que atiende un promedio de 200 FC/año. Material y métodos. Se incluyó a 383 pacientes ingresados consecutivamente en 2013 y en 2014 en un estudio analítico observacional prospectivo. Las complicaciones clínicas se definieron según recomendaciones avaladas por la AOTrauma Network (Red de Trabajo de la Asociación Internacional de Traumatólogos para el estudio de la osteosíntesis). Resultados. Doscientos setenta y tres pacientes (71,28%) presentaron alguna complicación. Las principales fueron el delirium (55,4%), la insuficiencia renal (15,4%) y las complicaciones cardiacas (12,3%). Se asociaron a la presencia de alguna complicación la clasificación ASA III-IV (OR=1,962; IC del 95%, 1,040-3,704; p = 0,038), un índice de Barthel al alta inferior (b = -3,572;IC del 95%, -0,866 a -0,104; p = 0,01), el incremento en la estancia media (b = 2,683; IC del 95%, 3,522-0,325; p < 0,001) y preoperatoria (OR = 1,165; IC del 95%, 1,050-1,294; p = 0,004). Conclusiones. Las complicaciones clínicas más frecuentes son el delirium, la insuficiencia renal y las complicaciones cardiacas. Una puntuación en la escala de ASA III-IV, una peor situación funcional al alta, así como una estancia preoperatoria y media prolongada, son factores asociados a la presencia de alguna complicación clínica. Las complicaciones cardiacas, pulmonares y digestivas son las principales causas de mortalidad en la unidad

Introduction. The incidence of clinical complications in hip fracture (HF) patients is high and variable due to their heterogeneous nature. The aim of the study was to assess the clinical complications and their associated factors in HF patients admitted to the Orthopaedic Geriatric Unit of a 283 bed University Hospital. An average of 200 HF patients is attended yearly. Material and methods. A prospective, observational and analytical study was conducted on 383 consecutive patients admitted to the unit during the years 2013 and 2014. Clinical complications were defined according to recommendations supported by the AOTrauma Network (International Network of Traumatologists for the Study of Osteosynthesis). Results. A total of 273 patients (71.28%) showed some clinical complication. The main ones were, delirium (55.4%), renal failure (15.4%), and cardiac complications (12.3%). An ASA III-IV score of OR = 1.962 (95% CI; 1.040-3.704, P=.038), lower Barthel index at discharge (b = -3.572, 95% CI -0.866 to -0.104, P=.01), the increase in pre-operative stay (OR = 1.165, 95% CI 1.050-1.294, P=.004) and an increased length of stay (b = 2.663, 95% CI 3.522-0.325; P<.001) were factors associated with clinical complications. Conclusions. Delirium, renal failure, and cardiac complications were the most frequent complications according the new recommendations. An ASA III-IV score, worse functional status at discharge, prolonged pre-operative period, and increased length of stay, were risk factors associated with clinical complications. Cardiac, pulmonary, and gastrointestinal complications were the main causes of mortality in the unit

Puntuación de la escala de Norton al ingreso y mortalidad en pacientes hospitalizados en Medicina Interna / Norton scale score on admission and mortality of patients hospitalised in Internal Medicine departments

Objetivo. Determinar la asociación entre la puntuación de la escala de Norton (que valora el riesgo de padecer úlceras por presión) y la mortalidad a corto, medio y largo plazo en los pacientes hospitalizados en Medicina Interna. Pacientes y métodos. Estudio de cohortes prospectivo, unicéntrico, de pacientes ingresados en los meses de octubre de 2010, y enero, mayo y octubre de 2011. Se recogieron la edad, sexo, índice de Barthel, escala de Norton, presencia de úlceras por presión, categoría diagnóstica mayor, estancia hospitalaria y peso del grupo relacionado de diagnóstico. Se dividió a los pacientes según las categorías de riesgo de la escala de Norton. El seguimiento fue de 3 años. Resultados. Se incluyeron 624 pacientes con una edad mediana (rango intercuartílico) de 79 (17) años y una puntuación mediana en la escala de Norton de 16 (7). Durante el ingreso fallecieron 74 (11,9%) pacientes, a los 6 meses 176 (28,2%), al año 212 (34,0%), y a los 3 años 296 (47,4%). La mortalidad fue mayor en las categorías de más riesgo en la escala de Norton. La puntuación en la escala de Norton se asoció de forma independiente con la mortalidad a los 6 meses (p<0,001), al año (p=0,005), y 3 años (p=0,002). Las áreas bajo la curva de la escala de Norton fueron 0,746 (IC95% 0,686-0,806), 0,735 (IC95% 0,691-0,780) y 0,751 (IC95% 0,713-0,789), respectivamente (p<0,001). Conclusiones. La escala de Norton es útil para predecir el pronóstico a corto, medio y largo plazo en pacientes ingresados en Medicina Interna

