Factores asociados con la aparición de caídas en ancianos institucionalizados: un estudio de cohortes / Risk factors for falls amongst older people living in nursing home. A cohort study

ObjetivoDeterminar los factores asociados con caídas en ancianos institucionalizados.Material y métodosEstudio de cohorte, con una duración de 18 meses. Se incluyeron 203 internos mayores de 65 años con capacidad para la deambulación. Se determinaron edad, sexo, IMC, índices de Barthel, Pfeiffer, Tinetti y FRAT (Falls Risk Assessment Tool), caídas previas, ayudas para deambular, existencia de hipotensión ortostática, delirium en el mes previo, presencia de diferentes enfermedades crónicas (10), número y naturaleza de los fármacos habituales (15). Cada caída fue registrada por la enfermera responsable del paciente. El análisis se realizó mediante regresión logística.ResultadosLa media de edad de los participantes fue de 80,1 años (desviación estándar [DE]=9,1 años), siendo varones el 37,9%. Hubo 35 pérdidas (11,5%/año). Se registró un total de 204 caídas en 99 personas (incidencia acumulada del 48,8% a los 18 meses de seguimiento). Cuarenta y cuatro personas (21,7%) sufrieron caídas repetidas. El análisis de regresión mostró asociación con la presencia de delirium en el mes previo a la inclusión en el estudio (OR: 6,7; intervalo de confianza del 95% [IC95]: 1,6–30,3) y menor IMC (OR: 1,1; IC95: 1,01–1,12), y con la deficiencia visual en el caso de las caídas repetidas (OR: 2,2; IC95: 1,1–4,5).ConclusionesLa incidencia de caídas en ancianos institucionalizados es alta. Se constata asociación con algunas condiciones expresivas de fragilidad como indicadores de riesgo(AU)

ObjectiveTo determine factors associated with falls in institutionalized elderly.Material and methodsA prospective cohort study was carried out, over a 18 months period. We included 203 subjects aged 65 and over who were able to walk. We recorded: age, sex, BMI, Barthel, Pfeiffer, Tinetti and FRAT tests, history of falls during the previous year, walking aids, the existence of orthostatic hypotension, delirium in the previous month, presence of various chronic diseases (10), number and nature of the usual drugs (15). Each fall was recorded by the nurse in charge of the patient. The analysis was carried out using logistic regression.ResultsThe average age of participants was 80.1 (SD=9.1) years, male 37.9%. There were 35 losses (11.5%/year). 204 falls were registered in 99 people (48.8% cumulative incidence at 18 months of follow-up). 44 people (21.7%) suffered repeated falls. Regression analysis showed association with the presence of delirium in the month prior to the inclusion in the study (OR 6.7; CI95% 1.6–30.3) and a smaller BMI (OR 1.1; CI95% 1.01–1.12), and visual impairment in the case of repeated falls (OR 2.2; CI95% 1.1–4.5).ConclusionThe incidence of falls in institutionalized elderly is high. It was found strong association with some conditions of fragility as indicators of risk(AU)

[Risk factors for falls amongst older people living in nursing home. A cohort study]. / Factores asociados con la aparición de caídas en ancianos institucionalizados: un estudio de cohortes.

OBJECTIVE: To determine factors associated with falls in institutionalized elderly. MATERIAL AND METHODS: A prospective cohort study was carried out, over a 18 months period. We included 203 subjects aged 65 and over who were able to walk. We recorded: age, sex, BMI, Barthel, Pfeiffer, Tinetti and FRAT tests, history of falls during the previous year, walking aids, the existence of orthostatic hypotension, delirium in the previous month, presence of various chronic diseases (10), number and nature of the usual drugs (15). Each fall was recorded by the nurse in charge of the patient. The analysis was carried out using logistic regression. RESULTS: The average age of participants was 80.1 (SD=9.1) years, male 37.9%. There were 35 losses (11.5%/year). 204 falls were registered in 99 people (48.8% cumulative incidence at 18 months of follow-up). 44 people (21.7%) suffered repeated falls. Regression analysis showed association with the presence of delirium in the month prior to the inclusion in the study (OR 6.7; CI95% 1.6-30.3) and a smaller BMI (OR 1.1; CI95% 1.01-1.12), and visual impairment in the case of repeated falls (OR 2.2; CI95% 1.1-4.5). CONCLUSION: The incidence of falls in institutionalized elderly is high. It was found strong association with some conditions of fragility as indicators of risk.

[Survival of patients diagnosed with prostate cancer and monitored in primary care]. / Supervivencia de pacientes diagnosticados de cáncer de próstata seguidos en atención primaria.

