Velocidad de la marcha como predictor de recuperación funcional en adultos mayores hospitalizados / Gait speed as predictor of functional recovery in hospitalized elderly adults

INTRODUCCIÓN. La funcionalidad es un parámetro importante en la evaluación del paciente geriátrico, que predispone a la fragilidad, institucionalización, morbilidad, discapacidad y muerte. OBJETIVO. Determinar el papel de la velocidad de la marcha como predictor de recuperación funcional en adultos mayores hospitalizados. MATERIALES Y MÉTODOS. Estudio observacional, de corte longitudinal, prospectivo. Con un total de 167 pacientes y una muestra de 152, con criterios de inclusión: adulto mayor que requirió hospitalización, que su patología de base no les impedía la marcha, y excluidos: 13 pacientes por incapacidad para realizar la prueba de velocidad de marcha, fase final de vida o presentar deterioro cognitivo severo, 1 por fallecimiento y 1 por pérdida de datos, realizado en el Servicio de Geriatría del Hospital Quito N° 1 de la Policía Nacional, en el período Mayo a Septiembre del 2014, los datos demográficos fueron obtenidos de las Historias Clínicas Unicas, los pacientes fueron evaluados mediante las escalas de valoración geriátrica integral: Índice de Barthel, Mini-Mental Test, Escala de Tinetti; y, medición de la velocidad de la marcha en 6 metros en dos momentos; al ingreso y al alta hospitalaria. Para el análisis se utilizó el programa Microsoft Excel 2010, en la correlación bivarial, se utilizó el programa estadístico Statistical Package for Social Sciences Inc. Chicago, versión 18.0. para Windows XP. RESULTADOS. Se encontró una asociación estadísticamente significativa (p<0,05) con todas las variables del estudio. CONCLUSIÓN. La mejoría de la marcha tras la intervención hospitalaria fue de relevancia, su velocidad fue un predictor de estancia hospitalaria confiable, aquellos pacientes con velocidades de marcha bajas a su ingreso, permanecieron hospitalizados por más tiempo.

INTRODUCTION. Functionality is an important parameter in the evaluation of the geriatric patient, which predisposes to frailty, institutionalization, morbidity, disability and death. OBJECTIVE. Determine the role of gait velocity as a predictor of functional recovery in hospitalized older adults. MATERIALS AND METHODS. Observational, longitudinal, prospective study. With a total of 167 patients and a sample of 152, with inclusion criteria: older adult who required hospitalization, that his basic pathology did not prevent them from walking, and excluded: 13 patients due to inability to perform the gait speed test, final phase of life or presenting severe cognitive impairment, 1 due to death and 1 due to loss of data, performed at the Geriatrics Service of the Quito Hospital No. 1 of the National Police, in the period May to September 2014, the demographic data were obtained from the Unique Medical Records, the patients were evaluated using the comprehensive geriatric assessment scales: Barthel Index, Mini-Mental Test, Tinetti Scale; and, measurement of the speed of the march in 6 meters in two moments; upon admission and hospital discharge. For the analysis the Microsoft Excel 2010 program was used, in the bivariate correlation, the statistical program Statistical Package for Social Sciences Inc. Chicago, version 18.0 was used for Windows XP. RESULTS. A statistically significant association (p <0.05) was found with all the study variables. CONCLUSION. The improvement in gait after hospital intervention was relevant, its speed was a predictor of reliable hospital stay, those patients with low gait rates at admission, remained hospitalized for longer.

Cecum and appendix perforation due to inadvertent ingestion of two toothpicks.

Bowel perforation due to inadvertent ingestion of foreign objects is, fortunately, a rare event. However, it can lead to deadly complications when it occurs. Thin, sharp and pointed objects like toothpicks are more likely to pierce the bowel wall. Diagnosing toothpick ingestion and perforation is difficult since most patients do not recall swallowing the toothpick, symptoms and physical examinations are nonspecific, the symptoms can resemble many abdominal pathologies, and since a toothpick has a radiolucent nature that makes it difficult to detect through X-ray imaging. Due to this, most of the cases are identified during the transoperative period. We present the case of a 27-year-old male who presented with symptoms clinically indistinguishable from acute appendicitis. During surgery, two toothpicks were discovered that compromised the cecum and the appendix. After successful removal of the foreign objects, the patient underwent a full recovery.