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      Perfil y satisfacción del patrón evacuador en pacientes hospitalizados en una unidad de ortogeriatría Translated title: Satisfaction profile of the evacuation pattern in patients hospitalized in an orthogeriatric unit

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          Abstract

          RESUMEN Objetivos: Describir el perfil de los pacientes hospitalizados en la unidad de ortogeriatría de un hospital terciario en lo que respecta a su patrón evacuador e identificar la satisfacción de aquellos durante la hospitalización y los posibles motivos de insatisfacción. Metodología: Estudio descriptivo y transversal sobre 200 personas mayores de 65 años ingresadas en la Unidad de Ortogeriatría del Hospital Vall d'Hebron (Barcelona). Variables: sociodemográficas (edad y sexo), polifarmacia, consumo de fibra, consumo de laxantes previo y durante la hospitalización, ingesta hídrica, consumo de mórficos durante la hospitalización, movilización precoz, estreñimiento crónico (Escala Roma III), satisfacción del patrón evacuador tanto en domicilio como durante la hospitalización, principales síntomas y factores desencadenantes de la posible insatisfacción. Resultados: Predominio del sexo femenino (77%) frente al masculino (23%), edad media 83,92 años. Destaca polifarmacia (>5 fármacos) (63%), consumo de opiáceos (57,5%), automedicación de laxantes (52,5%), insatisfacción del patrón evacuador durante el ingreso (65%) respecto al previo (38%) y estreñimiento crónico (25%) según criterios Roma III. El síntoma más descrito por los pacientes es el esfuerzo excesivo para evacuar (60%) y la demora en la respuesta de la llamada (43,84%). Se identificaron 8 factores que explican hasta el 61,25% de la varianza total. Conclusión: El estudio ha permitido identificar los factores relacionados con el perfil de los pacientes hospitalizados en la Unidad de Ortogeriatría del Hospital Vall d'Hebron en lo que respecta a su patrón evacuador e identificar la satisfacción respecto al patrón de eliminación durante la hospitalización y los posibles motivos de insatisfacción.

          Translated abstract

          ABSTRACT Objective: Describe the defecation pattern profile of patients hospitalized at Orthogeriatrics Unit of a tertiary Trauma Center, to evaluate defecation satisfaction during hospitalization and potential reasons for dissatisfaction. Methods: This is a cross-sectional descriptive study of 200 patients (> 65 years old) admitted to the Orthogeriatrics Unit of Hospital Vall d'Hebron. Evaluated variables incloude: sociodemographic date (age and sex), polypharmacy (>5 drugs), fiber intake, laxatives use before and during hospitalization, water intake, morphine intake during hospitalization, early mobilization, chronic constipation (Rome III scale), satisfaction of the evacuation pattern at home and during hospitalization, symptoms and trigger factors of their potential dissatisfaction. Results: Most of the patients were female (77%) with a mean (23%) age of 83.92 years. Among the enrolled patients, (63%) take more than (>5 drugs), 57.5% use opioid and 52.5% reported self-prescribed laxatives use 65% were dissatisfied with their evacuation pattern during admission compared to the previous one (38%). According to Rome III criteria, 25% suffer from chronic constipation. The most reported symptom was the excessive straining (60%) and the trigger factor for dissatisfaction was the delayed response to the call of sanitary teams (43.84%). We obtained eight factors that explain up to 61.25% of the total variance. Conclusion: Due to the high rate of dissatisfaction reported by patients while, we believe it is necessary to carry out further research on new tools that improve constipation diagnosis, including specific criteria. Moreover, we recommend the implementation of an action algorithm could diminish the variability of therapeutic approaches in our clinical practice.

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          SOME PRELIMINARY FINDINGS ON PHYSICAL COMPLAINTS FROM A PROSPECTIVE STUDY OF 1,064,004 MEN AND WOMEN

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            Prevalence of constipation: agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a population-based survey in Spain.

            The aims of this study were to estimate the prevalence of chronic constipation and to evaluate the diagnostic accuracy of the symptoms and the self-reported definition of constipation. A cross-sectional survey was conducted in the general community in 1999. A questionnaire comprising 21 items was developed and mailed to a random sample of 489 subjects who were aged between 18 and 65 years and who belonged to a Spanish population. In the 349 subjects (71%) responding to the questionnaire, the prevalence of self-reported constipation was 29.5% (95% confidence interval (CI): 24.9, 34.3) versus 19.2% (95% CI: 15.1, 23.3) and 14.0% (95% CI: 10.4, 17.7) based on Rome I and Rome II criteria, respectively. Agreement was good between self-reported and Rome I criteria (kappa: 0.68) and between Rome I and Rome II criteria (kappa: 0.71), and it was moderate between self-reported and Rome II criteria (kappa: 0.55). Female gender was identified to be a risk factor for constipation; fiber intake and physical exercise were found to be protective factors. Likelihood ratios were higher for the presence of anal blockage and straining and for the absence of hard stools. Chronic constipation is a highly prevalent problem, especially in women. Different prevalence estimates of constipation were observed using different criteria, although agreement between them was acceptable. Anal blockage, straining, and hard stools show the greatest accuracy for the diagnosis of constipation.
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              Thirty-day mortality after hip fractures: has anything changed?

              Bone density insufficiency is the main cause for significant musculoskeletal trauma in the elderly population following low-energy falls. Hip fractures, in particular, represent an important public health concern taking into account the complicated needs of the patients due to their medical comorbidities as well as their rehabilitation and social demands. The annual cost for the care of these patients is estimated at around 2 billion pounds (£) in the UK and is ever growing. An increased early and late mortality rate is also recognised in these injuries together with significant adversities for the patients. Lately, in order to improve the outcomes of this special cohort of patients, fast-track care pathways and government initiatives have been implemented. It appears that these measures have contributed in a steady year-by-year reduction of the 30-day mortality rates. Whether we have currently reached a plateau or whether an ongoing reduction in mortality rates will continue to be observed is yet to be seen.
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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2020
                : 31
                : 4
                : 211-215
                Affiliations
                [4] Barcelona orgnameHospital Universitari Vall d'Hebron Spain
                [2] Barcelona orgnameHospital Universitari Vall d'Hebron orgdiv1Unidad de Ortogeriatría Spain
                [3] Barcelona orgnameHospital Universitari Vall d'Hebron orgdiv1Unidad de Geriatría Spain
                [5] Barcelona orgnameHospital Universitari Vall d'Hebron Spain
                [1] Barcelona orgnameHospital Universitari Vall d'Hebron orgdiv1Unidad de Ortogeriatría Spain
                [6] Barcelona orgnameHospital Universitari Vall d'Hebron Spain
                Article
                S1134-928X2020000500211 S1134-928X(20)03100400211
                3341b925-ea2f-480b-91d2-c26dd64810ac

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 18 February 2019
                : 16 July 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 5
                Product

                SciELO Spain

                Categories
                Originales

                fractura de fémur,anciano hospitalizado,hip fracture,Constipation,hospitalized elders,Estreñimiento

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