ABSTRACT
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Subject(s)
Humans , Male , Female , Aged , Alzheimer Disease/drug therapy , Antipsychotic Agents , Drugs, Investigational , Risk Factors , Clinical Trials as Topic , Patient Selection , Aged , Focus GroupsABSTRACT
Fundamentos: Comparamos los resultados a un año de la rehabilitación física de la fracturade fémur (FF) mediante rehabilitación domiciliaria o mediante ingreso hospitalario y analizamos el coste. Métodos: Cohorte de 226 pacientes mayores de 65 años, atendidos en el año 2002 en el Hospital de Sabadell, que siguieron rehabilitación en nuestra unidad ortogeriátrica (RH 84) o de forma domiciliaria (RD 142). Variables estudiadas: edad, sexo, entorno social, estancia media hospitalaria, número sesiones de fisioterapia, días tratamiento domiciliario, mortalidad e Índicede Barthel al ingreso, al final rehabilitación y al año de esta. Estimación del coste directo. Resultados: (RH): 84 pacientes, edad media 79,7 años ± 8,2, mujeres 73 (86,9%), coste directo por paciente de 3.250,21 . (RD): 142 pacientes, edad media 80,72 años ± 8,9, mujeres 112 (79%), coste directo 542,3 . Resultados al año: mediante llamada telefónica: se consiguió contactar con 61 del grupo RH y con 96 del grupo RD. La mortalidad fue del 21% y 23 % y el Barthel al año de 75,82 ± 25,7 y 80,83 ± 16,8, no se detectan diferencias significativas en las dos formas de rehabilitación. Conclusiones: Con los criterios utilizados en nuestro centro la efectividad al año de un programa de rehabilitación domiciliaria es similar al conseguido en una unidad ortogeriátrica en cuantoa autonomía y mortalidad pero a 1/6 de su coste directo (AU)
Grounds: During a one-year period, the costs and results of physical rehabilitation of fractures of the femur (FF), comparing by way of hospital admitted patients with and domiciliary rehabilitation patients. Methodology: A cohort of 226 patients, over the ages of 65 years, who were attended toduring 2002 in the Hospital de Sabadell and continued rehabilitation in our orthogeriatric unit. (RH84) or in domiciliary method (RD 42). Variables in the study: age, sex, social environment, average hospital stay, number of physiotherapy sessions, domiciliary treatment visits, death rate and the Barthel index upon admission, at the end of the rehabilitation, in the same year. Estimation of the direct costs. Results: (RH) 84 patients, mean age 79,7 years ± 8,2, women 73 (86.9%), direct cost perpatient 3.250,21 euros (RD) 142 patients, mean age 80,72 years ± 8,9, women 112 (79%), direct cost 542.3 euros. Results for the year: by way of telephone calls - 61 of the RH group and with 96 of the RD group. The death rate was 21% and 23% with the Barthel for the year 75.82 ± 25.7 and 80.83± 16.8, but no significant differences were detected between the two ways of carrying out the rehabilitation. Conclusions: With the criteria used in our center, the effectiveness during the year of a domiciliary rehabilitation program was similar to that achieved in an orthogeriatric unit, regarding autonomy and mortality, but at 1/6 of the direct costs (AU)
Subject(s)
Humans , Male , Female , Aged , Femoral Fractures/rehabilitation , Physical Therapy Modalities , Recovery of Function , Home Nursing , Rehabilitation ServicesABSTRACT
Fundamentos: La fractura de fémur es una de las mayorescausas de morbi-mortalidad en los ancianos. Junto ala prevención, parece obligado priorizar la eficiencia enla rehabilitación. Este trabajo analiza prospectivamentelas variables ligadas a la rehabilitación hospitalaria o endomicilio.Métodos: Estudio descriptivo y prospectivo de los pacientesmayores de 65 años con tratamiento quirúrgicode fractura de fémur durante el año 2002 (382 pacientes),remitidos a rehabilitación hospitalaria (RH: 84 pacientes)o domiciliaria (RD: 142 pacientes).Resultados: No había diferencias significativas en edad,sexo ni Índice de Barthel al acabar. Si la hubo (p< 0.001)en el Barthel al inicio: 50,5 (DE 15,9) frente a 56,41 (DE17,9). Así como en el entorno social: en RH 30 (35,7%)vivían solos y ninguno vivía en residencia, frente a RDdonde 12 vivían solos (8,5%) y 25 en residencias (17%).Conclusiones: Tanto el entorno social como el nivel funcionalinfluyen en la decisión del tipo de rehabilitación.La RH se asocia a vivir solo i a una peor capacidadfuncional tras la fractura, la RD se asocia a vivir previamenteen residencia i a una mejor capacidad funcional.No hay diferencias en la mejoría funcional conseguida enlos dos grupos