Objective. To determine the association between the Norton scale score (which assesses the risk of pressure ulcers) and mortality in the short, medium and long term in patients hospitalised in Internal Medicine departments. Patients and methods. A prospective, single-centre cohort study was conducted on patients hospitalised in the months of October 2010 and January, May and October 2011. Data was collected on age, sex, Barthel index, Norton scale, presence of pressure ulcers, major diagnostic category, hospital stay and weight of the diagnosis-related group. The patients were divided according to the risk categories of the Norton scale. The follow-up was 3 years. Results. The study included 624 patients with a median age (interquartile range) of 79 (17) years and a median Norton scale score of 16 (7). During hospitalisation, 74 (11.9%) patients died, 176 (28.2%) died at 6 months, 212 (34.0%) died at 1 year, and 296 (47.4%) died at 3 years. Mortality was greater in the higher risk categories of the Norton scale. The Norton score was independently associated with mortality at 6 months (p<.001), at 1 year (p=.005), and at 3 years (p=.002). The areas under the curve of the Norton scale were 0.746 (95% CI 0.686-0.806), 0.735 (95% CI 0.691-0.780) and 0.751 (95% CI 0.713-0.789), respectively (p<.001). Conclusions. The Norton scale is useful for predicting the prognosis in the short, medium and long term in patients hospitalized in internal medicine departments

Impacto da promoção do autocuidado nos idosos / Impact of the promotion of self-care in the elderly

Com o aumento da esperança de vida e consequente envelhecimento, surgem como consequência o aumento das limitações funcionais ao nível do autocuidado. É preciso distinguir se ajudamos o idoso, ou se o prejudicamos ao substitui-lo nas suas tarefas. Nesse campo, só com base na avaliação de cada caso é possível auxiliar e reabilitar cada um deles de uma forma individualizada e adequada, consciencializandoos para a prática do autocuidado. Objetivo: Avaliar o impacto da promoção do autocuidado, pelos auxiliares de ação direta, na alimentação e higiene dos idosos. Metodologia: A metodologia aplicada foi quantitativa descritiva simples, de abordagem exploratória e longitudinal. A população englobou um total de noventa e quatro utentes, e a amostra obtida foi de quarenta indivíduos, nove do sexo masculino e trinta e um do sexo feminino, utilizando critérios de exclusão por intermédio da utilização da Escala de Barthel. As avaliações dos autocuidados foram realizadas através da aplicação da classificação CIFI em dois momentos distintos, com intervalo de tempo de três meses. Resultados: Os resultados demonstram que houve uma evolução positiva com o incentivo da prática do autocuidado por parte dos idosos, sendo que existiu uma diminuição da média final da primeira avaliação da CIFI (78,3) para a segunda (76,3). Mais especificamente, essa redução da média é mais acentuada nos parâmetros da alimentação, onde são bastante significativos os resultados obtidos. Nos restantes parâmetros, os resultados são mais dispersos. Conclusão: Após a intervenção junto dos auxiliares de ação direta, foi possível verificar que a amostra estudada evoluiu num sentido positivo, de uma forma visível, nas atividades de vida diária Comer e Beber, e também, embora menos relevante, na atividade de vida diária Lavar-se.

With the increase in life expectancy and consequent aging, the result is an increase in functional limitations in terms of self-care. One must distinguish whether we help the elderly, or whether we harm them by replacing them in their tasks. In this field, only on the basis of the evaluation of each case is it possible to help and rehabilitate each of them in an individualized and adequate way, making them more aware of the practice of self-care. Objective: To evaluate the impact of the promotion of self-care, by the direct acting auxiliaries, on the self feeding and personal hygiene of the elderly. Methodology: The applied methodology was simple descriptive quantitative, of exploratory and longitudinal approach. The population comprised a total of ninety-four users, and the sample obtained was forty individuals, nine males and thirty-one females, using exclusion criteria through the use of the Barthel Scale. Self-care evaluations were performed through the application of the CIFI classification in two distinct moments, with a time lapse of three months. Results: The results show that there was a positive evolution with the encouragement of the elderly self-care practice, and there was a decrease in the final average of the first evaluation of the CIFI (78.3) for the second (76.3). More specifically, this reduction of the average is more pronounced in the feeding parameters, where the results are quite significant. In the remaining parameters, the results are more dispersed. Conclusion: After the intervention with the direct-acting care givers, it was possible to verify that the studied sample evolved in a positive sense, in a visible way, in the activities of daily living Eating and Drinking, and also, although less relevant, in the activity of daily living Bathing.

