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Medicación potencialmente inadecuada como factor de riesgo para Síndrome Confusional Agudo en adultos mayores internados en Emergencia del Hospital Nacional Edgardo Rebagliati Martins-EsSalud, 2011 / Potentially inappropriate medication as a risk factor for syndrome of acute confusion in older adults admitted in Emergency at the Hospital Edgardo Rebagliati Martins-EsSalud, 2011
Lima; s.n; 2012. ix,65 p. tab, graf.
Thesis in Spanish | LILACS, LIPECS | ID: lil-682703
Responsible library: PE13.1
Localization: PE13.1; MG, W, 88, A52, ej.1. 010000091010 / PE13.1; MG, W, 88, A52, ej.2. 010000091011
RESUMEN
Empleo de medicación potencialmente inadecuada y síndrome confusional agudo son problemas frecuentes en adultos mayores, muy relacionados a emergencias.

Objetivos:

Describir factores asociados a síndrome confusional agudo, describir medicación habitual, determinar medicación potencialmente inadecuada y compararla con factores asociados a síndrome confusional agudo.

Metodología:

Estudio de casos y controles en pacientes de 65 años o más, hospitalizados en emergencia. Caso presencia de síndrome confusional agudo. Muestreo sistemático, 102 casos y 136 controles. Entrevista y evaluación a paciente o cuidador al ingreso. Instrumentos Confusion Assessment Method adaptado para pacientes críticos y lista de Screening Tool of Older Person's Potentially inappropriate. Empleando modelo de regresión logística, según criterios de Buenas Prácticas Clínicas.

Resultados:

238 pacientes, masculino 47,1 por ciento, edad promedio 78,36 (+/-7,83) años. Presentaron p<0,05 edad mayor a 85 años, grado de instrucción secundaria o menor, estado civil solo, institucionalización, hospitalización año previo, pluripatología, antecedentes de enfermedad cerebrovascular, demencia, dependencia funcional, deshidratación moderada-severa e infección al ingreso. Se prescribió 731 fármacos en 238 pacientes, promedio 3 fármaco s por paciente (rango 0-10), siendo más frecuentes enalapril, aspirina y furosemida. Medicación potencialmente inadecuada se encontró en 24,6 por ciento (30 por ciento de casos y 20 por ciento de controles; p=0,138), teniendo mayor frecuencia glibenclamida, digoxina, nifedipino y diazepam; y como grupo farmacológico los del sistema nervioso. Con análisis multivariado se obtuvo Odds Ratio > 1,0 para grado de instrucción secundaria o menor, antecedente de enfermedad cerebrovascular, cirrosis hepática, demencia y deshidratación moderada-severa al ingreso.

Conclusiones:

Son factores de riesgo para síndrome confusional agudo instrucción secundaria o menor, antecedente...
ABSTRACT
Potentially inadequate prescription and acute confusional state are frequent problems in aged, 65 and over, related to emergencies.

Aims:

To describe factors associated with acute confusional state, to describe habitual medication, to determine potentially inadequate medication and to compare it with factors associated with acute confusional state.

Methodology:

Study of cases and controls in 65 or more year-old patients, hospitalized in emergency. Case presence of acute confusional state. Systematic sampling, 102 cases and 136 controls. Interview and evaluation to patient or keeper to admition. Instruments Confusion Assessment Method adapted for critical patients and Screening Tool of Older Person's Potentially inappropriate. Analysis was realized with logistic regression. Applying criteria of Good Clinical Practices.

Results:

238 patients, masculine 47,1 per cent, average age 78,36 (+/-7,83) years. p<0,05 presented in age 85 or more years, degree of secondary or less instruction, alone marital status, institutionalization, hospitalization previous year, pluripathology, precedents of vascular brain disease, dementia, functional dependence, moderate-severe dehydration and infection to admition. 731 medicaments were prescribed in 238 patients, average 3 medicaments for patient (range 0-10), enalapril, aspirin and furosemide were most frecuent. Potentially inadequate medication was in 24,6 per cent (30 per cent of cases and 20 per cent of controls; p=0,138), being the most frequent glibenclamida, digoxin, nifedipin and diazepam; and as pharmacological group those of the nervous system. According to multivaried analysis, we were obtained Odds Ratio > 1,0 for secondary or less degree of instruction, precedent of vascular brain disease, hepatic cirrhosis, dementia and moderate-severe dehydration to admition.

Conclusions:

They are factors of risk for acute confusional state secondary or less instruction degree, precedent of vascular brain disease...
Subject(s)
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Collection: National databases / Peru Database: LILACS / LIPECS Main subject: Homeopathic Prescription / Confusion Type of study: Etiology study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Aged / Aged, 80 and over / Female / Humans / Male Language: Spanish Year: 2012 Document type: Thesis
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Collection: National databases / Peru Database: LILACS / LIPECS Main subject: Homeopathic Prescription / Confusion Type of study: Etiology study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Aged / Aged, 80 and over / Female / Humans / Male Language: Spanish Year: 2012 Document type: Thesis
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