Puesta en marcha de una Unidad de Ortogeriatría en un hospital de segundo nivel. Resultados clínicos y funcionales a corto y medio plazo / Start-up of an Orthogeriatric Unit in a general hospital. Short and medium-term clinical and functional outcomes

Introducción. En el año 2010 creamos la Unidad de Ortogeriatría (UOG) de nuestro hospital, una iniciativa multidisciplinaria que ofrece una asistencia continuada y especializada para ancianos con fractura de cadera (FC). Objetivo. Describir el funcionamiento de la unidad y evaluar las principales características médicas y funcionales de los pacientes ingresados. Material y método. Estudio descriptivo retrospectivo que incluye a los pacientes con FC osteoporótica ingresados desde noviembre del 2010 hasta abril del 2012. Se recogen variables sociodemográficas, médicas y funcionales durante el ingreso, al alta y a los 3 meses del alta. Resultados. Ciento noventa pacientes, con una media de edad 84 años, 74,2% mujeres, 91,1% procedentes de domicilio, 74,7% autónomos o levemente dependientes para las actividades básicas de la vida diaria (ABVD) y el 80,1% realizaba marcha independiente o supervisada. Estancia media prequirúrgica 5,4 días y total 14,7, por encima de las de los estudios de otras UOG pero inferiores a las de los pacientes atendidos por FC en nuestro hospital durante el 2009. Mortalidad intrahospitalaria 1,1%, inferior a la de los pacientes ingresados por FC en nuestro hospital durante el 2009. A los 3 meses eran autónomos o dependientes leves para las ABVD, el 48,3% de los pacientes y el 60,2% realizaba marcha independiente o supervisada. Conclusión. La UOG parece aportar mejoras en la evolución clínica y funcional del paciente anciano con FC y una disminución de la estancia hospitalaria, reduciéndose así los costes asistenciales. Estos resultados invitan a seguir con este sistema de atención del anciano con FC (AU)

Introduction. An Orthogeriatric Unit (UOG) was created in our hospital in 2010. This is a multidisciplinary initiative that provides continuous specialized care for elderly persons with hip fracture (HF). Objective. To describe the operation of the unit and evaluate the medical and functional characteristics of admitted patients. Material and method. A retrospective descriptive study was conducted of all patients with osteoporotic HF admitted from November 2010 to April 2012. We collected socio-demographic, medical and functional variables during admission, at discharge, and 3 months after discharge. Results. A total of 190 patients were included, with a mean age of 84 years. Of these, 74.2% were women, 91.1% were admitted from home, 74.7% were independent or slightly dependent for basic activities of daily living (BADL), and 80.1% performed independent or supervised ambulation. Mean pre-surgical length of stay was 5.4 days and the total length of stay was 14.7 days, which was higher than rates reported in other UOG studies but lower than our hospital data for 2009. In-hospital mortality was 1.1%, representing a decrease compared with patients admitted to our hospital for HF in 2009. At 3 months after discharge, 48.3% of the patients were independent or slightly dependent for BADL and 60.2% were able to walk independently or with supervision. Conclusion. UOG appears to improve clinical and functional outcomes in elderly persons with HF and to decrease length of hospital stay, thus reducing healthcare costs. These results support the continued use of this care system for elderly persons with HF (AU)

Guía sobre el manejo de desfibriladores automáticos implantables al final de la vida / Guidelines on the management of implantable cardioverter defibrillators at the end of life

El presente artículo es un documento conjunto de la Sociedad Española de Geriatría y Gerontología, la Sociedad Española de Cuidados Paliativos y la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología. Su objetivo es paliar la laguna que existe en España en lo que respecta al manejo de los desfibriladores automáticos implantables (DAI) en las fases finales de la vida. Cada vez es más frecuente encontrarse enfermos portadores de DAI en fase terminal de una enfermedad avanzada, como insuficiencia cardíaca refractaria, enfermedades oncológicas, otras insuficiencias orgánicas o enfermedades neurodegenerativas con mal pronóstico a corto plazo. La enorme mayoría de estos pacientes tiene más de 65 años, por ello el documento se enfoca de forma particular a los ancianos que se encuentran en esta situación, aunque el proceso de toma de decisiones es similar en portadores de DAI más jóvenes que están en la fase final de su vida

This article is a joint document of the Spanish Society of Geriatrics and Gerontology, the Spanish Society of Palliative Care and the Section of Geriatric Cardiology of the Spanish Society of Cardiology. Its aim is to address the huge gap that exists in Spain with regard to the management of implantable cardioverter defibrillators (ICDs) in the final stages of life. It is increasingly common to find patients carrying these devices that are in the terminal stage of an advanced disease. This occurs in patients with advanced heart disease and subsequent heart failure refractory to treatment but also in a patient with an ICD who develops cancer disease, organ failure or other neurodegenerative diseases with poor short-term prognosis. The vast majority of these patients are over 65, so the paper focuses particularly on the elderly who are in this situation, but the decision-making process is similar in younger patients with ICDs who are in the final phase of their life

Guía sobre el manejo de desfibriladores automáticos implantables al final de la vida / Guidelines on the management of implantable cardioverter defibrillators at the end of life