Determinación de la situación de dependencia funcional. Revisión sobre los instrumentos de evaluación más utilizados / Determination upon functional dependence situation. Reviewing the most used evaluation tools

Introducción: la medición de la situación de dependencia es un acto fundamental para las diferentes administraciones públicas con competencias en el campo de la salud y de los servicios sociales, para así poder planificar de forma idónea las políticas encaminadas a la atención e intervención en este ámbito. Objetivo: el objetivo del presente trabajo es analizar los instrumentos de valoración de la situación de dependencia más utilizados en España, informando de su contenido y sus campos de aplicación más relevantes. Del mismo modo, conocer en qué se diferencian estas escalas de medida, del baremo de valoración de dependencia utilizado como puerta de acceso al Sistema para la Autonomía y Atención a la Dependencia. Método: este estudio se lleva a cabo mediante una revisión bibliográfica en las siguientes bases de datos: Dialnet, Scopus, SciELO y Fisterra.com. Conclusiones: Tras la pertinente revisión de la literatura existente, los resultados apuntan a que, a causa de la variabilidad de contextos en los que se enmarcan las situaciones de dependencia, existen una gran variedad de instrumentos de medida

Background: the measure of the dependence situation is a fundamental act for the different public administration, which are concerned with the health and also the social services; therefore appropriate way to plan the policies toward the assistance and procedure as well at this field. Objective: the aim of the present work is analyzing the most used valuation tools in Spain about the dependence situation. Reporting upon its content and its outstanding application fields is the goal. Knowing about the differences between these measurement scales, in relation to the dependence evaluation rate, is other goal as well. These scales are used to access to the System for Autonomy and Assistance to Dependence. Method: this study is made through a bibliographic review in the following database: Dialnet, Scopus, SciELO and Fisterra.com. Conclusion: after the appropriate reviewing of currently literature, the results indicate a wide variety of measure tools in spite of the fact that there are a huge variety of possible contexts inner dependence

Úlcera por presión en talón, en paciente frágil multirresistente a antibióticos / Pressure ulcer in heel, in fragile patient multiresistant to antibiotics

Objetivo: describir el proceso de curación de una úlcera en un paciente frágil. Metodología: antes de realizar el artículo se llevó a cabo la información previa a la familia y la obtención del consiguiente consentimiento informado. Una vez hecho esto, se procedió a la elaboración del mismo sobre los datos ya obtenidos de la práctica enfermera llevada en el centro hasta la curación de la lesión. Resultados: tras 11 meses, se completó el proceso de curación de la úlcera. Conclusiones: en pacientes con procesos crónicos en los que se ve afectado el estado físico y el deterioro es paulatino en todos los ámbitos, es muy probable la aparición de estas lesiones. No obstante, con una buena actuación del equipo de enfermería es posible la curación, a pesar de barreras como fue la multirresistencia a antibióticos de la residente

Objective: To describe the healing process of an ulcer in a fragile patient. Methodology: prior to the completion of the article the previous information was carried out to the family and the consequent informed consent. Once this was done, it was elaborated; On data already obtained from the nurse practice carried out in the center until the lesion was healed. Results: after 11 months, the healing process of the ulcer was completed. Conclusions: in patients with chronic processes in which physical condition is affected and deterioration is gradual in all areas is very likely the appearance of these lesions. However, with a good performance of the nursing team is possible the cure, despite barriers such as multiresistance to antibiotics of the resident

Disability and its influence in nutritional assessment tools in elderly people living in nursing homes / Discapacidad y su influencia en las herramientas de valoración nutricional en ancianos institucionalizados en residencias geriátricas

Introduction: Poor nutritional status is associated with increased morbidity and mortality, especially in older people. Objective: The aim of this study was to assess nutritional status in elderly nursing home residents with different nutritional test, and to determine which parameters used for nutritional assessment can be carried out in this population, which usually have a high prevalence of functionally dependent residents. Methods: A cross-sectional study was performed in 383 elderly. The nutritional assessment tools used were the Mini Nutritional Assessment (MNA), the new ESPEN consensus definition of malnutrition, and the tool for Controlling Nutritional Status (CONUT). Moreover, the ability to perform basic activities of daily living was assessed with the Barthel index (BI). Results: According to BI, 78.9% had a total dependence and only 20.9% could be weighed and heighed. The prevalence of malnutrition with MNA, ESPEN and CONUT was 21.3%, 17.6% and 20.7%, respectively. The agreement between MNA vs ESPEN criteria was moderate (κ = 0.483), but with CONUT was low. Conclusions: Nursing homes had a high percentage of totally dependent residents. This high degree of functional dependence made difficult to obtain some anthropometric parameters such as weight and height, which are essential to carry out most nutritional tests. MNA, CONUT and the new ESPEN criteria of malnutrition showed a high prevalence of malnutrition and risk of malnutrition in subjects in which they could be performed (AU)

