Innovative model for older inpatients falls predictors assessment: a prognostic cohort study: Innovative model for older inpatients falls predictors assessment

Lea Godino; Daniela Mosci; Elisa Ambrosi; Luisa Sist; Roberta Decaro; Paolo Chiari; Domenica Gazineo

doi:10.54103/dn/28125

Autori/Autrici

Lea Godino Medical Genetics Unit, IRCCS AOUBO https://orcid.org/0000-0002-3763-9372
Daniela Mosci Hospital Hygiene and Prevention, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Elisa Ambrosi Department of Diagnostic and Public Health University of Verona Italy, Italy
Luisa Sist Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy https://orcid.org/0000-0002-1283-7364
Roberta Decaro Postoperative and Abdominal Organ Transplant Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
Paolo Chiari Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
Domenica Gazineo Governo Clinico e Qualità, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy https://orcid.org/0000-0003-1866-3358

DOI:

https://doi.org/10.54103/dn/28125

Parole chiave:

Studio di coorte prognostico, pazienti anziani ricoverati, rischio di caduta, scala di Conley, modello

Abstract

Background. Le cadute ospedaliere sono incidenti evitabili ma continuano a rappresentare una problematica rilevante e frequente per la sicurezza dei pazienti. Il 60% delle cadute è causato da più di un fattore. L’identificazione e la valutazione precoce del rischio elevato di caduta nei pazienti ricoverati, all’inizio del ricovero, rimane poco chiara.

Obiettivi. Questo studio valuta i fattori prognostici che predicono le cadute nei pazienti ospedalizzati in una coorte consecutiva di soggetti.

Metodi. Uno studio prospettico multicentrico di coorte è stato condotto in 12 reparti del Nord Italia tra aprile 2015 e dicembre 2016, includendo 11,768 pazienti ricoverati a rischio di caduta. Sono state analizzate variabili come sesso, età, difficoltà ad alzarsi dal letto, storia di cadute, vertigini, limitazioni fisiche, frequenza di utilizzo del bagno, trattamenti farmacologici cardiovascolari o neurologici e il punteggio della Scala di Conley.

Risultati. L'analisi di regressione multivariata ha mostrato che il sesso femminile, la difficoltà ad alzarsi dal letto, una storia di cadute, vertigini o capogiri negli ultimi tre mesi, le limitazioni fisiche (ad esempio equilibrio e deambulazione compromessi), il giudizio compromesso/mancanza di consapevolezza del pericolo e l'assunzione di farmaci cardiovascolari o neurologici sono fattori di rischio associati alle cadute.

Conclusioni. Questo studio identifica i principali predittori delle cadute ospedaliere e propone un modello innovativo per la valutazione precoce del rischio di caduta nei pazienti anziani ricoverati. Questi risultati possono guidare lo sviluppo di modelli di valutazione del rischio e informare future ricerche sull’utilizzo delle cartelle cliniche elettroniche per migliorare le strategie di prevenzione delle cadute.

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