OBJECTIVE: To study survival of patients with prostate cancer and its relationship with diagnostic delay. DESIGN: Retrospective cohort study. SETTING: Six rural primary care practices. PARTICIPANTS: All patients diagnosed with prostate cancer and monitored in these practices between 1992 and 2005. MAIN MEASUREMENTS: Patient age at definite diagnosis, dates of definite and suspected diagnosis, diagnostic method, treatment strategy, and date of death, if it occurred, were determined. Kaplan-Meier analysis was used to estimate survival probability; and Cox's regression, to examine prognostic factors. RESULTS: A total of 84 patients were identified. Mean (SD) age at diagnosis was 75.8 (8.6) years. Median delay until definite diagnosis was 31 days. The diagnosis was carried out through biopsy in 38 cases (45.2%). Eighteen patients were given possibly curative treatment (21.4%) and 66 patients (78.6%) received palliative treatment. Mean age of the deceased was 82.6 (9.1) years. Of 49 patients who died by the end of the study, 22 (44.9%) died from prostate cancer. Mean survival was 72.1 months (SE, 6.1). The probability of overall survival 10 years after diagnosis was 33.3%, and specific survival was 57.5%. There were no differences in survival due to delay in definite diagnosis. CONCLUSIONS: Survival after diagnosis of prostate cancer can be considered high. There is no relationship between survival and delay in definite diagnosis in patients with prostate cancer.

Supervivencia de pacientes diagnosticados de cáncer de próstata seguidos en atención primaria / Survival of patients diagnosed with prostate cancer and monitored in primary care

Objetivo. Analizar la supervivencia de los pacientes afectados de cáncer de próstata y su relación con la demora diagnóstica. Diseño. Estudio de cohortes retrospectivo. Emplazamiento. Seis consultas rurales de atención primaria. Participantes. La totalidad de pacientes diagnosticados de cáncer de próstata entre 1992 y 2005 atendidos en dichas consultas. Mediciones principales. Se determinaron la edad en el momento del diagnóstico de confirmación, las fechas de diagnóstico de sospecha y confirmación, el método diagnóstico, la estrategia terapéutica y la fecha de fallecimiento cuando procedía. Se utilizó el método de Kaplan-Meier en la determinación de la probabilidad de supervivencia y el análisis de regresión de Cox en la investigación de los factores pronósticos. Resultados. Se estudiaron 84 casos. La edad media ± desviación estándar (DE) en el momento del diagnóstico fue de 75,8 ± 8,6 años. La mediana del retraso en la confirmación diagnóstica fue de 31 días. El diagnóstico se realizó mediante biopsia en 38 casos (45,2%). Se realizó tratamiento potencialmente curativo en 18 casos (21,4%) y recibieron tratamiento paliativo 66 pacientes (78,6%). La edad media de los fallecidos era de 82,6 ± 9,1 años. Entre los 49 fallecidos en el momento del cierre del estudio, 22 (44,9%) murieron por el cáncer de próstata. La mediana de la supervivencia fue de 72,1 ± 6,1 meses. La probabilidad de supervivencia global a los 10 años tras el diagnóstico fue del 33,3%, y la específica, del 57,5%. No se encontraron diferencias en la supervivencia en función del retraso en la confirmación diagnóstica. Conclusiones. La supervivencia tras el diagnóstico de cáncer de próstata se puede considerar alta. No hay relación entre la supervivencia y el retraso en la confirmación del diagnóstico en el conjunto de los pacientes afectados de cáncer de próstata

Objective. To study survival of patients with prostate cancer and its relationship with diagnostic delay. Design. Retrospective cohort study. Setting. Six rural primary care practices. Participants. All patients diagnosed with prostate cancer and monitored in these practices between 1992 and 2005. Main measurements. Patient age at definite diagnosis, dates of definite and suspected diagnosis, diagnostic method, treatment strategy, and date of death, if it occurred, were determined. Kaplan-Meier analysis was used to estimate survival probability; and Cox's regression, to examine prognostic factors. Results. A total of 84 patients were identified. Mean (SD) age at diagnosis was 75.8 (8.6) years. Median delay until definite diagnosis was 31 days. The diagnosis was carried out through biopsy in 38 cases (45.2%). Eighteen patients were given possibly curative treatment (21.4%) and 66 patients (78.6%) received palliative treatment. Mean age of the deceased was 82.6 (9.1) years. Of 49 patients who died by the end of the study, 22 (44.9%) died from prostate cancer. Mean survival was 72.1 months (SE, 6.1). The probability of overall survival 10 years after diagnosis was 33.3%, and specific survival was 57.5%. There were no differences in survival due to delay in definite diagnosis. Conclusions. Survival after diagnosis of prostate cancer can be considered high. There is no relationship between survival and delay in definite diagnosis in patients with prostate cancer

Influencia de la edad y el sexo en la información del paciente en fase terminal / Influence of age and sex on information for terminal-stage patients

No disponible

No disponible