OBJETIVO: Avaliar a validade de predição do Instrumento de Predição de Risco de Admissão Hospitalar Repetida da hospitalização de idosos. MÉTODOS: Estudo de coorte de base populacional com seguimento de seis meses com 515 idosos (> 60 anos de idade) não-institucionalizados, atendidos pela Estratégia Saúde da Família na cidade de Progresso, RS, em 2005. Os idosos responderam a oito perguntas objetivas, que foram reunidas em modelo de regressão logística para estimar seu risco de admissão hospitalar futura, por estratos de risco. Análise de sobrevida e a curva Receiver Operating Characteristics foram empregadas para aferir a validade do instrumento. RESULTADOS: Dos entrevistados, 56,1% eram mulheres e 10,1% foram hospitalizados. O grupo de risco alto teve freqüência de internação hospitalar 6,5 vezes superior em relação ao grupo de risco baixo. CONCLUSÕES: O instrumento é efetivo ao predizer o risco de hospitalização dos idosos atendidos pela Estratégia Saúde da Família do Sistema Único de Saúde.
Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men.ObjectiveTo investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH).MethodsThis retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version) above 5. Other clinical and psychiatric diagnoses were obtained from medical files.ResultsOut of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3%) of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent.ConclusionThe prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.
Identified the inappropriate prescription of drugs in elderly assisted geriatric outpatient clinic in the region of Vale do Rio Pardo in Rio Grande do Sul according to the criteria of STOPP and START. Cross-sectional study of 221 elderly, based on retrospective analysis of medical records using comprehensive geriatric assessment data held in the first visit. Descriptive variables were age, sex, number of pathologies and number of medications in use. And the study variables were potentially inappropriate medications (MPI) and potentially omitted medications (MPO), according to the STOPP and START criteria. Descriptive statistics were performed with frequencies, means and standard deviations where appropriate. It was observed 157 (71%) female patients. The average age was 75 (±8.26) years, 49.8% in the range of 75-84 years. The average number of drugs was 3 (±2.27), with 22.63% using 5 or more medications. The average pathologies was 3.45 (±2.02). They identified 194 prescriptions of MPI and observed 93 MPO. The most identified were the MPI for the cardiovascular system, especially β noncardioselective blockers and acetylsalicylic acid. Also MPO were found most of the cardiovascular system, with emphasis on acetylsalicylic acid and inhibitors of angiotensin converting enzyme. This is sample of elderly with significant prevalence of inappropriate prescribing of drugs. Studies using the STOPP criteria and START in different health care settings can qualify the care provided to the elderly.
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