El presente artículo es un documento conjunto de la Sociedad Española de Geriatría y Gerontología, la Sociedad Española de Cuidados Paliativos y la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología. Su objetivo es paliar la laguna que existe en España en lo que respecta al manejo de los desfibriladores automáticos implantables (DAI) en las fases finales de la vida. Cada vez es más frecuente encontrarse enfermos portadores de DAI en fase terminal de una enfermedad avanzada, como insuficiencia cardíaca refractaria, enfermedades oncológicas, otras insuficiencias orgánicas o enfermedades neurodegenerativas con mal pronóstico a corto plazo. La enorme mayoría de estos pacientes tiene más de 65 años, por ello el documento se enfoca de forma particular a los ancianos que se encuentran en esta situación, aunque el proceso de toma de decisiones es similar en portadores de DAI más jóvenes que están en la fase final de su vida (AU)

This article is a joint document of the Spanish Society of Geriatrics and Gerontology, the Spanish Society of Palliative Care and the Section of Geriatric Cardiology of the Spanish Society of Cardiology. Its aim is to address the huge gap that exists in Spain with regard to the management of implantable cardioverter defibrillators (ICDs) in the final stages of life. It is increasingly common to find patients carrying these devices that are in the terminal stage of an advanced disease. This occurs in patients with advanced heart disease and subsequent heart failure refractory to treatment but also in a patient with an ICD who develops cancer disease, organ failure or other neurodegenerative diseases with poor short-term prognosis. The vast majority of these patients are over 65, so the paper focuses particularly on the elderly who are in this situation, but the decision-making process is similar in younger patients with ICDs who are in the final phase of their life (AU)

Guía sobre el manejo de desfibriladores automáticos implantables al final de la vida / Guidelines on the management of implantable cardioverter defibrillators at the end of life

El presente artículo es un documento conjunto de la Sociedad Española de Geriatría y Gerontología, la Sociedad Española de Cuidados Paliativos y la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología. Su objetivo es paliar la laguna que existe en España en lo que respecta al manejo de los desfibriladores automáticos implantables (DAI) en las fases finales de la vida. Cada vez es más frecuente encontrarse enfermos portadores de DAI en fase terminal de una enfermedad avanzada, como insuficiencia cardíaca refractaria, enfermedades oncológicas, otras insuficiencias orgánicas o enfermedades neurodegenerativas con mal pronóstico a corto plazo. La enorme mayoría de estos pacientes tiene más de 65 años, por ello el documento se enfoca de forma particular a los ancianos que se encuentran en esta situación, aunque el proceso de toma de decisiones es similar en portadores de DAI más jóvenes que están en la fase final de su vida (AU)

This article is a joint document of the Spanish Society of Geriatrics and Gerontology, the Spanish Society of Palliative Care and the Section of Geriatric Cardiology of the Spanish Society of Cardiology. Its aim is to address the huge gap that exists in Spain with regard to the management of implantable cardioverter defibrillators (ICDs) in the final stages of life. It is increasingly common to find patients carrying these devices that are in the terminal stage of an advanced disease. This occurs in patients with advanced heart disease and subsequent heart failure refractory to treatment but also in a patient with an ICD who develops cancer disease, organ failure or other neurodegenerative diseases with poor short-term prognosis. The vast majority of these patients are over 65, so the paper focuses particularly on the elderly who are in this situation, but the decision-making process is similar in younger patients with ICDs who are in the final phase of their life (AU)

Guidelines on the management of implantable cardioverter defibrillators at the end of life.

This article is a joint document of the Spanish Society of Geriatrics and Gerontology, the Spanish Society of Palliative Care and the Section of Geriatric Cardiology of the Spanish Society of Cardiology. Its aim is to address the huge gap that exists in Spain with regard to the management of implantable cardioverter defibrillators (ICDs) in the final stages of life. It is increasingly common to find patients carrying these devices that are in the terminal stage of an advanced disease. This occurs in patients with advanced heart disease and subsequent heart failure refractory to treatment but also in a patient with an ICD who develops cancer disease, organ failure or other neurodegenerative diseases with poor short-term prognosis. The vast majority of these patients are over 65, so the paper focuses particularly on the elderly who are in this situation, but the decision-making process is similar in younger patients with ICDs who are in the final phase of their life.

[Guidelines on the management of implantable cardioverter defibrillators at the end of life]. / Guía sobre el manejo de desfibriladores automáticos implantables al final de la vida.

This article is a joint document of the Spanish Society of Geriatrics and Gerontology, the Spanish Society of Palliative Care and the Section of Geriatric Cardiology of the Spanish Society of Cardiology. Its aim is to address the huge gap that exists in Spain with regard to the management of implantable cardioverter defibrillators (ICDs) in the final stages of life. It is increasingly common to find patients carrying these devices that are in the terminal stage of an advanced disease. This occurs in patients with advanced heart disease and subsequent heart failure refractory to treatment but also in a patient with an ICD who develops cancer disease, organ failure or other neurodegenerative diseases with poor short-term prognosis. The vast majority of these patients are over 65, so the paper focuses particularly on the elderly who are in this situation, but the decision-making process is similar in younger patients with ICDs who are in the final phase of their life.