Introducción: un estado nutricional deficiente está asociado con un incremento de la morbilidad y la mortalidad, especialmente en personas ancianas. Objetivo: el objetivo de este estudio fue evaluar el estado nutricional en ancianos institucionalizados en residencias geriátricas mediante diferentes test nutricionales, y determinar qué parámetros utilizados en la valoración nutricional pueden ser realizados en esta población. Métodos: se llevó a cabo un estudio transversal en 383 ancianos. Las herramientas de valoración nutricional empleadas fueron el Mini Nutritional Assessment (MNA), el nuevo consenso de definición de malnutrición, y el CONUT. Además, la capacidad de realizar las actividades básicas de la vida diaria fue evaluada con el índice de Barthel. Resultados: según el índice de Barthel, hasta un 78,9% de los residentes tenía una dependencia total, y en solo el 20,9% se pudo determinar el peso y la talla. La prevalencia de malnutrición con MNA, el consenso de ESPEN y CONUT fueron 21,3%, 17,2% y 20,7%, respectivamente. La concordancia (kappa) entre el MNA y el ESPEN fue moderada (κ = 0,483), pero con CONUT fue baja. Conclusiones: en las residencias geriátricas públicas existe un elevado porcentaje de ancianos totalmente dependientes. Este alto grado de dependencia funcional dificulta la obtención de algunos parámetros antropométricos como el peso y la talla, que son esenciales para llevar a cabo la mayoría de los test de valoración nutricional. El MNA, el CONUT y los nuevos criterios de desnutrición de la ESPEN mostraron una elevada prevalencia de desnutrición y de riesgo de desnutrición en esta población de ancianos institucionalizados, en aquellos en los que fue posible realizarlos (AU)

Ortogeriatría: primer registro multicéntrico autonómico de fracturas de cadera en Castilla y León (España) / Orthogeriatrics: The First multicentre regional register of hip fractures in Castilla y León (Spain)

Objetivo: El objetivo de este trabajo es describir las características de los pacientes con fractura de cadera en los hospitales públicos de Castilla y León recogidos durante un periodo de tiempo de 3 meses (noviembre del 2014 y octubre y noviembre del 2015). Material y método: El grupo de trabajo de Ortogeriatría de Castilla y León elabora un registro común para recoger datos de las fracturas de cadera. Se incluyen mayores de 74 años ingresados por fractura de cadera, en 13 hospitales públicos de la comunidad, los meses de noviembre del 2014 y octubre-noviembre del 2015. Es un estudio multicéntrico, prospectivo y observacional en el que se recogieron variables clínicas, funcionales, sociales y mortalidad intrahospitalaria. Resultados: Se analizaron 776 pacientes, con una edad media de 86,6±6 años. La demora quirúrgica fue de 4±2,8 días y la estancia media hospitalaria de 10±4,7 días. El riesgo anestésico fue ASA 3±0,6. El 66,5% de los pacientes tuvieron complicaciones médicas intrahospitalarias y precisaron transfusión el 55,5%. Fallecieron durante la hospitalización un 4,6%. La estancia media prequirúrgica se relacionó con la estancia global, con p<0,001. Conclusiones: Los registros de fractura de cadera son una herramienta esencial para evaluar el proceso y mejorar la calidad asistencial de estos pacientes. Este es el primer registro multicéntrico de fracturas de cadera en ancianos realizado en una región de España y puede ser un buen precedente de referencia ante el futuro registro nacional (AU)

Objective: The objective of this study is to describe the characteristics of the patients with hip fracture admitted to the Public Hospitals of Castilla y León during three monthly periods (November 2014, and October and November 2015). Material and method: The Castilla y León orthogeriatrics work group created a common register to collect data on hip fractures. The study included patients 75 years-old and over hospitalised with hip fractures in the 13 public hospitals in the community during November 2014, and October and November 2015. A multicentre, prospective, and observational study was conducted, in which clinical, functional, and social variables, as well as in-hospital mortality, were collected. Results: The analysis included data from a total of 776 patients with a mean age of 86 (±6) years. The surgical delay was 4±2.8 days, and the mean hospital stay was 10±4.7 days. The anaesthesia risk was ASA 3±0.6. Around two-thirds (66.5%) of the patients had medical complications while in hospital, and 55.5% required a transfusion. In-hospital mortality was 4.6%. The mean pre-surgical stay was related to the overall stay: P<.001. Conclusions: Hip fracture registers are an essential tool for evaluating the process and for improving the treatment quality of these patients. This is the first multicentre register of hip fracture in the elderly created in a Spanish region, and could be a good precedent reference for a future national register (AU)

Bacteriemia persistente por Staphylococcus aureus resistente a meticilina en paciente anciano con fractura compleja de hemipelvis izquierda / Persistent bacteraemia due to methicillin-resistant Staphylococcus aureus in an elderly patient with a complex fracture in left side of the pelvis

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Niveles de ansiedad en enfermos hospitalizados afectados de cardiopatía isquémica / Anxiety levels of hospitalized patients with ischemic heart disease

