Riesgo de caídas e incidencia de delirio en pacientes hospitalizados en el servicio de ortopedia
Fall risk and incidence of delirium in hospitalized orthopedic patients
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
Mostrar biografía de los autores
Introducción: el riesgo de caídas y de lesiones relacionadas, así como el de presentar delirio, representan un problema de salud pública en constante aumento, en especial en sociedades con una población que envejece. Objetivo: el propósito de este estudio fue evaluar el nivel de riesgo de caídas, previo a cirugía de cadera o rodilla, y la frecuencia de desarrollar delirio después de las intervenciones quirúrgicas. Materiales y métodos: estudio observacional, analítico de corte transversal en el que se encuestaron pacientes hospitalizados en la Clínica de Cirugía Ortopédica y Traumatología, Novi-Sad, Serbia, entre el inicio de diciembre de 2022 y fin de enero de 2023.
Resultados: del número total de pacientes (N = 106), la mayoría (61.3%) tenían más de 70 años, de los cuales la mayor parte eran de sexo femenino (N = 80 (75.5%). El porcentaje más alto de los que respondieron la encuesta fueron categorizados en nivel II de riesgo de caída (73.6%), mientras que se clasificó como nivel I y III a 14 pacientes en cada uno de dichos niveles (13.2%). Los resultados del puntaje 4AT evidenciaron que en la mayoría de los pacientes (N = 50 47.2%) la probabilidad de presentar delirio o deterioro cognitivo fue baja, con posibles deterioro cognitivo en 40 (37.7%) y delirio en 16 (15.1%).
Conclusión: los pacientes hospitalizados en el servicio de ortopedia de la Clínica de Cirugía Ortopédica y Traumatología del Centro Clínico Universitario tenían riesgo de caída nivel II, con baja probabilidad de presentar deterioro cognitivo o delirio en el postoperatorio.
Visitas del artículo 78 | Visitas PDF 42
Descargas
- Van Der Velde N, Seppala L, Petrovic M, et al. Sustainable fall prevention across Europe: challenges and opportunities. Aging Clin Exp Res. 2022;34(10). http://dx.doi.org/10.1007/s40520-022-02178-w
- Luzia M de F, Cassola TP, Suzuki LM, Dias VLM, de Pinho LB, Lucena A de F. Incidence of falls and preventive actions in a University Hospital. Revista da Escola de Enfermagem. 2018;52. http://dx.doi.org/10.1590/S1980-220X2017024203308
- Najafpour Z, Godarzi Z, Arab M, Yaseri M. Risk factors for falls in hospital in-patients: A prospective nested case control study. Int J Health Policy Manag. 2019;8(5). http://dx.doi.org/10.15171/ijhpm.2019.11
- Flynn Makic MB, Martinez-Kratz MR. Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care. Thirteenth edition. Elsevier; 2022.
- King B, Pecanac K, Krupp A, Liebzeit D, Mahoney J. Impact of Fall Prevention on Nurses and Care of Fall Risk Patients. Gerontologist. 2018;58(2). http://dx.doi.org/10.1093/geront/gnw156
- Zhao Y, Alderden J, Lind B, Stibrany J. Risk factors for falls in homebound community-dwelling older adults. Public Health Nurs. 2019;36(6). http://dx.doi.org/10.1111/phn.12651
- Ye C, Li J, Hao S, et al. Identification of elders at higher risk for fall with statewide electronic health records and a machine learning algorithm. Int J Med Inform. 2020;137. http://dx.doi.org/10.1016/j.ijmedinf.2020.104105
- Seppala LJ, Wermelink AMAT, de Vries M, et al. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics. J Am Med Dir Assoc. 2018;19(4). http://dx.doi.org/10.1016/j.jamda.2017.12.098
- Ben Natan M, Yonai Y, Goldschmid N, Berkovich Y. Characteristics of those who fall during orthopedic hospitalization - A retrospective case-control study. Int J Orthop Trauma Nurs. 2021;43. http://dx.doi.org/10.1016/j.ijotn.2021.100868
- Kobayashi K, Ando K, Inagaki Y, et al. Characteristics of falls in orthopedic patients during hospitalization. Nagoya J Med Sci. 2018;80(3). http://dx.doi.org/10.18999/nagjms.80.3.341
- Durmayüksel E, Çinar F, Guven BB, Aslan FE. Risk factors for the development of delirium in elderly patients undergoing orthopaedic surgery: A systematic review and metaanalysis. Journal of Clinical and Investigative Surgery. 2021;6(2):94-103. http://dx.doi.org/10.25083/2559.5555/6.2.3
