1
|
Yan J, Zhang Q, Zhou J, Zha F, Gao Y, Li D, Zhou M, Zhao J, Feng J, Ye L, Wang Y. Inverted U-shaped relationship between Barthel Index Score and falls in Chinese non-bedridden patients: a cross-sectional study. Top Stroke Rehabil 2024; 31:692-702. [PMID: 38402602 DOI: 10.1080/10749357.2024.2318089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/04/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Performing activities of daily living comprise an important risk factor for falls among non-bedridden stroke inpatients in rehabilitation departments. OBJECTIVES To explore the correlation between Barthel Index score and the occurrence of falls in non-bedridden stroke rehabilitation inpatients. METHODS In this cross-sectional study, information of patients grouped as non-bedridden patients by the Longshi Scale was collected. RESULTS A total of 3097 patients were included in this study, with a fall incidence of 10.43%. After adjusting covariates, the total score of Barthel Index and falls in non-bedridden inpatients after stroke presented an inverted U-shaped curve relationship, in which inflection point was 60. The effect sizes on the left and right sides of infection point were 1.02 (95%CI 1.00-1.04) and 0.97 (95%CI 0.96-0.99), respectively. CONCLUSIONS Non-bedridden stroke patients with moderate activities of daily living (ADL) capacity may be at particularly increased risk of falls in rehabilitation departments.
Collapse
Affiliation(s)
- Jie Yan
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Qingfang Zhang
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
- Department of Rehabilitation, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jing Zhou
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Fubing Zha
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Yan Gao
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Dongxia Li
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Mingchao Zhou
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Jingpu Zhao
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Jun Feng
- Department of Rehabilitation, Linping Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, China
| | - Liang Ye
- Department of Rehabilitation, Linping Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, China
| | - Yulong Wang
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| |
Collapse
|
2
|
Baráth EM, Wiegand D, Nemes VA, Hegyi P, Szabó I, Csutak A, Wiegand N, Jandó G, Patczai B. Mobile assessment of visual function helps to prevent Re-Injury in elderly patients with recent hip fractures. Injury 2024; 55 Suppl 3:111541. [PMID: 39300626 DOI: 10.1016/j.injury.2024.111541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/11/2024] [Accepted: 04/01/2024] [Indexed: 09/22/2024]
Abstract
INTRODUCTION Patients undergoing surgery due to hip fracture face an elevated risk of a subsequent fall during rehabilitation. An important contributing factor to this risk is deteriorated visual function, often responsive to intervention. This study aims to explore differences in visual acuity (VA) and stereovision (SV) between individuals with a history of fall-related hip injuries (study group) and age-matched controls, utilizing a mobile application (EuvisionTab, ET) to distinguish age-related visual decline from pathological vision. MATERIALS & METHODS A total of 32 and 71 participants were enrolled in the study and control groups, respectively (mean age: 74.9 years, range: 60-96). Monocular logMAR VA was measured using a tablet by means of an adaptive threshold-search algorithm. SV was assessed using low-dot density static and dynamic random dot stereograms. An age-dependent reference limit for VA was established. For ET stereotests, the number of correctly identified optotypes out of 10 random presentations served as the measure for further comparisons. Visually impaired status in the study group was determined if patients failed either the VA threshold or the SV criteria. RESULTS In the control group, an apparent but statistically nonsignificant decline in VA was observed, while stereovision remained stable and did not exhibit significant age-related variations based on ET stereotests. Conversely, the study group demonstrated significantly worse results in monocular VA (p = 0.0032) and for both stereotests (p = 0.018 for static, p = 0.036 for dynamic) according to paired samples t-test and chi-square test, respectively. Hip injuries were significantly associated with visual impairment (OR = 4.88, p = 0.0012). DISCUSSION This study focuses on one possible risk factor of elderly falls, namely, vision impairment. Patients with visual decay present a higher incidence of hip injuries compared to age-matched controls. This data suggest that vision screening and, when feasible, restoration of visual function may contribute to the prevention of secondary falls, refractures, or contralateral fractures. A mobile-based screening protocol, executable as part of a postoperative bedside examination and independent of specialized eye care, can be proposed.