Objetivo. Evaluar el nivel de ansiedad de los pacientes diagnosticados de cardiopatía isquémica en el ingreso y en el alta hospitalaria. Material y método. Estudio longitudinal con pacientes hospitalizados por cardiopatía isquémica en el Hospital Universitari Josep Trueta de Girona. Se estudiaron variables sociodemográficas, características y gravedad de la enfermedad y nivel de ansiedad mediante el inventario State-Trait Anxiety Inventory (STAI) Estado (E) y Rasgo (R) al ingreso y alta. Los datos se analizaron mediante el programa SPSS 19.0. Se realizaron modelos de regresión lineal para estudiar las variables asociadas a la ansiedad estado al ingreso y alta. Resultados. Se estudiaron 72 pacientes, 72 % hombres y 28 % mujeres, con edad media de 62.5 (DS = 4), jubilados (42 %), con diagnóstico de infarto (76 %) y con algún tipo de antecedente psiquiátrico (27 %). Las mujeres presentaron puntuaciones superiores de ansiedad respecto a los hombres en el STAI E al alta (p = 0.034), STAI R al ingreso (p = 0.008) y STAI R al alta (p = 0.008). Los participantes con menos estudios presentaron mayor ansiedad. Los pacientes con antecedentes de ansiedad, depresión o ambos presentaron mayor ansiedad STAI R al ingreso (p = 0.006) y los que tuvieron complicaciones tenían puntuaciones más elevadas de STAI R al alta (p = 0.007). En los modelos de regresión lineal, el STAI E al ingreso y al alta se asoció con el STAI R al ingreso (p = 0.000). Conclusiones. Los pacientes con cardiopatía isquémica presentan niveles moderados de ansiedad. El ser mujer, tener un menor nivel de estudios, presentar antecedentes de trastorno mental, presentar complicaciones intrahospitalarias y puntuaciones elevadas de ansiedad rasgo son factores relacionados con la ansiedad estado. El conocimiento de estos factores permitirá intervenciones enfermeras para mejorar el bienestar y la calidad de vida de las personas hospitalizadas (AU)

Objective. To evaluate anxiety levels in hospitalized patients with ischemic heart disease during admission and discharge. Materials and methods. Longitudinal study of hospitalized patients with ischemic heart disease at the University Hospital Josep Trueta in Girona. Sociodemographic variables, characteristics and disease severity, together with levels of anxiety measured through the State-Trait Anxiety Inventory (STAI) State (E) and Trait (R) at admission and discharge were studied. Data was analysed using SPSS 19.0 software. Linear regression models were performed to study the variables associated to state anxiety upon admission and discharge. Results. 72 patients, 72 % male and 28 % female, with a mean age of 62.5 (SD = 4), retired (42 %), with a diagnosis of infarction (76 %) and with some type of psychiatric history (27 %). were studied. Women showed higher anxiety scores than men in the STAI E at discharge (p = 0.034), STAI R at admission (p = 0.008) and STAI R at discharge (p = 0.008). Participants with lower levels of studies reported greater anxiety levels. Patients with a history of anxiety disorders, depression or both, experienced higher anxiety STAI R at admission (p = 0.006). Patients with complications had STAI R scores higher at discharge (p = 0.007). In linear regression models, the STAI E at admission and discharge was associated with STAI R at admission (p = 0.000). Conclusions. Patients with ischemic heart disease have moderate levels of anxiety. The female gender, lower levels of education, a history of mental disorders, presenting hospital complications and high scores of trait anxiety are factors related to state anxiety. Knowledge of these factors will allow nursing interventions to improve the well being and life quality of these hospitalized patients (AU)

Utilidad del índice FEV1/FEV6 en pacientes pluripatológicos hospitalizados para detectar la prevalencia de obstrucción pulmonar / Usefulness of the FEV1/FEV6 ratio to detect the prevalence of lung obstruction in hospitalised patients with multiple morbidities

Introducción. La prevalencia de obstrucción pulmonar aumenta con la edad y la presencia de comorbilidades. Aunque para confirmar su diagnóstico es necesario completar una espirometría, esta puede ser difícil de realizar en ancianos con deterioro cognitivo o dependencia funcional. Recientemente el uso de dispositivos portátiles que utilizan el índice FEV1/FEV6 han demostrado su utilidad para evaluar la presencia de obstrucción pulmonar, con una mayor facilidad de uso, aunque su utilidad en población anciana con pluripatología no ha sido establecida. Metodología. Estudio transversal, realizado en pacientes ingresados en la Unidad de pacientes crónicos complejos del Hospital Universitario Mútua de Terrassa. A todos ellos se les realizó un cuestionario que incluía -entre otras- medidas de dependencia funcional y deterioro cognitivo y se intentaron completar previamente al alta 3 maniobras válidas de FEV1/FEV6 con el aparato Piko-6, considerándose criterio de obstrucción un FEV1/FEV6≤0,75. Se analizaron las características de la población que fue capaz de realizar las pruebas, y la prevalencia de obstrucción pulmonar. Resultados. Se estudiaron 54 pacientes, de los cuales 35 (64,81%) realizaron las maniobras correctamente. Los pacientes que no completaron las maniobras tenían más dependencia funcional (Barthel 19 vs. 72, p<0,0001) y más deterioro cognitivo (Pfeiffer 1 vs. 9, p<0,0001; MEC 3/35 vs. 28/35, p<0,010). La prevalencia de obstrucción fue del 71,43%, con un 72% de infradiagnóstico. Conclusiones. En un 35,18% de los pacientes no se consiguió determinar el FEV1/FEV6, por deterioro cognitivo o dependencia funcional. Tanto la prevalencia de obstrucción como el infradiagnóstico superaron el 70% (AU)

