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      QUEDA DO MESMO NÍVEL EM IDOSOS: FATORES ASSOCIADOS AO TRAUMA CRANIOENCEFÁLICO E RAQUIMEDULAR Translated title: CAÍDA DESDE ALTURA SIMILAR EN ANCIANOS: FACTORES ASOCIADOS AL TRAUMA CRANEOENCEFÁLICO Y RAQUIMEDULAR Translated title: SAME-LEVEL FALLS IN OLDER ADULTS: FACTORS ASSOCIATED WITH TRAUMATIC BRAIN AND SPINAL CORD INJURIES

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          Abstract

          RESUMO: Objetivo: identificar fatores associados à ocorrência de trauma cranioencefálico e raquimedular entre idosos que sofreram queda do mesmo nível. Método: estudo retrospectivo, com 192 prontuários de idosos que sofreram queda do mesmo nível em 2014 e foram atendidos no Pronto Atendimento de um hospital de ensino do Paraná. Realizou-se teste Z, para comparação de proporções do grupo com (n=80) e sem (n=112) trauma cranioencefálico ou raquimedular com dados demográficos, de saúde, da queda e da avaliação/atendimento. Resultados: dos idosos identificados, 80 (41,7%) tiveram traumatismo cranioencefálico ou raquimedular. Houve associação significativa com a ocorrência de traumatismo cranioencefálico ou raquimedular: sexo masculino (p=0,0109), transporte especializado (p=0,0001), queda em via pública (p=0,0026), ausência de hipertensão arterial (p=0,0434) e presença de doença psiquiátrica (p=0,0048). Conclusão: o trauma cranioencefálico ou raquimedular é um evento frequente associado à queda do mesmo nível, o que denota a necessidade de medidas educativas e preventivas visando à redução da quedas.

          Translated abstract

          RESUMEN: Objetivo: Identificar factores asociados a la ocurrencia de traumas craneoencefálicos y raquimedulares entre ancianos que sufrieron caídas desde alturas similares. Método: Estudio retrospectivo, con 192 historias clínicas de ancianos que cayeron desde alturas similares en 2014, atendidos en la Guardia de un hospital de enseñanza de Paraná. Se realizó test Z para comparación de proporciones del grupo con (n=80) y sin (n=112) trauma craneoencefálico o raquimedular con datos demográficos, de salud, de la caída y de la evaluación/atención. Resultados: Ochenta (41,7%) ancianos sufrieron traumatismo craneoencefálico o raquimedular. Existió asociación significativa con traumatismo craneoencefálico o raquimedular en: sexo masculino (p=0,0109), transporte especializado (p=0,0001), caída en vía pública (p=0,0026), ausencia de hipertensión arterial (p=0,0434) y presencia de enfermedad psiquiátrica (p=0,0048). Conclusión: El trauma craneoencefálico o raquimedular constituye un evento frecuentemente asociado a caídas desde niveles similares, expresando ello necesidad de medidas educativas y preventivas apuntando a reducir las caídas.

          Translated abstract

          ABSTRACT: Objective: to identify factors associated with the occurrence of traumatic brain and spinal cord injuries among older adults who suffered a same-level fall. Method: a retrospective study, with 192 medical records of older adults that suffered a same-level fall in 2014 and were attended in the Emergency Care Unit of a teaching hospital in Paraná. The Z test was performed to compare the proportions of the groups with (n=80) and without (n=112) traumatic brain or spinal cord injuries with demographic, health, fall and evaluation/care data. Results: 80 (41.7%) of the older adults identified had traumatic brain or spinal cord injuries. There was a significant association of the occurrence of traumatic brain or spinal cord injuries with: male gender (p=0.0109), specialized transport (p=0.0001), fall on public road (p=0.0026), absence of arterial hypertension p=0.0434) and presence of psychiatric illness (p=0.0048). Conclusion: traumatic brain and spinal cord injuries are frequent events associated with same-level falls, which indicates the need for educational and preventive measures aimed at the reduction of falls.

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          Most cited references21

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          Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies.

          Falls are the leading cause of injuries among older adults, aged 65 years and older. Furthermore, falls are an increasing public health problem because of ageing populations worldwide due to an increase in the number of older adults, and an increase in life expectancy. Numerous studies have identified risk factors and investigated possible strategies to prevent (recurrent) falls in community-dwelling older people and those living in long-term care facilities. Several types of drugs have been associated with an increased fall risk. Since drugs are a modifiable risk factor, periodic drug review among older adults should be incorporated in a fall prevention programme.
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            Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.

            Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care.
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              Deaths from unintentional injury among adults aged 65 and over: United States, 2000-2013.

              In 2012-2013, 55% of all unintentional injury deaths among adults aged 65 and over were due to falls. From 2000 through 2013, the age-adjusted fall injury death rate among adults aged 65 and over nearly doubled from 29.6 per 100,000 to 56.7 per 100,000. In 2012-2013, the death rate due to suffocation was more than 8 times higher among adults aged 85 and over (26.5 per 100,000) compared with adults aged 65-74 (3.1 per 100,000). Among adults aged 65 and over, the death rate due to fire was more than twice as high for non-Hispanic black adults as for non-Hispanic white and Hispanic adults. The death rate from motor vehicle traffic crashes among adults aged 65 and over was 1.7 times higher in nonmetropolitan areas compared with metropolitan areas.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ce
                Cogitare Enfermagem
                Cogitare enferm.
                Universidade Federal do Paraná (Curitiba, PR, Brazil )
                1414-8536
                2176-9133
                January 2018
                : 23
                : 4
                : e56325
                Affiliations
                [1] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                [3] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                [4] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                [2] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                Article
                S1414-85362018000400313
                10.5380/ce.v24i3.56325
                ff9e18fd-d6e4-49b8-b049-cda4321ab02c

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

                History
                : 14 November 2017
                : 22 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigo Original

                Medicina de Emergencia,Health services for the older adults,Aging,Traumatology,Wounds and injuries,Emergency medicine,Serviços de saúde para idosos,Envelhecimento,Traumatologia,Ferimentos e lesões,Medicina de emergência,Servicios de Salud para Ancianos,Envejecimiento,Traumatología,Heridas y Lesiones

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