Collapse
Affiliation(s)
- Eszter Mikó Baráth
- Institute of Physiology, Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary.
| | - Dorottya Wiegand
- Institute of Physiology, Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary; Department of Ophthalmology, Clinical Center, University of Pécs, 7623 Rákóczi Street 2., Pécs, Hungary, Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| | - Vanda A Nemes
- Institute of Physiology, Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| | - Péter Hegyi
- Institute of Physiology, Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| | - Ivett Szabó
- Department of Traumatology and Hand Surgery, Clinical Center, University of Pécs, 7624 Ifjúság Street 13., Pécs, Hungary and Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, Clinical Center, University of Pécs, 7623 Rákóczi Street 2., Pécs, Hungary, Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| | - Norbert Wiegand
- Department of Traumatology and Hand Surgery, Clinical Center, University of Pécs, 7624 Ifjúság Street 13., Pécs, Hungary and Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| | - Gábor Jandó
- Institute of Physiology, Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| | - Balázs Patczai
- Department of Traumatology and Hand Surgery, Clinical Center, University of Pécs, 7624 Ifjúság Street 13., Pécs, Hungary and Medical School, University of Pécs, 7624 Szigeti Street 12., Pécs, Hungary
| |
Collapse
|
3
|
González Aguña A, Gonzalo de Diego B, Páez Ramos S, Fernández Batalla M, Jiménez Rodríguez ML, Santamaría García JM. Care Robotics: An Assessment of Professional Perception in the Face of the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11070946. [PMID: 37046875 PMCID: PMC10094221 DOI: 10.3390/healthcare11070946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
The COVID-19 crisis accelerated the adoption of technologies. Technological advancement is also expected in robotics applied to any sector, including in healthcare. The aim is to assess the professional perception of care robotics facing COVID-19. This study aimed to (1) select a tool for assessing different aspects of healthcare, (2) analyse the professional perception about the development, usefulness and helpfulness of technologies and robotics in the field of healthcare and (3) evaluate the correlation between the perceived helpfulness of care robotics and the selected tool. We implement five validated clinical tests which integrate 80 items about a person and their clinical situation. From the sample of 46 professionals, 95.65% affirmed that technology was moderately to completely useful for professional performance in the context of the pandemic, lowering to 67.39% when asked only about robotics; 93.48% stated that the inclusion of robotics in at least one health area affected by COVID-19 would have helped them. Finally, the variables extracted from clinical tests corresponded to the most relevant health areas as identified by the professionals. This research shows the potential of care robotics oriented towards healthcare from a care paradigm.
Collapse
Affiliation(s)
- Alexandra González Aguña
- Henares University Hospital, Community of Madrid Health Service (SERMAS), 28822 Madrid, Spain
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Alcalá de Henares, Spain; (B.G.d.D.); (S.P.R.); (M.F.B.); (M.L.J.R.); (J.M.S.G.)
- Correspondence:
| | - Blanca Gonzalo de Diego
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Alcalá de Henares, Spain; (B.G.d.D.); (S.P.R.); (M.F.B.); (M.L.J.R.); (J.M.S.G.)
- Meco Health Centre, Community of Madrid Health Service (SERMAS), 28880 Madrid, Spain
| | - Sandra Páez Ramos
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Alcalá de Henares, Spain; (B.G.d.D.); (S.P.R.); (M.F.B.); (M.L.J.R.); (J.M.S.G.)
- Meco Health Centre, Community of Madrid Health Service (SERMAS), 28880 Madrid, Spain
| | - Marta Fernández Batalla
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Alcalá de Henares, Spain; (B.G.d.D.); (S.P.R.); (M.F.B.); (M.L.J.R.); (J.M.S.G.)
| | - María Lourdes Jiménez Rodríguez
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Alcalá de Henares, Spain; (B.G.d.D.); (S.P.R.); (M.F.B.); (M.L.J.R.); (J.M.S.G.)
- Computer Science Department, University of Alcala, 28805 Madrid, Spain
| | - José María Santamaría García
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Alcalá de Henares, Spain; (B.G.d.D.); (S.P.R.); (M.F.B.); (M.L.J.R.); (J.M.S.G.)
