Experiencia de una Unidad de Prevención de Caídas de un hospital de cuidados intermedios / Experience of a falls prevention unit in an intermediate care hospital

Introducción: La función de una Unidad de Prevención de Caídas, mediante su valoración integral y tratamiento individualizado, es la prevención de nuevas caídas. Presentamos la experiencia de nuestra Unidad. Se describen las características clínicas e intervenciones realizadas. Material y métodos: Revisamos historias clínicas que recogen las variables del protocolo de la Unidad de Prevención de Caídas entre octubre de 2010 a junio de 2012. Expresamos los resultados en medias con desviación estándar. Resultados: Pacientes estudiados 68, acudieron por caídas 53 (77,9%) y 15 (22%) por alteración de la marcha. La edad promedio fue de 77,6 ± 7,9 años, las mujeres fueron 63 (92,6%). El índice de Barthel previo 94/100, deterioro cognitivo 23 (33,8%), polifarmacia en el 69,1%, hipotensión ortostática 18 (26,4%). La velocidad de la marcha 0,66 ± 0,19 m/s y el «time up and go to» 16,6 ± 4,5 s. La posturografía detecta disfunción vestibular en 34 (77%). El origen clínico de caídas o/y alteración de la marcha más frecuente fue la multifactorial en 33 (48,5%), seguida del parkinsonismo en 19 (27,9%), artropatía-dolor crónico en 8 (11,4%) y síndrome vestibular en 8 (11,4%). Se inició fisioterapia en 45 (66,1%) y vitamina D en 47 (69,1%). El control telefónico a los 3 meses del alta mostró que 48 (70,5%) no presentaron caídas, siguieron las recomendaciones 59 (86,7%) y hubo satisfacción en 57 (83,8%). Conclusiones: En esta población de edad avanzada, mayoritariamente mujeres y con buen estado funcional y cognitivo el origen de las caídas fue multifactorial en la mitad de los casos, y la posturografía detectó alteración vestibular en la mitad de los pacientes (AU)

Introduction: The aim of this study is to determine clinical features and interventions in patients attended in our hospital falls prevention unit. Material and methods: Medical records and evaluation protocols from October 2010 to June 2012 were reviewed. Results are expressed in means and standard deviation. Results: We studied 68 patients: 53 came due to falls (77.9%), and 15 (22%) due to gait disorders. The mean age was 77.6±7.9. Number of women: 63 (92.6%). Previous Barthel Index was 94/100, cognitive impairment 23 (33.8%), polypharmacy 69.1%, orthostatic hypotension 18 (26.4%). Walking speed 0.66± 0.19 m/s and Time up and go to (TUG) 16.6±4.5 s. Post-urography detected vestibular dysfunction in 34 patients (77%). Clinical cause of fall and/or gait disorder was multifactorial in 33 (48.5%), Parkinsonism 19 (27.9%), chronic pain/arthropathy 8 (11.4%), and vestibular syndrome 8 (11.4%). Two-thirds (45; 66.1%) of the patients began Physical therapy, and vitamin D was given to 47 (69.1%). Phone calls were made to patients and/or their relatives and noted that after 3 months of the treatment: 48 (70.5%) had no fall; 59 (86.7%) patients followed the recommendations, and 57 (83.8%) were satisfied. Conclusions: In this sample of older patients, mostly female with a good functional and cognitive condition, the causes of the falls were multifactorial in the half of the cases, and the post-urography detected vestibular changes in the half of the patients (AU)

[Experience of a falls prevention unit in an intermediate care hospital]. / Experiencia de una Unidad de Prevención de Caídas de un hospital de cuidados intermedios.

INTRODUCTION: The aim of this study is to determine clinical features and interventions in patients attended in our hospital falls prevention unit. MATERIAL AND METHODS: Medical records and evaluation protocols from October 2010 to June 2012 were reviewed. Results are expressed in means and standard deviation. RESULTS: We studied 68 patients: 53 came due to falls (77.9%), and 15 (22%) due to gait disorders. The mean age was 77.6±7.9. Number of women: 63 (92.6%). Previous Barthel Index was 94/100, cognitive impairment 23 (33.8%), polypharmacy 69.1%, orthostatic hypotension 18 (26.4%). Walking speed 0.66± 0.19m/s and Time up and go to (TUG) 16.6±4.5 s. Post-urography detected vestibular dysfunction in 34 patients (77%). Clinical cause of fall and/or gait disorder was multifactorial in 33 (48.5%), Parkinsonism 19 (27.9%), chronic pain/arthropathy 8 (11.4%), and vestibular syndrome 8 (11.4%). Two-thirds (45; 66.1%) of the patients began Physical therapy, and vitamin D was given to 47 (69.1%). Phone calls were made to patients and/or their relatives and noted that after 3 months of the treatment: 48 (70.5%) had no fall; 59 (86.7%) patients followed the recommendations, and 57 (83.8%) were satisfied. CONCLUSIONS: In this sample of older patients, mostly female with a good functional and cognitive condition, the causes of the falls were multifactorial in the half of the cases, and the post-urography detected vestibular changes in the half of the patients.