Prevalencia de hiponatremia en pacientes mayores de 65 años que sufren una caída intrahospitalaria / Prevalence of hyponatraemia in patients over the age of 65 who have an in-hospital fall

Fundamento y objetivo: La hiponatremia es el trastorno electrolítico más frecuente. Algunos estudios afirman que aumenta la morbimortalidad. Existen nuevas líneas de investigación que buscan la relación entre hiponatremia y caídas. Objetivo: Determinar si la hiponatremia es un factor relacionado con las caídas en ancianos hospitalizados. Método: Diseño observacional analítico de casos y controles. Población de estudio: Se consideraron casos los pacientes mayores de 65 años que experimentaron una caída durante su ingreso en unidades de hospitalización del Hospital General Universitario Gregorio Marañón de Madrid. Los controles fueron pacientes que no wxperimentaron caída, pareados según las variables: unidad, edad, periodo de ingreso, género y Downton. El tamaño fue de 206 sujetos. Recogida de datos: Se estudiaron factores sociodemográficos, las variables incluidas en la ficha de registro de caídas y escala de Downton, y el sodio sérico. Se consideró hiponatremia Na+<135mmol/l. Análisis: Se realizó un análisis descriptivo para valorar la homogeneidad de la muestra, un análisis analítico utilizando el test chi cuadrado, calculando la OR y un análisis multivariante con regresión logística. Resultados: De 103 casos, 61 eran hombres (50,4%) y 42 mujeres (49,4%). En 29 se detectó hiponatremia; la relación con las caídas fue p: 0,002. La OR ajustada fue de 3,708 (1,6-8,3), IC 95%. Se identificaron como factores de riesgo para las caídas: hiponatremia y déficits sensoriales en extremidades. Conclusiones: Dado que la hiponatremia puede considerarse un factor de riesgo de caídas, sería importante valorar la inclusión de la determinación de sodio sérico dentro de las estrategias de prevención de caídas en ancianos (AU)

Background and aim: Hyponatraemia is the most common electrolyte disorder. Some studies have found that it increases morbidity and mortality. There are new lines of research that are investigating the link between hyponatraemia and patient falls. Aim: To determine if hyponatraemia is associated with falls in elderly hospitalised patients. Methods: Design observational, analytical, case-control study. Study population: Patients older than 65 years who had fallen during their hospitalisation at Gregorio Marañón Hospital (Madrid) were considered cases. Patients who did not fall were considered to be controls, paired according to the following variables: hospital ward, age, length of hospital stay, gender and Downton fall risk index. The sample size was 206 subjects. Data collection: Socio-demographic factors, variables included in the falls record sheet, Downton fall risk index and sodium levels were studied (hyponatraemia was considered Na+< 135mmol/l). Analysis: A descriptive analysis was performed to determine the sample homogeneity. The OR was calculated, and an analytical analysis using Chi-square test and a multivariate logistic regression analysis were also performed. Results: Of 103 cases recruited, 61 were men (50.4%) and 42 were women (49.4%). Hyponatraemia was detected in 29 cases with an association with falls of P: 0.002. The adjusted OR was 3.708 (1.6-8.3), 95% CI. Risk factors for falls were identified as hyponatraemia and limb sensory deficits. Conclusions: Given that hyponatraemia could be considered a risk factor for falls, the inclusion of the determination of sodium level would be important for fall prevention strategies in the elderly (AU)

Prevalence of hyponatraemia in patients over the age of 65 who have an in-hospital fall. / Prevalencia de hiponatremia en pacientes mayores de 65 años que sufren una caída intrahospitalaria.

