ABSTRACT
BACKGROUND: Incidence and clinical characteristics of foot pressure ulcers (FPU) in hospitalized elderly patients are not well known. The aim of the study was to determine the incidence of FPU during hospitalization, to describe main FPU characteristics and to assess main risk factors for FPU in hospitalised elderly subjects. METHODOLOGY: An observational prospective study was performed in which patients 65 years or older admitted to Vascular Surgery, Orthopaedic or Geriatric departments were followed from admission to discharge. Trained nurses evaluated all recruited patients on a daily basis for possible FPU. Main characteristics of the patient (age, sex and co-morbidities) and the ulcer (location, grade) were registered. RESULTS: 299 patients were recruited (62.2% women, mean age 82.3 years, mean number of co-morbidities 2.8). Prevalence of FPU was 30.1% at admission and 73.9% at discharge. Incidence of FPU during hospitalization was 9.5 new FPU/100 person-day. 97.0% of the new FPU were grade 1 (erythema) and the most common locations were in the heel (57.6%), the external lateral part of the foot (13.1%), and the hallux of the fist toe (11.8%). Apart from immobility, main risk factors for FPU are age, geriatric residence origin and not able to outdoor life. CONCLUSIONS: FPU has a high incidence among hospitalised elderly patients; most of them are grade 1 and located in the heel. More attention must be paid in the prevention of pressure ulcers in hospitalized frail subjects.
Subject(s)
Pressure Ulcer , Aged , Aged, 80 and over , Female , Humans , Incidence , Male , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Prevalence , Prospective Studies , Risk FactorsSubject(s)
Anti-Allergic Agents/therapeutic use , Antibodies, Anti-Idiotypic/therapeutic use , Antibodies, Monoclonal/therapeutic use , Pulmonary Aspergillosis/drug therapy , Adult , Aged , Antibodies, Monoclonal, Humanized , Drug Evaluation , Drug Therapy, Combination , Female , Glucocorticoids/therapeutic use , Humans , Male , Middle Aged , Omalizumab , Retrospective Studies , Treatment OutcomeABSTRACT
UNLABELLED: Sleep apnea-hypopnea syndrome (SAHS) has been associated with traffic accidents. The aim of this study was to estimate the prevalence of SAHS and analyze risk factors. We studied 163 professional drivers (86.7%) of the 188 employed by 25 participating companies. The subjects completed a questionnaire on SAHS symptoms and risk factors and underwent physical examination and conventional nighttime polysomnographic testing. RESULTS: The prevalence of an apnea-hypopnea index (AHI) ( 5 was 25.2% (95% CI 18.7-32.5) among the drivers. The prevalence of SAHS was 8.6% (95% CI 3.4-12.1). The prevalence increased with age (p = 0.012). Sleepiness while driving or habitual snoring had a sensitivity of 67.5%, specificity of 62.6% and a positive predictive value of 38.6% for detecting SAHS. Logistic regression modelling showed that the risk factors were a body mass index over 29 kg/m2 (OR: 3.56, 95% CI 1.53-8.4) and sleepiness while driving (OR: 3.7, 95% CI: 1.303-10.3). CONCLUSION: These results suggest that detecting SAHS among drivers may be useful for preventing traffic accidents; a questionnaire on SAHS symptoms and objective measures such as polysomnography allow cases to be detected and treated.
Subject(s)
Automobile Driving , Occupational Diseases/epidemiology , Sleep Apnea Syndromes/epidemiology , Adult , Humans , Male , Middle Aged , Prevalence , Risk Factors , Sensitivity and Specificity , Surveys and Questionnaires , Time FactorsABSTRACT
OBJETIVO: Estimar la prevalencia de SAHS y sus factores de riesgo. MATERIAL Y MÉTODOS: Se ha estudiado a 163 conductores profesionales de los 188 que componen las plantillas de las 25 primeras empresas (86,7 por ciento) estudiadas. Se aplicó un cuestionario sobre síntomas de SAHS, factores de riesgo, examen físico y una polisomnografía nocturna convencional. RESULTADOS: La prevalencia de conductores con índice de apnea-hipopnea (IAH) 5 fue de 25,2 por ciento (IC del 95 por ciento: 18,732,5), con SAHS de 8,6 por ciento (IC del 95 por ciento: 3,4-12,1). Se apreció un incremento de la prevalencia con la edad (p = 0,012).La somnolencia al conducir o el hecho de ser roncador habitual tenían una sensibilidad del 67,5 por ciento, una especificidad del 62,6 por ciento y un valor predictivo positivo del 38,6 por ciento para detectar SAHS. En el análisis de regresión logística, los factores de riesgo fueron el índice de masa corporal (IMC) superior a 29 kg/m2 (OR: 3,56; IC del 95 por ciento: 1,53-8,4) y la somnolencia al conducir (OR: 3,7; IC del 95 por ciento: 1,303-10,3).CONCLUSIÓN: Nuestros resultados sugieren que en empresas de transporte la detección de los conductores con SAHS mediante un cuestionario sobre síntomas de SAHS y una medición objetiva, como la polisomnografía, que permitan detectar los casos para su tratamiento puede ser útil en la prevención de accidentes de tráfico (AU)
