P-393: Functional decline in the hospitalized elderly patient Modifiable risk factors

摘要

Introduction: A hospital admission is considered as a risk to the geriatric patient, with a high probability of suffering adverse events. Method: Objective: Know the modifiable risk factors associated with the hospital functional decline (HFD). Observational, retrospective study. It was included all the patients admitted in an acute care geriatric ward from January 15th to April 15th 2019. Dividing the patients in presence of HFD (lost of C 1 activity of daily living at discharge in comparison of the previous functional status) and without presence of HFD, using Barthel index (BI). Variables: Modifiable factors (first 48 h post admission): urinary catheter (UC), fluid-therapy, mechanical containment measures (MC), bedding, delirium, polypharmacy, use of psychotropic drugs. Results: 199 patients. 87.6 years. 66.8% women. 34% institutionalized. At hospital admission: 24% with HFD (48/192), mean of 23 points less in the BI at discharge. HFD group: mean age 88.13 years. 72.9% women. First 48 h: 12.5% bedding, 68.8% fluid-therapy. 12.5% had UC. 14.6% MC. 87.5% had polypharmacy. 62.5% had psychotropic drugs. 37.5% presented delirium. No HFD group: mean age 87.47 years. 67.4% women. First 48 h: 4.9% bedding. 58.3% fluid-therapy. 9.7% had UC. 4.9% MC. 80.6% polypharmacy. 54.9% had psychotropic drugs. 18% presented delirium. Factors that were associated with HFD: bedding p = 0.068. MC p = 0.025 and delirium: p = 0.006. Conclusions: During hospitalization were observed several risk factors like bedding, mechanical containment measures and delirium that are preventable. Identifying patients in risk of hospital functional decline is fundamental to make a multidisciplinary intervention.