BACKGROUND AND AIM: Hyponatraemia is the most common electrolyte disorder. Some studies have found that it increases morbidity and mortality. There are new lines of research that are investigating the link between hyponatraemia and patient falls. AIM: To determine if hyponatraemia is associated with falls in elderly hospitalised patients. METHODS: Design observational, analytical, case-control study. STUDY POPULATION: Patients older than 65 years who had fallen during their hospitalisation at Gregorio Marañón Hospital (Madrid) were considered cases. Patients who did not fall were considered to be controls, paired according to the following variables: hospital ward, age, length of hospital stay, gender and Downton fall risk index. The sample size was 206 subjects. DATA COLLECTION: Socio-demographic factors, variables included in the falls record sheet, Downton fall risk index and sodium levels were studied (hyponatraemia was considered Na(+)< 135mmol/l). ANALYSIS: A descriptive analysis was performed to determine the sample homogeneity. The OR was calculated, and an analytical analysis using Chi-square test and a multivariate logistic regression analysis were also performed. RESULTS: Of 103 cases recruited, 61 were men (50.4%) and 42 were women (49.4%). Hyponatraemia was detected in 29 cases with an association with falls of P: 0.002. The adjusted OR was 3.708 (1.6-8.3), 95% CI. Risk factors for falls were identified as hyponatraemia and limb sensory deficits. CONCLUSIONS: Given that hyponatraemia could be considered a risk factor for falls, the inclusion of the determination of sodium level would be important for fall prevention strategies in the elderly.

Evaluación de la eficacia en la limpieza de la vía aérea entre dos métodos de toma de aerosolterapia en pacientes con enfermedad pulmonar obstructiva crónica / Evaluation of the efficiency of cleaning the air between two methods of making in patients with aerosol chronic obstructive pulmonary disease

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) es un trastorno que requiere la administración de medicación broncodilatadora y antiinflamatoria, entre otras, como uno de los cuidados de la enfermedad. Ayudan a mantener la limpieza de la vía aérea y a evitar recaídas por el acúmulo de secreciones. La vía inhalatoria, por su acción local y rápida, es la más usada para la aplicación de estos fármacos, que habitualmente se realiza en forma de aerosolterapia. El objetivo de este estudio es evaluar la eficacia en la limpieza de la vía aérea entre dos métodos de administración de aerosolterapia en pacientes con EPOC ingresados por una exacerbación de su enfermedad. También se pretende evaluar su efecto sobre los días de estancia, saturación de oxígeno, grado de disnea, autonomía y complicaciones. Método. Ensayo clínico aleatorizado. Se compararon dos formas de administrar aerosolterapia: método tradicional (grupo control) y dispositivo vibratorio con espiración positiva (grupo intervención). Se consideraron las siguientes variables resultado: días de estancia, días con fiebre, saturación de oxígeno, necesidad de VMNI o VM, las actividades básicas de la vida diaria, grado de autonomía (Barthel), grado de disnea (Escala de Borg) y pico flujo. Resultados. Se incluyeron 39 pacientes. En cuanto a los días de ingreso, los pacientes del grupo intervención presentaban de media un día menos de ingreso. También en este grupo hubo menos reingresos. No se encontraron diferencias estadísticamente significativas en el resto de las variables. Conclusiones. El tratamiento inhalatorio con un dispositivo vibratorio con espiración positiva parece reducir los días de estancia y prevenir los reingresos. Es importante seguir investigando sobre intervenciones no farmacológicas que consigan prevenir sus recaídas (AU)

Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a condition which requires, among others, the administration of bronchodilators and anti-inflammatory drugs to control the disease. They help to keep the airways clear and prevent the buildup of fluid and mucus. Inhalation is the most widely used form of administrating the medication because of its local and rapid action which normally is done by aerosol therapy. The objective of this study is to evaluate the effectiveness of two aerosol methods in clearing the airways of COPD patients, admitted with an exacerbation due to their disease. It also aims to evaluate its effects on the length of stay, oxygen saturation, dyspnea, autonomy and complications. Methods. Randomized clinical trial. Traditional method (control group) and positive expiratory vibrating device (intervention group): two ways to deliver aerosol were compared. The following outcome variables were considered: length of stay, days of fever, oxygen saturation, need for NIV or VM, the basic activities of daily living index autonomy (Barthel), dyspnea (Borg scale) and peak-flow. Results. 39 patients were included. Regarding hospital stay, patients in the intervention group spend an average of one day less in hospital. Also in this group there were fewer readmissions. No statistically significant differences were found in the remaining variables. Conclusions. The inhalation treatment with a vibrating device with positive exhalation, appears to reduce the length of stay and prevent readmissions. It is important to continue research on non-pharmacological interventions as to achieve the prevention of relapses (AU)