Background. The prevalence of lung obstruction increases with age and the presence of comorbidities. Although a complete spirometry is necessary to confirm the diagnosis, this may be impractical in elderly patients with cognitive impairment or functional dependence. Recently, the use of portable devices using the FEV1/FEV6 ratio have shown to be useful for assessing the presence of lung obstruction, with greater ease of use, but its usefulness has not been established in the elderly population with multiple morbidities. Methods. A cross-sectional study was conducted on patients hospitalised in the complex chronic patients Unit of the University Hospital Mútua de Terrassa. All of them completed a questionnaire that included -among other things- measurements of functional dependence and cognitive impairment. Three manoeuvres validated with the Piko-6 device were attempted before discharge, and considering an FEV1/FEV6<0.75 as criteria for obstruction. An analysis was performed on the characteristics of the population that was able to perform the tests, as well as the prevalence of pulmonary obstruction. Results. A total of 54 patients were included in the study, of which 35 (64.81%) performed the manoeuvres correctly. Patients who were unable to complete the manoeuvres of the Piko-6 had more functional dependence (Barthel 19 vs. 72, P<.0001) and cognitive impairment (Pfeiffer 1 vs. 9, P<.0001; MEC 28/35 vs. 3/35, P<.010). The prevalence of obstruction was 71.43%, with an underdiagnosis of 72%. Conclusions. The FEV1/FEV6 ratio was not determined in 35.18% of the patients due to cognitive impairment or functional dependence. The prevalence of obstruction and underdiagnosis exceeded 70% (AU)

Declive funcional y presencia de síntomas en cuidados paliativos: ¿causa o consecuencia? / Functional decline and presence of symptoms in palliative care: cause or consequence?

Introducción. Diversas publicaciones han relacionado el declive funcional con la aparición de síntomas, especialmente psicológicos o psiquiátricos, como ansiedad y depresión. Por otra parte, un trastorno depresivo inicial o previo al declive funcional también suele empeorarlo. Nos planteamos conocer la relación entre la existencia de declive funcional medido mediante descenso en índice de Barthel (IB) y la presencia de síntomas. Material y métodos. Estudio analítico prospectivo con los pacientes derivados a un Equipo de Soporte para Atención Domiciliaria (ESAD). Resultados. Seiscientos treinta y ocho casos, 53,9% (N=344) hombres, 56% (N=357) oncológicos y 44% (N=281) no oncológicos. La edad media fue 79,64 ± 10,8 años. Obtuvimos diferencias significativas (p<0,001) en declive funcional medido mediante descenso medio en el IB entre pacientes oncológicos (34,4) y no oncológicos (12,12). Encontramos diferencias significativas (p<0,001) en todos los síntomas registrados (dolor, disnea, anorexia, náuseas, ansiedad, depresión e insomnio) con mayor frecuencia en pacientes oncológicos, salvo en el caso de la agitación psicomotriz. En pacientes con mayor grado de declive funcional, con descensos en IB superior a 20 puntos, se detectó mayor presencia de síntomas. Salvo determinados analgésicos, no hubo diferencias en los tratamientos previos; sí encontramos diferencias en diversos tratamientos pautados por el ESAD. Conclusiones. La existencia de declive funcional y su grado pueden verse relacionados con la aparición de síntomas, especialmente en el paciente oncológico (AU)

Introduction. Several publications have related functional decline to the appearance of symptoms, especially psychiatric or psychological ones, such as anxiety and depression. Moreover, an initial depressive disorder or prior to functional decline usually worsens it. It was decided to investigate the relationship between the presence of functional decline, measured by a decrease in the Barthel index (BI), and the presence of symptoms. Material and methods. A prospective analytical study conducted on patients referred to a Home Care Support Team (HCST). Results. The study included 638 cases, of which 53.9% (N=344) were male, 56% (N=357) with cancer and 44% (N=281) geriatric. The mean age was 79.64 years+- 10.8. Significant differences (P<.001) were found in functional decline measured by mean decline in the BI between cancer (34.4) and non-cancer patients (12.12). Significant differences (P<.001) were also found in all recorded symptoms (pain, dyspnoea, anorexia, nausea, anxiety, depression, and insomnia), more frequently in cancer patients, except psychomotor agitation. A higher presence of symptoms was detected in patients with greater functional decline, with decreases in BI above 20 points. There were no differences in previous treatments, except in certain analgesics. Differences were found in the different treatments prescribed by HCST. Conclusions. The presence of functional decline and its level may be related to the appearance of symptoms, especially in cancer patients (AU)

Hipocalcemia crónica severa en paciente asintomática / Severe chronic hypocalcaemia in an asymptomatic patient

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Factores de riesgo de mortalidad tras intervención quirúrgica de fractura de cadera osteoporótica en pacientes mayores / Risk factors for mortality after surgery of osteoporotic hip fracture in patients over 65 years of age

