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¿Son las úlceras por presión al ingreso, un factor predictor negativo de los resultados en unidades de rehabilitación geriátrica? Resultados de un estudio de cohortes retrospectivo. / Does the presence of pressure ulcers entail "high risk of negative outcomes" in geriatric rehabilitation? Results from a retrospective cohort study.
Nutr Hosp ; 34(5): 1305-1310, 2017 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-29280644
ABSTRACT

AIM:

A retrospective cohort study was performed in order to evaluate the prevalence of pressure ulcers (PrUs) in older patients admitted to a geriatric rehabilitation unit of a postacute care hospital and to investigate the impact of the presence of PrUs on clinical outcomes of the rehabilitation process.

METHODS:

We studied 668 post-acute patients consecutively attended, from January 2010 to December 2011. The effect of having PrUs at admission was evaluated based on its impact on outcomes: final destination, functional status, mortality and length of stay in the rehabilitation unit.

RESULTS:

PrUs prevalence at admission was 16%. Patients with PrUs were older, more disabled and had more complex conditions, including malnutrition and cognitive impairment. In the bivariate analysis, we found patients with PrUs at admission had worst final outcome (%): discharge home (69.2 vs.82.5), discharge long term care setting (14 vs.6.4), discharge acute care (8.4 vs.6.2) and death (8.4 vs.4.8); p < 0.001, and worst Barthel Index score at discharge 57 (SD 34.1) vs.83 (SD 33.6); p < 0.001, with longer length of stay in the unit 61 (SD 42.3) vs.53 (SD 37.1); p 0.004. In the multivariate analysis, PrUs presence was found as one of the variables with significant association to no return to home. Finally, a negative association between PrUs at admission and functional gain at discharge of the postacute unit was identified.

CONCLUSIONS:

PrUs were prevalent and had negative impact on clinical outcomes of our geriatric unit, as discharge destination, functional gain and Length of Stay, in vulnerable patients.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Reabilitação / Resultado do Tratamento / Lesão por Pressão Tipo de estudo: Estudo de coorte Aspecto clínico: Etiologia / Predição / Prognóstico Limite: Idoso / Feminino / Humanos / Masculino Idioma: Inglês Revista: Nutr Hosp Assunto da revista: Ciências da Nutrição Ano de publicação: 2017 Tipo de documento: Artigo