Introduction: hip fracture is one of the major causes ofmortality and morbility in the elderly. Together withprevention, it is unavoidably to prioritize eficiency. Weprospectively analyzed the variables influencing therehabilitation at the hospital or at home.Method: a descriptive and prospective study of patientsolder than 65-years, with surgical intervention for femurfractures in 2002 (382 patients) who were referred forrehabilitation at hospital (RH: 84 patients) or at home(RD 142 patients).Results: no significant differences were detected for age,sex, nor Barthel Index upon completion of rehabilitation.There were significant differences (p<0.001) in Barthelat the commencement: UR 50.5 (SD15.9) and UD 56.41(SD 17.9). With respect to the social environment: in RH 30 (35.7%) lived alone and none in residence; but in RD12 lived alone (8.5%) and 15 in geriatric residences(17%).Conclusions: in both, the social environment and thefunctional level, the kind of rehabilitation decided uponand applied to our patients, is influential. The RH isassociated with living alone and with a worse functionalcapacity subsequent to a fracture, the RD is associatedwith previously having lived in a residence , with a betterfunctional capacity. There are no differences in thesuccessful functional improvement in the two groups
Subject(s)
Male , Female , Aged , Humans , Femoral Fractures/rehabilitation , Rehabilitation Centers/statistics & numerical data , Home Care Services/statistics & numerical data , Femoral Fractures/surgery , Rehabilitation Centers/supply & distribution , Activities of Daily Living , Rehabilitation Nursing/methods , Epidemiology, Descriptive , Prospective Studies , Social SupportABSTRACT
BACKGROUND: Norovirus belongs to the Caliciviridae family and causes outbreaks of infectious enteritis by fecal-oral transmission. In Spain, there have been few outbreaks reported due to this virus. We describe an outbreak on a long-term-care hospital ward. METHODS: Cases were classified as probable, confirmed, and secondary. Stool cultures were performed. Polymerase chain reaction detection of norovirus was also performed. RESULTS: The outbreak occurred from December 7 to 28, 2001, involving 60 cases (32 patients, 19 staff members, 8 patients' relatives, and 1 relative of a staff member). Most (82%) of the cases were female. The most frequently involved ages were 20 to 39 years for staff members and 70 to 89 years for patients. The incubation period of secondary cases in patients' families had a median of 48 hours (range, 1 to 7 days). Clinical symptoms included diarrhea (85%), vomiting (75%), fever (37%), nausea (23%), and abdominal pain (12%). Median duration of the disease was 48 hours (range, 1 to 7 days). All cases resolved and the outbreak halted with additional hygienic measures. Stool cultures were all negative for enteropathogenic bacteria and rotaviruses. In 16 of 23 cases, the norovirus genotype 2 antigen was detected. CONCLUSION: This outbreak of gastroenteritis due to norovirus genotype 2 affected patients, staff members, and their relatives in a long-term-care facility and was controlled in 21 days.
Subject(s)
Caliciviridae Infections/transmission , Cross Infection/virology , Disease Outbreaks , Norovirus/isolation & purification , Caliciviridae Infections/diagnosis , Caliciviridae Infections/epidemiology , Cross Infection/prevention & control , Feces/virology , Female , Gastroenteritis/prevention & control , Gastroenteritis/virology , Hospitals , Humans , Infectious Disease Transmission, Patient-to-Professional , Long-Term Care , Male , Spain/epidemiologyABSTRACT
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