- Meco Health Centre, Community of Madrid Health Service (SERMAS), 28880 Madrid, Spain
| |
Collapse
|
4
|
De Luca V, Femminella GD, Patalano R, Formosa V, Lorusso G, Rivetta C, Di Lullo F, Mercurio L, Rea T, Salvatore E, Korkmaz Yaylagul N, Apostolo J, Silva RC, Dantas C, van Staalduinen WH, Liotta G, Iaccarino G, Triassi M, Illario M. Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16050. [PMID: 36498125 PMCID: PMC9739796 DOI: 10.3390/ijerph192316050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Frailty is a complex interplay between several factors, including physiological changes in ageing, multimorbidities, malnutrition, living environment, genetics, and lifestyle. Early screening for frailty risk factors in community-dwelling older people allows for preventive interventions on the clinical and social determinants of frailty, which allows adverse events to be avoided. By conducting a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aimed to develop an updated framework for the main measurement tools to assess frailty risks in older adults, paying attention to use in the community and primary care settings. This search focused on the biopsychosocial domains of frailty that are covered in the SUNFRAIL tool. The study selected 178 reviews (polypharmacy: 20; nutrition: 13; physical activity: 74; medical visits: 0; falls: 39; cognitive decline: 12; loneliness: 15; social support: 5; economic constraints: 0) published between January 2010 and December 2021. Within the selected reviews, 123 assessment tools were identified (polypharmacy: 15; nutrition: 15; physical activity: 25; medical visits: 0; falls: 26; cognitive decline: 18; loneliness: 9; social support: 15; economic constraints: 0). The narrative review allowed us to evaluate assessment tools of frailty domains to be adopted for multidimensional health promotion and prevention interventions in community and primary care.
Collapse
Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Roberta Patalano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Valeria Formosa
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Grazia Lorusso
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Cristiano Rivetta
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Federica Di Lullo
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Teresa Rea
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Joao Apostolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - Rosa Carla Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | | | | | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| |
Collapse
|
5
|
Amiri A, Dong X, Frith K. Risk of Falls in adults 45-64 years old in the United States. Public Health Nurs 2022; 39:1235-1245. [PMID: 35864583 DOI: 10.1111/phn.13116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Abstract
Falls among the older adults (64+ years old [YO]) are considered public health issues. However, fall prevention in middle adulthood (age 45-64) has received less attention. We studied the associations between the number of falls and fall-related injuries and indicators for socio-demographics, chronic diseases, and difficulties in conducting activities in two age groups, 45-64 YO and 64+. In this secondary data analysis, we used the Behavioral Risk Factor Surveillance System (BRFSS) 2018 data. The study showed respondents in the 45-64 YO have higher average falls and fall-related injuries than those 64+ (P < .001). Variables that link to more falls and fall-related injuries in 64+ correspond to more falls and fall-related injuries in 45-64 YO. The finding indicates that the odds of falls and fall-related injuries are comparable across age groups when considering demographic characteristics. However, odds of falling in the presence of arthritis and asthma are higher for respondents in 45-64 YO than the 64+ YO. The risk of falls and fall-related injuries are not specific to older adults. Factors that matter to the number of falls and fall-related injuries in the older adults also count in the younger age group. Nurses are asked to validate available fall assessment tools for adults 45-64 years old and evaluate all clients over 45 for fall risk.
Collapse
Affiliation(s)
- Azita Amiri
- College of Nursing, The University of Alabama in Huntsville, Huntsville, Alabama, USA
| | - Xiaoxia Dong
- Stuart Weitzman School of Design, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Karen Frith
- College of Nursing, The University of Alabama in Huntsville, Huntsville, Alabama, USA
| |
Collapse
|
6
|
Foote CW, Vanier C, Chen C, Palacio CH. Evaluation of therapy in traumatic elderly falls to return autonomy and functional status. Surg Open Sci 2022; 10:174-181. [PMID: 36312868 PMCID: PMC9615312 DOI: 10.1016/j.sopen.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/19/2022] [Indexed: 11/28/2022] Open
Abstract
Background Traumatic falls among the elderly (≥ 65 years old) are the leading cause of injury, morbidity and mortality are increasing with rising medical costs. Methods This is a retrospective medical record review of elderly mechanical fall patients (288 patients) admitted to an American College of Surgeons level II trauma center from January 2016 to January 2021. Demographics and comorbidities were determined, and physical/occupational therapy used to predict subsequent fall readmissions. Results Out of 288 patients, 243 received therapy with 45 readmissions for subsequent falls. Age (P = .016), body mass index (P = .035), previous falls (P = .003), walker/cane use (P = .039), and dementia (P = .038) were predictive of readmission. Therapy was shown to benefit patients, but deferred therapy sessions were shown to be associated with prolonged hospitalization. Conclusion Directed therapy may improve functionality and return autonomy to elderly mechanical fall patients admitted to trauma services. Elderly fall patient evaluation after falls can predict need for therapy. Directed therapy can benefit and potentially prevent recurrence of falls. Deferrals of therapy are associated with prolonged hospital stays.
