No abstract

No abstract

Introduction: Increased occurrences of falls after discharge are reported, especially in elderly people. Falls are a major cause of disability and identification of risk factors associated with falls is required to plan preventive actions. This study aims to determine the occurrence of falls in the three months after discharge and risk factors in elderly patients. Materials and Methods: 100 patients over 65 admitted to an Internal Medicine Ward participated. Questionnaires were given during hospitalization and three months after discharge. Follow-up information was unavailable for 31 patients (25 deceased, 6 unreachable). Results: Of those analyzed 52% were males with 80 ± 8.1 years (mean ± SD). Polymedication (p = 0.002), use of psychoactive drugs (p = 0.007), analgesics (p = 0.034) and walking devices (p = 0.006) were associated with a higher incidence of falls 6 months before hospitalization. Post-discharge follow-up was obtained for 69 patients: 18 reported falling during the follow-up. There was a higher risk of fall in patients with a history of falls in the 6 months before admission (p = 0.015 RR = 2.76). Patients who had one or more falls after discharge had a significantly shorter length of hospital stay compared to those who didn't fall (p = 0.012). In multivariate logistic regression, we found that patients who were hospitalized more than 7 days had a lower risk of falling in the post-discharge period (OR = 0.195, p = 0.017) independently of the history of falls 6 months prior to admission. Conclusions: Further studies are required to validate the risk factors identified after discharge and to evaluate preventive measures. Elderly patients discharged from an Internal Medicine Ward should be screened to determine the risk of falls, specifically previous history of falls and medication. These patients should integrate a fall prevention program. How to cite this paper: Caetano, P., Freitas, J., Brandão, C., Teófilo, T., Campos, I., Laíns, J. and Veríssimo, M. (2018) Risk Factors for Fall in Elderly Patients: Follow-Up Study after Hospital Discharge. Open Journal of Internal Medicine, 8, 220-231.

No abstract

Aims: Stroke represents one of the main causes of mobility and mortality, occurring in three-quarters of the elderly. Rehabilitation aims at improving deficits, function and social integration of patients with stroke sequelae. We characterized an elderly population admitted for post-stroke rehabilitation and evaluated the differences in the functional evolution between elderly and non-elderly patients.Methods: We analyzed retrospectively all the patients suffering a stroke admitted in a Centre of Rehabilitation Medicine between June 1, 2014, and May 31, 2016. Patients were divided into 2 groups: elderly (65 years) and non-elderly (<65 years). The following variables were analyzed: sex, age, days of admission, post-discharge destination and Functional Independence Measure (FIM) at admission and discharge.Results: We analyzed 134 patients with stroke. The majority were elderly with a mean age of 72.07±6.50. 51.3% were men and the number of days of admission was 107.4±59.5 (vs 109.50±55.7 days in the non-elderly group). 86.4% of these patients were discharged home. Comparing FIM mean values at admission and discharge, we found differences between these two groups, the elderly patients having lower FIM values at admission (75.75 vs 82.96 non-elderly; p=0.005) and at discharge (88.93 vs 99.12 non-elderly; p=0.005). There was also some difference in the FIM increase between admission and discharge in these groups. Despite not being statistically significant.Conclusions: Most patients hospitalized were over 65 years old. FIM values at admission of the elderly patients are lower than of the non-elderly, probably because the latter present specific characteristics associated with the ageing process. Although FIM increases were lower in the elderly patients’ group, this difference was not significant whereby they appeared to have functionally benefited as much as the non-elderly. Therefore, age on its own does not appear to be a decision criteria for admission.

No abstract