Objetivo. Valorar desde una perspectiva clínica y con variables fácilmente identificables aquellos factores que influyen en la supervivencia de los pacientes ingresados en una unidad asistencial diseñada para el tratamiento integral de pacientes con fractura de cadera, tras ser intervenidos quirúrgicamente. Material y método. Estudio prospectivo de una cohorte de pacientes (n=202) de edad igual o mayor de 65 años con fractura de cadera de bajo impacto, intervenidos quirúrgicamente en un hospital terciario, que analizó la mortalidad a 90 días, 1 y 2años tras la intervención con relación a variables demográficas, clínicas, analíticas y de funcionalidad. Resultados. Los factores de riesgo independientes de mortalidad en los 3periodos analizados fueron la edad (p=0,047; 0,016 y 0,000 a 90 días, 1 y 2 años, respectivamente) y el bajo índice de Barthel (p=0,014; 0,005 y 0,004 a 90 días, 1 y 2 años respectivamente). Sin embargo, el sexo masculino (p=004) y el riesgo para anestesia (p=0,011) resultaron ser solo factores de riesgo independientes de mortalidad a los 2años de la intervención quirúrgica. Discusión y conclusión. Tanto a corto plazo (30 días) como hasta los 2 años de la intervención quirúrgica por fractura de cadera los mayores condicionantes de mortalidad fueron la edad y la dependencia. Ambos son parámetros fácilmente medibles que permiten identificar a pacientes susceptibles de mala evolución desde el ingreso y que podrían beneficiarse de una atención más exhaustiva (AU)

Objective. To evaluate, from a clinical perspective, and with easily identifiable variables, those factors that influence the survival of patients admitted to a care unit designed for the comprehensive treatment of patients with hip fracture after being surgically treated. Material and methods. A prospective study was conducted on a cohort of patients (n=202) aged 65 years or older with a low impact hip fracture, who were surgically intervened in a tertiary hospital. An analysis was performed to determine mortality at 90 days, and at one and 2years after surgery using demographic, clinical, analytical, and functional variables. Results. The independent risk factors of mortality in the 3periods analysed were age (P=.047, P=.016, and P=.000 at 90 days, 1, and 2 years, respectively) and a low Barthel index (P=.014, P=.005, and P=.004 to 90 days, 1, and 2 years, respectively). Male sex (P=.004) and a high risk for anaesthesia (P=.011) were only independent risk factors of mortality at 2years after surgery. Discussion and conclusion. Age and dependency were the major determining factors of mortality at 30 days, 1, and 2 years after surgery for hip fracture. Both are easily measurable to identify patients susceptible to poor outcomes, and could benefit from a more thorough care plan (AU)

Avaliação funcional e nutricional em pacientes idosos do foro cirúrgico / Functional and nutritional assessment in elderly surgical patients

O processo de envelhecimento implica declínio funcional, muitas vezes exacerbado por inúmeros fatores de risco como a desnutrição associada à doença. Objetivo: Avaliar a capacidade funcional e o estado nutricional em pacientes com mais de 65 anos admitidos num serviço de cirurgia geral. Metodologia: Estudo de caráter descritivo e correlacional, transversal, numa abordagem quantitativa que incluiu 89 idosos hospitalizados. A capacidade funcional foi avaliada recorrendo ao Índice de Barthel e à escala de Lawton & Brody. A força de preensão manual foi avaliada por dinamometria e o estado nutricional recorrendo ao Mini Nutritional Assessment Short-Form (MNA-SF). Resultados: Os utentes apresentavam em média 78 (± 6,9) anos. Os valores do Barthel correlacionam-se de forma positiva, com os valores do MNA-SF (R=0,400; p=0,000). Conclusões semelhantes são observadas entre a Escala de Lawton & Brody e o MNA-SF (R=0,280; p=0,009). Obtiveram-se ainda correlações estatisticamente significativas entre as pontuações do Barthel e as variáveis força de preensão manual (R=0,460; p=0,000), IMC (R=0,250; p=0,018) e idade (R=-0,570; p=0,000). Conclusão: A capacidade funcional correlacionou-se com a idade, força de preensão manual e estado nutricional. É fundamental que a avaliação da capacidade funcional do idoso hospitalizado seja feita o mais precocemente possível, no sentido de se delinearem estratégias individualizadas ao nível nutricional e da funcionalidade global, que visem prevenir e/ou corrigir défices, para encurtar os tempos de internamento e promover qualidade de vida.

The aging process implies functional decline, often exacerbated by numerous risk factors such as malnutrition associated with the disease. Objective: To evaluate functional capacity and nutritional status in patients over 65 admitted to a general surgery service. Methodology: A cross-sectional, descriptive and correlational study in a quantitative approach that included 89 hospitalized elderly. Functional capacity was assessed using the Barthel Index and the Lawton & Brody scale. The manual grip strength was evaluated by dynamometry and nutritional status using the Mini Nutritional Assessment Short-Form (MNA-SF). Results: Patients had an average of 78 (± 6.9) years. The Barthel values are positively correlated with the MNA-SF values (R = 0.400; p = 0.000). Similar conclusions are observed between the Lawton & Brody Scale and the MNA-SF (R = 0.280; p = 0.009). There were statistically significant correlations between the Barthel score and the manual grip strength (R = 0.460, p = 0.000), BMI (R = 0.250; p = 0.018) and age (R = -0.570; p = 0.000). Conclusions: Functional capacity correlated with age, manual grip strength, and nutritional status. It is essential that the evaluation of the functional capacity of the hospitalized elderly is done as early as possible, in order to delineate individualized nutritional strategies and global functionality, aimed at preventing and / or correcting deficits, shortening hospital stays and promoting hospitalization quality of life.