Collapse
Affiliation(s)
- Christopher W Foote
- South Texas Health System Trauma Department, McAllen Medical Center, McAllen, TX
- Valley Health System General Surgery Residency Program, Las Vegas, NV
- Corresponding author at: Trauma Surgery/General Surgery Department, Valley Health System, Graduate Medical Education, Las Vegas, NV, United States of America.
| | - Cheryl Vanier
- Touro University Nevada College of Osteopathic Medicine, Touro University Nevada, Henderson, NV
- Corresponding author at: Trauma Surgery/General Surgery Department, Valley Health System, Graduate Medical Education, Las Vegas, NV, United States of America.
| | - Chaoyang Chen
- Orthopedic Surgery and Sports Medicine, Detroit Medical Center, Detroit, MI
| | - Carlos H Palacio
- South Texas Health System Trauma Department, McAllen Medical Center, McAllen, TX
| |
Collapse
|
7
|
Gimunová M, Sebera M, Kasović M, Svobodová L, Vespalec T. Spatio-Temporal Gait Parameters in Association with Medications and Risk of Falls in the Elderly. Clin Interv Aging 2022; 17:873-883. [PMID: 35663050 PMCID: PMC9156521 DOI: 10.2147/cia.s363479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to analyze factors affecting spatio-temporal gait parameters in elderly people of both genders and different ages with different risks of fall, fall history, and medications. Patients and Methods A total of 210 community-dwelling older adults (156 females, 54 males; mean age 72.84±6.26 years) participated in this study. To assess the risk of falls, the Downton Fall Risk Index was used. An additional question about medication intake (all prescribed drugs) was asked. To assess the spatio-temporal gait parameters, the Zebris FDM platform was used. Gait parameters and Downton Fall Risk Index, stratified by participants' history of falls, multiple medication use (0/1/2+), gender, age, and medication categories, were statistically analyzed using the Mann-Whitney U-test and Kruskal-Wallis test. Results When comparing different medication categories, a Downton Fall Risk Index score indicating a high risk of falls was observed in the psychotropic medication category (3.56±1.67). A gait velocity suggesting a higher risk of falls (≤3.60 km/h) was observed in the psychotropic (2.85±1.09 km/h) and diabetes (2.80±0.81 km/h) medication categories, in the age groups 70-79 years (3.30±0.89 km/h) and 80+ years (2.67±0.88 km/h), and in participants using two or more medications (3.04±0.93 km/h). Conclusion The results of this study confirm previous observations and show that higher age and multiple medication negatively affect the gait, and that the higher risk of falls is associated with psychotropic and diabetes medication use. These results provide important information for future fall preventive programs for the elderly that would be especially beneficial for elderly people taking psychotropic and diabetes medication.
