Анализа Морзеове скале код хоспитализованих пацијената са цереброваскуларном болешћу
Морзеовa скалa код хоспитализованих пацијената
Sažetak
Увод/циљ. Падови пацијената у болничким условима су међу најчешћим озбиљним нежељеним догађајима након цереброваскуларног инсулта у свим стадијумима болести. Циљ ове студије је био да се испита ризик од падова код пацијената са цереброваскуларном болешћу.
Методе.У овом истраживању је спроведена клиничка студија случаја и контроле. Узорак су чинили пацијенти који су боловали од цереброваскуларних болести и примљени у Специјалну болницу за цереброваскуларне болести „Свети Сава“ у Београду, у периоду од 3. фебруара 2018. до 28. јуна 2019. За процену ризика од пада коришћен је Морзеов упитник. Сви статистички прорачуни су обављени коришћењем стандардног комерцијалног софтверског пакета СПСС, верзија 21.0.
Резултати. Већина испитаника са цереброваскуларним инсултом (505 (90,0%)) имала је висок ризик од пада, односно имали су вредности Морзеовог скора ≥45. Просечна Морзеова оцена испитаника у студији била је 67,07±21,08. Број испитаника код којих је дошло до пада је нешто већи него у контролној групи, а испитаници у групи са високим ризиком према Морзеовом скору имају дијагнозу крварења (95,7%:96,7%), левог неуролошког дефицита (91,7%), који су били на јединици интензивне неге (100%).
Закључак. Од велике је важности да се организују програми обуке за пацијенте, здравствене раднике и медицинско особље како би се спречили падови у болничким условима.
Reference
1. GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019; 18(5): 439-458.
2. Walsh M, Galvin R, Williams D, Harbison J, Murhy S, Collins R. et al. Falls-Related EvEnts in the first year after Stroke in Ireland: Results of the multi-centre prospective FREESE cohort study. Europen Stroke Journal. 2018; 3(3): 246-253
3. Xu T, Clemson L, O’Loughlin K, et al. Risk factors for falls in community stroke survivors: a systematic review and meta-analysis. Arch Phys Med Rehabil 2018; 99: 563– 573
4. Callaly EL, Chroinin DN, Hannon N, et al. Falls and fractures 2 years after acute stroke: the North Dublin Population Stroke Study. Age Ageing 2015; 44: 882–886.
5. Intercollegiate Stroke Working Party. National clinical guideline for stroke. 5th Edition. London: Royal College of Physicians, 2016.
6. Horozović V, Živković Šulović M, Dukić D, Ljubičić M, Atanasijević D, Bracanski J. et al. Report on improving the quality of work in healthcare institutions of the Republic of Serbia in 2017. Institute for Public Health of Serbia "Dr. Milan Jovanović Batut". 2018; 226-233.
7. Gaskell N, Choulerton J, Shaw L, et al. Fracture risk and bone health following a stroke are inadequately considered by physicians: a UK survey of practice. Eur Geriatr Med 2016; 7: 547–550
8. Anghelescu A. Considerations of Gait Limitations and High Prevalence of Falls, in Elderly with Most Common, Disabling Neurological Diseases. Int J Neurorehabilitation. 2017; 4(2): 262.
9. Barker A, Morello R, Wolfe R, Brand C, Haines T, Hill K, et al. 6- PACK programme to decrease fall injures in acute cluster randomized controlled trial. BMJ. 2016; 352.
10. Florence CE, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical Costs of fatal and Nonfatal Falls in Older Adults. J Am Geriatr Soc. 2018; 66(4): 693-698.
11. Hoffman GJH, Ron D, Shapiro Martin F, Wallace Steven P, Ettner Susan L. Claims-based Identification Methods and the Cost of Fall-related Injuries Among US Older Adults. Medical Care. 2016;54:664–671.
12. Patient falls improvement collaborative. Available from: https://improvement.nhs.uk/resources/patient-falls-improvement-collaborative
13. Licul R, Matteoni T, Močenić M. Procjena riika od pada: pregled skala za evaluaciju rizika. JAHS. 2017; 3(1): 73-78.
14. Mansfield A, Innes E, Mciloroy W. Stroke. Handbook of Clinical Neurology (3rd series). Balance, Gait and Falls. Elsevier B.V.2018 (Vol 159).
15. Morello R, Barker A, Watts J, Haines T, Zavarsek S, Hill K, et al. The extra resource burden of in-hospital falls: a cost of falls study. MJA. 2015; 203(9): 367e1-367e8.
16. Morse JM, Black C, Oberle K, Donahue P. (1989). A prospective study to identify the patient at risk for falls.Soc Sci Med, 28(1): 81-86.