- Wu H, Kapur A, Gibson B, Bubb K, Alrawashdeh M, Cipkala-Gaffin J. Preoperative Delirium Nursing Model Initiatives to Determine the Incidence of Postoperative Delirium among Elderly Orthopaedic Patients. Orthopaedic Nursing. 2021;40(2). http://dx.doi.org/10.1097/NOR.0000000000000741
- Song KJ, Ko JH, Kwon TY, Choi BW. Etiology and Related Factors of Postoperative Delirium in Orthopedic Surgery. Clin Orthop Surg. 2019;11(3):297. http://dx.doi.org/10.4055/cios.2019.11.3.297
- Esmaeeli S, Franco-Garcia E, Akeju O, et al. Association of preoperative frailty with postoperative delirium in elderly orthopedic trauma patients. Aging Clin Exp Res. 2022;34(3). http://dx.doi.org/10.1007/s40520-021-01961-5
- Choi JY, Kim K Il, Kang MG, et al. Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: A retrospective cohort study. BMC Geriatr. 2019;19(1). http://dx.doi.org/10.1186/s12877-019-1303-z
- Buker N, Eraslan U, Kitis A, Kiter AE, Akkaya S, Sutcu G. Is quality of life related to risk of falling, fear of falling, and functional status in patients with hip arthroplasty? Physiotherapy Research International. 2019;24(3). http://dx.doi.org/10.1002/pri.1772
- Chen SK, Voaklander D, Perry D, Jones CA. Falls and fear of falling in older adults with total joint arthroplasty: a scoping review. BMC Musculoskelet Disord. 2019;20(1):599. http://dx.doi.org/10.1186/s12891-019-2954-9
- Vaishya R, Vaish A. Falls in Older Adults are Serious. Indian J Orthop. 2020;54(1). http://dx.doi.org/10.1007/s43465-019-00037-x
- LeLaurin JH, Shorr RI. Preventing Falls in Hospitalized Patients: State of the Science. Clin Geriatr Med. 2019;35(2). http://dx.doi.org/10.1016/j.cger.2019.01.007
- College Physical and Surgeons of Britsh Columbia. Guidelines for ASA Physical Status Classification System. 2023.
- Hagino T, Ochiai S, Senga S, et al. Validity of a fall risk assessment score sheet for patients hospitalized in general wards. Nagoya J Med Sci. 2022;84(2). http://dx.doi.org/10.18999/nagjms.84.2.311
- Bellelli G, Morandi A, Davis DHJ, et al. Validation of the 4AT, a new instrument for rapid delirium screening: A study in 234 hospitalised older people. Age Ageing. 2014;43(4). http://dx.doi.org/10.1093/ageing/afu021
- Ehn M, Kristoffersson A. Clinical Sensor-Based Fall Risk Assessment at an Orthopedic Clinic: A Case Study of the Staff’s Views on Utility and Effectiveness. Sensors. 2023;23(4):1904. http://dx.doi.org/10.3390/s23041904
- Johansen A, Golding D, Brent L, et al. Using national hip fracture registries and audit databases to develop an international perspective. Injury. 2017;48(10). http://dx.doi.org/10.1016/j.injury.2017.08.001
- Hamood R, Tirosh M, Fallach N, Chodick G, Eisenberg E, Lubovsky O. Prevalence and incidence of osteoarthritis: A population‐based retrospective cohort study. J Clin Med. 2021;10(18). http://dx.doi.org/10.3390/jcm10184282
- Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2020;29-30:100587. http://dx.doi.org/10.1016/j.eclinm.2020.100587
- Rajeev A, Railton C, Devalia K. The crucial factors influencing the development and outcomes of postoperative delirium in proximal femur fractures. Aging Medicine. 2022;5(2). http://dx.doi.org/10.1002/agm2.12206
- Cheong JL, Shariffuddin II, Danaee M, Khor HM, Teang SC, Loh PS. Understanding risk factors for postoperative delirium after elective surgery in a university-based tertiary hospital. Neurol Asia. 2021;26(1).
- Viravan N, Prachason T. Test Assessment of Postoperative Delirium Screening with the Thai-Version 4 ‘A’ s Test in Elderly Patients Undergoing Hip / Knee Replacement. J Psychiatr Assoc Thailand. 2018;63(1):77-88.
- Muzzana C, Mantovan F, Huber MK, et al. Delirium in elderly postoperative patients: A prospective cohort study. Nurs Open. 2022;9(5). http://dx.doi.org/10.1002/nop2.1263
- Ramoutar C, Ventour D. An assessment of postoperative cognitive impairment in the elderly patients at the Port of Spain General Hospital. Caribb Med J. 2019. http://dx.doi.org/10.48107/cmj.2019.11.005