Recuperación funcional al alta y a tres meses tras una intervención multicomponente de ejercicio físico en ancianos hospitalizados en una unidad de agudos de geriatría / Functional recovery at discharge and at three months after a multicomponent physical exercise intervention in elderly subjects hospitalized in an Acute Geriatric Unit

Introducción: La hospitalización en ancianos, aún en estancias cortas, se asocia frecuentemente a un deterioro funcional. La evolución de este deterioro una vez revertida la enfermedad aguda que generó la hospitalización es muy variable, observándose que más de la mitad de los pacientes mantiene la discapacidad adquirida incluso un año después del ingreso. Dicha discapacidad se asocia con un mayor riesgo de institucionalización y muerte al alta y a los 30 días. Diversos estudios han demostrado que los programas interdisciplinares de ejercicio físico tienen el potencial de mejorar el estado funcional al alta y además pueden conseguir un descenso de la tasa de mortalidad, de la estancia media y una menor tasa de institucionalización.Diseño y objetivos: El objetivo de este estudio es evaluar la efectividad de un programa de ejercicios y educación sanitaria en la prevención del deterioro funcional durante la hospitalización y a los tres meses en mayores de 74 años, mediante un ensayo clínico aleatorizado en la Unidad de Agudos de Geriatría del Hospital General Universitario Gregorio Marañón. Se excluyeron pacientes con un Barthel basal (15 días antes del ingreso) menor a 20, con deterioro cognitivo severo o incapaces de caminar. La intervención consistió en un programa de ejercicio físico (sentadillas, equilibrio, estimulación de la marcha, bandas elásticas y entrenamiento de la musculatura inspiratoria) y educación sanitaria. El grupo control recibe el cuidado habitual. (AU)

Introduction: Hospitalization in the elderly, even in short stays, is associated with functional impairment. Once the acute illness is reversed, the evolution of this hospital-generated impairment can be variable, and a year after hospitalization more than half of the elderly patients remain impaired. This impairment is associated with a higher risk of institutionalization, of mortality at discharge and of 30-day mortality. Previous studies have shown how interdisciplinary physical exercise programs can improve functionality at discharge and decrease mortality rate, hospital stay and institutionalization.Study design and objectives: In the Acute Geriatric Unit of the Gregorio Marañon University hospital a randomized controlled trial was carried out to assess the effectiveness of an exercise and health education program to prevent functional decline during hospitalization and at three months after discharge in elderly subjects aged 74 years or older. Patients were excluded if at least one of the following exclusion criteria was met: baseline Barthel Index (15-days prior hospitalization) below 20, severe cognitive impairment or inability to walk. The intervention consisted on a physical exercise program (that included squats, balance, gait stimulation, elastic bands, and inspiratory muscle training) and health education program. The control group received usual care. (AU)

[Functional recovery at discharge and at three months after a multicomponent physical exercise intervention in elderly subjects hospitalized in an Acute Geriatric Unit]. / Recuperación funcional al alta y a tres meses tras una intervención multicomponente de ejercicio físico en ancianos hospitalizados en una unidad de agudos de geriatría.

INTRODUCTION: Hospitalization in the elderly, even in short stays, is associated with functional impairment. Once the acute illness is reversed, the evolution of this hospital-generated impairment can be variable, and a year after hospitalization more than half of the elderly patients remain impaired. This impairment is associated with a higher risk of institutionalization, of mortality at discharge and of 30-day mortality. Previous studies have shown how interdisciplinary physical exercise programs can improve functionality at discharge and decrease mortality rate, hospital stay and institutionalization. STUDY DESIGN AND OBJECTIVES: In the Acute Geriatric Unit of the Gregorio Marañon University hospital a randomized controlled trial was carried out to assess the effectiveness of an exercise and health education program to prevent functional decline during hospitalization and at three months after discharge in elderly subjects aged 74 years or older. Patients were excluded if at least one of the following exclusion criteria was met: baseline Barthel Index (15-days prior hospitalization) below 20, severe cognitive impairment or inability to walk. The intervention consisted on a physical exercise program (that included squats, balance, gait stimulation, elastic bands, and inspiratory muscle training) and health education program. The control group received usual care.

Pileflebitis o trombosis séptica portal persistente en paciente nonagenaria / Persistent septic portal vein thrombosis in a nonagenarian patient

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