Collapse
Affiliation(s)
- Marta Gimunová
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Martin Sebera
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Mario Kasović
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Lenka Svobodová
- Department of Gymnastics and Combatives, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
- Incubator of Kinanthropology Research, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Tomáš Vespalec
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| |
Collapse
|
8
|
Qian XX, Chen Z, Fong DYT, Ho M, Chau PH. Post-hospital falls incidence and risk factors among older adults: a systematic review and meta-analysis. Age Ageing 2022; 51:6408804. [PMID: 34718373 DOI: 10.1093/ageing/afab209] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital. OBJECTIVES To systematically summarise existing evidence on the incidence and risk factors for post-hospital falls among older adults. METHODS A systematic review and meta-analysis was conducted. Six electronic databases were searched to identify cohort studies investigating the incidence and risk factors for post-hospital falls in older adults. The incidence and risk factors for post-hospital falls were extracted. The meta-analysis was used to calculate pooled incidences and 95% confidence intervals (CI). The meta-regression and subgroup meta-analysis were conducted to explore sources of heterogeneity in incidence proportions across the eligible studies. A qualitative synthesis was performed for the post-hospital falls risk factors. RESULTS Eighteen studies from eight countries (n = 9,080,568) were included. The pooled incidence proportion of any and recurrent post-hospital falls was 14% (95% CI: 13%-15%) and 10% (95% CI: 5%-14%), respectively. Follow-up period, study quality, study country, setting, percentage of female subjects, percentage of subjects with previous falls and the primary data collection method for falls significantly contributed to the 64.8% of the heterogeneity in incidence proportions. Twenty-six risk factors for post-hospital falls were identified in the eligible studies, where biological factors were the most commonly identified factors. The highest risks were reported for previous falls, previous fractures, delirium and neurological diseases. CONCLUSION The findings of this study suggested future post-hospital falls prevention should prioritise the needs of older adults with the dominant risk factors. Further investigations into the period-specific incidence and socioeconomic and environmental risk factors for post-hospital falls are also required.
Collapse
Affiliation(s)
- Xing Xing Qian
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Zi Chen
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Daniel Y T Fong
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| |
Collapse
|
9
|
The Impact of COVID-19 on Levels of Adherence to the Completion of Nursing Records for Inpatients in Isolation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111262. [PMID: 34769780 PMCID: PMC8583626 DOI: 10.3390/ijerph182111262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has led to an increased workload for nurses and organisational and structural changes, which have been necessary to meet the needs of inpatients in isolation. AIM To describe the impact of the COVID-19 pandemic on levels of adherence to the completion of nursing records that document the risk of developing pressure ulcers, falling, and social vulnerability among hospitalised patients in isolation. METHODS Observational pre-post comparison study. Comparison between nursing records (the Braden, Downton, and Gijón scales) belonging to 1205 inpatients took place in two phases. Phase 1: 568 patients admitted in February 2020, prior to the COVID-19 pandemic, vs. phase 2: 637 patients hospitalised with COVID-19 in March-April 2020, during the peak of the first wave of the pandemic. This research adheres to the STROBE guidelines for the reporting of observational studies. RESULTS The degree of completion of the Braden, Downton, and Gijón scales decreased significantly in phase 2 vs. phase 1 (p < 0.001). The mean Downton and Gijón scale scores for patients admitted in phase 1 were higher compared to those of patients admitted in phase 2 (p < 0.001). The mean Braden scale score in phase 2 was higher than in phase 1 (p < 0.05). CONCLUSION During the COVID-19 pandemic, there was a decrease in the completion of nursing records in the clinical records of patients in isolation. The levels of risk of developing PUs, falling, and social vulnerability of patients admitted to hospital were lower during the first wave of the pandemic.
Collapse
|
10
|
Willers C, Boström AM, Carlsson L, Lager A, Lindqvist R, Rydwik E. Readmission within three months after inpatient geriatric care-Incidence, diagnosis and associated factors in a Swedish cohort. PLoS One 2021; 16:e0248972. [PMID: 33750976 PMCID: PMC7984622 DOI: 10.1371/journal.pone.0248972] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Readmissions are very costly, in monetary terms but also for the individual patient's safety and health. Only by understanding the reasons and drivers of readmissions, it is possible to ensure quality of care and improve the situation. The aim of this study was to assess inpatient readmissions during the first three months after discharge from geriatric inpatient care regarding main diagnosis and frequency of readmission. Furthermore, the aim was to analyze association between readmission and patient characteristics including demography and socioeconomics, morbidity, physical function, risk screening and care process respectively. METHODS The study includes all individuals admitted for inpatient care at three geriatric departments operated by the Stockholm region during 2016. Readmission after discharge was studied within three different time intervals; readmission within 10 days after discharge, within 11-30 days and within 31-90 days, respectively. Main diagnosis at readmission was assessed. RESULTS One fourth of the individuals discharged from inpatient geriatric care was readmitted during the first three months after discharge. The most common main diagnoses for readmission were heart failure, chronic obstructive pulmonary disease and pneumonia. Statistically significant risk factors for readmission included age, sex, number of diagnoses at discharge, and to some extent polypharmacy and destination of discharge. CONCLUSIONS Several clinical risk factors relating to physical performance and vulnerability were associated with risk of readmission. Socioeconomic information did not add to the predictability. To enable reductions in readmission rates, proactive monitoring of frail individuals afflicted with chronic conditions is necessary, and an integrated perspective including all stakeholders involved is crucial.