Aplicación clínica del test «Detenerse al andar mientras se habla» (Stop walking while talking test). Relación con parámetros funcionales y otras pruebas de marcha y equilibrio / Clinical application of the 'Stop walking while talking test'. Relationship with geriatric assessment parameters and other tests of balance and gait

Objetivo. Estudiar la relación entre el test Stop walking while talking (SWWT) y los parámetros de valoración geriátrica y otras pruebas de equilibrio y marcha. Pacientes y métodos. Estudio prospectivo, observacional y transversal de 108 pacientes (62% mujeres), edad media: 80,5±8,4. Veintitrés vivían en el domicilio, 24 en una residencia y 61 estaban ingresados en una unidad de convalecencia. Se registró: índice de Barthel, Mini-mental state examination of Folstein (MMSE), comorbilidad (Charlson), la presencia de caída previa y miedo a caer. Se les aplicó a todos ellos el test Timed up and go (TUG), el test de Tinetti y el test SWWT. Según el SWWT los pacientes se dividieron en 2 grupos: stoppers y non-stoppers. Todos tenían capacidad de deambulación (con o sin ayudas). Resultados. Los del grupo de stoppers presentaron medias de edad 82,2±8,7; Barthel 64,6±20,7; MMSE 21,6±5,1; Charlson 1,8±1,7 y los non-stoppers de 78,5±7,6 (p=0,024), 86,0±18,1 (p<0,001), 24,3±4,0 (p=0,004) y 1,3±1,6 (p=0,130), respectivamente. De los 58 stoppers 39 (67,2%) tuvieron caída previa y 19 (32,8%) no (p=0,002); 43 (74,1%) miedo a caer y 15 (25,9%) no (p<0,009). De los 63 pacientes con TUG>20seg, 52 (82,5%) eran stoppers y 11 (17,5%) non-stoppers; de los 31 con TUG entre 10-20seg, 5 (16,1%) y 26 (83,9%); de los 14 con TUG<10, uno (7,1%) y 13 (92,9%) (p<0,0001), respectivamente. La puntuación en el test de Tinetti fue 15,4±5,1 y 23,9±4,6 (p<0,001), respectivamente. Conclusiones. El grupo de stoppers presentaba mayor edad, dependencia, deterioro cognitivo, caída previa, miedo a caer, puntuaciones inferiores en el test de Tinetti y tiempos más prolongados en el TUG (AU)

Objective. To assess the relationship between the Stop Walking While Talking (SWWT) test and some parameters of the geriatric assessment, as well as other tests of balance and gait. Patients and methods. A prospective, observational and cross-sectional study conducted on 108 patients (62% women), with a mean age of 80.5±8.4 years. Twenty-three of them were living at home, 24 in a nursing home, and 61 in an intermediate care unit. A record was made of the Barthel index, Mini-Mental State Examination of Folstein (MMSE), comorbidity (Charlson index), the presence of previous falls, and fear of falling. Timed Up and Go (TUG), Tinetti test, and Stop Walking While Talking (SWWT) test, were performed on all the patients. Based on the results of the SWWT test patients were divided in two groups: "stoppers" and "non-stoppers". All patients were able to walk (with or without walking aids). Results. The stoppers group of patients had a mean age 82.2±8.7; Barthel index 64.6±20.7; MMSE 21.6±5.1; Charlson index 1.8±1.7, and the non-stoppers 78.5±7.6 (P=.024), 86.0±18.1 (P<.001), 24.3±4.0 (P=.004), and 1.3±1.6 (P=.130), respectively. Of the 58 stoppers patients, 39 (67.2%) had a previous fall, and 19 (32.8%) had not (P=.002); 43 (74.1%) had fear of falling, and 15 (25.9%) had not (P<0.009). Of the 63 patients with TUG>20seconds, 52 (82.5%) were stoppers and 11 (17.5%) non-stoppers. Of the 31 with TUG between 10-20seconds, 5 (16.1%) were stoppers and 26 (83.9%) non-stoppers. Of the 14 with TUG<10 seconds, 1 (7.1%) were stoppers, and 13 (92.9%) non-stoppers (P<0.0001). The score of Tinetti test in the stoppers group was 15.4±5.2, and in non-stoppers 23.9±4.6 (P<0.001). Conclusions. Those in the stopper group were significantly older, were more dependent in activities of daily living, had greater cognitive impairment, more previous falls, had greater fear of falling, lower scores on the Tinetti test, and longer times in the TUG (AU)