17. Indredavik B, Rohweder G, Naalsund E, Lydersen S. Medical complications in a comprehensive stroke unit and an early supported discharge service. Stroke. 2008; 39:414-42
18. Giles LC, Whitehead CH, Jeffers L, McErlean B, Thompson D, Crotty M. Falls in hospitalized patients: can nursing information systems data predict falls? Comput Inform Nurs. 2006;24(3):167-72.
19. Healey F. A guide on how to prevent falls and injury in hospital. Nurs Older People. 2010;22(9):16–22.
20. Lovallo C, Rolandi S, Rossetti AM, Lusignani M. Accidental falls in hospital inpatients: evaluation of sensitivity and specificity of two risk assessment tools. J Adv Nurs. 2010;66(3):690–6.
21. Diccini S, Gomes de Pinho P, Oliveira da Silva F. Assessment of risk and incidence of falls in neurosurgical inpatients. Rev Lat Am Enfermagem. 2008;16(4):752–7.
22. Hunderfund ANL, Sweeney CM, Mandrekar JN, Johnson LM, Britton JW. Effect of multidisciplanary fall risk assessment on falls among neurology inpatients. Mayo Clin Proc. 2011;86(1):19–24.
23. Albernaz PLM, Dos Santos Cabral FS. Vertigo and dizziness in elderly patients with neurological disorders. Einstein (Sao Paulo). 2011;9(4):466–9.
24. Koç Z, Memiş A, Sağlam Z. Prevalence, etiology and risk factors for falls in neurological patients admitted to the hospital in northern Turkey. Acta Clin Croat. 2020; 59(2): 199–208.
25. Nakai A, Akeda M, Kawabata I. Incidence and risk factors for inpatient falls in an academic acute-care hospital. J Nippon Med Sch. 2006;73(5):265–70.
26. Jönsson AC, Lindgren I, Delavaran H, Norrving B, Lindgren A. Falls After Stroke: A Follow-up after Ten Years in Lund Stroke Register. J Stroke Cerebrovasc Dis. 2021;30(6):105770.
27. Campbell GB, Matthews JT. An integrative review of factors associated with falls during post-stroke rehabilitation. J Nurs Scholarsh. 2010;42(4):395-404.
28. Bugdayci D, et al. Frequency, features and factors for falls in a group of subacute stroke patients hospitalized for rehabilitation in Instanbul. Arch Gerontol Geriatr. 2011;52:215-9.
29. Homann B, Plaschg A, Grundner M, Haubenhofer A, Griedl T, Ivanic G, Hofer E, Fazekas F, Homann CN. The impact of neurological disorders on the risk for falls in the community dwelling elderly: a case-controlled study. BMJ Open. 2013;3(11):e003367.
30. Walsh ME, Galvin R, Williams DJ, Harbison JA, Murphy S, Collins R, McCabe DJ, Crowe M, Horgan NF. Falls-Related EvEnts in the first year after StrokE in Ireland: Results of the multi-centre prospective FREESE cohort study. Eur Stroke J. 2018;3(3):246-253.
31. Wei WE, De Silva DA, Chang HM, Yao J, Matchar DB, Young SHY, See SJ, Lim GH, Wong TH, Venketasubramanian N. Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study. BMC Geriatr. 2019;19(1):373.
32. Teasell R, McRae M, Foley N, Bhardwaj A. The incidence and consequences of falls in stroke patients during inpatient rehabilitation: factors associated with high risk. Arch Phys Med Rehabil. 2002;83(3):329-33.
33. Tsur A, Segal Z. Falls in stroke patients: risk factors and risk management. Isr Med Assoc J. 2010;12(4):216-9.
34. Fasano A, Plotnik M. Neurologic aspects and falls. Clin Cases Miner Bone Metab. 2012;9(1):17-20.
35. Moylan KC, Binder EF. Falls in older adults: risk assessment, management, and prevention. Am J Med. 2007;120(6):493.e1–7.e6.
36. Özden D, Karagözoğlu Ş, Kurukız S. Determination of fall risk according to Hendrich II and Morse Fall Scale: a pilot study. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2012;15(1):80–8.
37. Hitcho EB, Krauss M, Brige S, Dunagan WC, Fischer I, Johnson S, et al. Characteristics and circumstances of falls in a hospital setting: a prospective analysis. J Gen Intern Med. 2004;19(7):732–9.
38. LeLaurin JH, Shorr RI. Preventing Falls in Hospitalized Patients: State of the Science. Clin Geriatr Med. 2019;35(2):273-283.
39. LeLaurin JH, Shorr RI. Preventing Falls in Hospitalized Patients: State of the Science. Clin Geriatr Med. 2019;35(2):273-283.