Collapse
Affiliation(s)
- Carl Willers
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Region Stockholm, FOU nu, Research and Development Center for the Elderly, Stockholm, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Theme Aging, Stockholm, Sweden
- R&D Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Lennart Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anton Lager
- Region Stockholm, Centre for Epidemiology and Community Medicine, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Rikard Lindqvist
- Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Rydwik
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Region Stockholm, FOU nu, Research and Development Center for the Elderly, Stockholm, Sweden
- Medical Unit for Aging, Health and Function, Function Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
11
|
Huang HC, Tsai TF, Subeq YM. Using grey relational analysis and grey integrated multi-objective strategy to evaluate the risk factors of falling of aboriginal elders in Taiwan. Soft comput 2020. [DOI: 10.1007/s00500-019-04178-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
12
|
Neuroimaging signatures of cerebral small vessel disease and risk of falls in stroke-free older adults living in rural Ecuador. The Atahualpa Project. J Neurol Sci 2019; 402:133-135. [PMID: 31132535 DOI: 10.1016/j.jns.2019.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/26/2019] [Accepted: 05/20/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE This study aimed to assess the association between neuroimaging signatures of cerebral small vessel disease (cSVD) and the risk of falls in stroke-free older adults living in rural Ecuador. METHODS Risk of falls was evaluated by the Downton Fall Risk Index (DFRI). MRI readings focused on white matter hyperintensities (WMH) of presumed vascular origin, deep cerebral microbleeds (CMB), silent lacunar infarcts (LI), and > 10 enlarged basal ganglia-perivascular spaces (BG-PVS). Logistic regression models were fitted to evaluate whether these neuroimaging signatures were associated with the DFRI, after adjusting for relevant confounders. RESULTS We included 288 participants. The DFRI was positive in 69 (24%). Moderate-to-severe WMH were noticed in 55 individuals (19%), deep CMB in 18 (6%), LI in 23 (8%), and > 10 BG-PVS in 65 (23%). Multivariate models showed a significant association between moderate-to-severe WMH and the DFRI (p = .016). There were no associations between other neuroimaging signatures of cSVD and the DFRI. Age was the single covariable remaining significant in all models. CONCLUSIONS WMH is associated with the DFRI in stroke-free older adults living in a remote rural setting. A target for fall prevention should include the control of factors favoring the development of diffuse subcortical damage of vascular origin.
Collapse
|
13
|
Prevalence, Severity, and Risk of Future Falls in Community-Dwelling Older Adults Living in a Rural Community: The Atahualpa Project. J Community Health 2019; 44:487-491. [PMID: 30989455 DOI: 10.1007/s10900-019-00664-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Accidental falls are a leading cause of disability and death in older adults living in urban centers. However, little is known about the consequences of falls in rural communities. We aimed to assess characteristics and risk of falls in community-dwellers aged ≥ 60 years living in rural Ecuador. Of 463 older adults enrolled in the Atahualpa Project, 327 (71%) were included. Multivariate logistic regression models were fitted to assess factors associated with history of falls and risk of future falls. Sensitivity analysis was conducted to determine which component of the Downton fall risk index (DFRI) better predicts risk of future falls. A history of falls was reported by 173 (53%) individuals. Most were related to stumbling due to uneven (non-paved) streets. Only three individuals had bone fractures after the fall. Previous falls were not associated with any of the investigated covariables. The DFRI was positive in 87 (27%) participants, and was associated with age (p < 0.001) and history of stroke (p < 0.001). None of the subjects were taking tranquilizers/sedatives. The most reliable component of the DFRI was the presence of sensory/motor deficits. History of falls in our population is similar to that reported elsewhere. However, the risk of future falls is lower. Such discrepancies are probably because the DFRI does not take into account environmental factors resulting in falls. There were almost no severe complications from falls, which could be partly related to the lack of use of tranquilizers/sedatives.
Collapse
|