Browsing by Subject "falls"

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  • Weichert, I.; Romero-Ortuno, R.; Tolonen, J.; Soe, T.; Lebus, C.; Choudhury, S.; Nadarajah, C. V.; Nanayakkara, P.; Orru, M.; Di Somma, S. (2018)
    What is known and objectiveDrugs with anticholinergic properties increase the risk of falls, delirium, chronic cognitive impairment, and mortality and counteract procholinergic medications used in the treatment of dementia. Medication review and optimisation to reduce anticholinergic burden in patients at risk is recommended by specialist bodies. Little is known how effective this review is in patients who present acutely and how often drugs with anticholinergic properties are used temporarily during an admission. The aim of the study was to describe the changes in the anticholinergic cognitive burden (ACB) in patients admitted to hospital with a diagnosis of delirium, chronic cognitive impairment or falls and to look at the temporary use of anticholinergic medications during hospital stay. MethodsThis is a multi-centre observational study that was conducted in seven different hospitals in the UK, Finland, The Netherlands and Italy. Results and discussion21.1% of patients had their ACB score reduced by a mean of 1.7%, 19.7% had their ACB increased by a mean of 1.6%, 22.8% of DAP naive patients were discharged on anticholinergic medications. There was no change in the ACB scores in 59.2% of patients. 54.1% of patients on procholinergics were taking anticholinergics. Out of the 98 medications on the ACB scale, only 56 were seen. Medications with a low individual burden were accounting for 64.9% of the total burden. Anticholinergic drugs were used temporarily during the admission in 21.9% of all patients. A higher number of DAPs used temporarily during admission was associated with a higher risk of ACB score increase on discharge (OR=1.82, 95% CI for OR: 1.36-2.45, P What is new and conclusionThere was no reduction in anticholinergic cognitive burden during the acute admissions. This was the same for all diagnostic subgroups. The anticholinergic load was predominantly caused by medications with a low individual burden. More than 1 in 5 patients not taking anticholinergics on admission were discharged on them and similar numbers saw temporary use of these medications during their admission. More than half of patients on cholinesterase-inhibitors were taking anticholinergics at the same time on admission, potentially directly counteracting their effects.
  • Bousquet, J.; Bewick, M.; Cano, A.; Eklund, P.; Fico, G.; Goswami, N.; Guldemond, N. A.; Henderson, D.; Hinkema, M. J.; Liotta, G.; Mair, A.; Molloy, W.; Monaco, A.; Monsonis-Paya, I.; Nizinska, A.; Papadopoulos, H.; Pavlickova, A.; Pecorelli, S.; Prados-Torres, A.; Roller-Wirnsberger, R. E.; Somekh, D.; Vera-Munoz, C.; Visser, F.; Farrell, J.; Malva, J.; Ranberg, K. Andersen; Camuzat, T.; Carriazo, A. M.; Crooks, G.; Gutter, Z.; Iaccarino, G.; Manuel De Keenoy, E.; Moda, G.; Rodriguez-Manas, L.; Vontetsianos, T.; Abreu, C.; Alonso, J.; Alonso-Bouzon, C.; Ankri, J.; Arredondo, M. T.; Avolio, F.; Bedbrook, A.; Bialoszewski, A. Z.; Blain, H.; Bourret, R.; Cabrera-Umpierrez, M. F.; Catala, A.; O'Caoimh, R.; Cesari, M.; Chavannes, N. H.; Correia-Da-Sousa, J.; Dedeu, T.; Ferrando, M.; Ferri, M.; Fokkens, W. J.; Garcia-Lizana, F.; Guerin, O.; Hellings, P. W.; Haahtela, T.; Illario, M.; Inzerilli, M. C.; Carlsen, K. C. Lodrup; Kardas, P.; Keil, T.; Maggio, M.; Mendez-Zorrilla, A.; Menditto, E.; Mercier, J.; Michel, J. P.; Murray, R.; Nogues, M.; O'Byrne-Maguire, I.; Pappa, D.; Parent, A. S.; Pastorino, M.; Robalo-Cordeiro, C.; Samolinski, B.; Siciliano, P.; Teixeira, A. M.; Tsartara, S. I.; Valiulis, A.; Vandenplas, O.; Vasankari, T.; Vellas, B.; Vollenbroek-Hutten, M.; Wickman, M.; Yorgancioglu, A.; Zuberbier, T.; Barbagallo, M.; Canonica, G. W.; Klimek, L.; Maggi, S.; Aberer, W.; Akdis, C.; Adcock, I. M.; Agache, I.; Albera, C.; Alonso-Trujillo, F.; Angel Guarcia, M.; Annesi-Maesano, I.; Apostolo, J.; Arshad, S. H.; Attalin, V.; Avignon, A.; Bachert, C.; Baroni, I.; Bel, E.; Benson, M.; Bescos, C.; Blasi, F.; Barbara, C.; Bergmann, K. C.; Bernard, P. L.; Bonini, S.; Bousquet, P. J.; Branchini, B.; Brightling, C. E.; Bruguiere, V.; Bunu, C.; Bush, A.; Caimmi, D. P.; Calderon, M. A.; Canovas, G.; Cardona, V.; Carlsen, K. H.; Cesario, A.; Chkhartishvili, E.; Chiron, R.; Chivato, T.; Chung, K. F.; D'Angelantonio, M.; De Carlo, G.; Cholley, D.; Chorin, F.; Combe, B.; Compas, B.; Costa, D. J.; Costa, E.; Coste, O.; Coupet, A. -L.; Crepaldi, G.; Custovic, A.; Dahl, R.; Dahlen, S. E.; Demoly, P.; Devillier, P.; Didier, A.; Dinh-Xuan, A. T.; Djukanovic, R.; Dokic, D.; Du Toit, G.; Dubakiene, R.; Dupeyron, A.; Emuzyte, R.; Fiocchi, A.; Wagner, A.; Fletcher, M.; Fonseca, J.; Fougere, B.; Gamkrelidze, A.; Garces, G.; Garcia-Aymeric, J.; Garcia-Zapirain, B.; Gemicioglu, B.; Gouder, C.; Hellquist-Dahl, B.; Hermosilla-Gimeno, I.; Heve, D.; Holland, C.; Humbert, M.; Hyland, M.; Johnston, S. L.; Just, J.; Jutel, M.; Kaidashev, I. P.; Khaitov, M.; Kalayci, O.; Kalyoncu, A. F.; Keijser, W.; Kerstjens, H.; Knezovic, J.; Kowalski, M.; Koppelman, G. H.; Kotska, T.; Kovac, M.; Kull, I.; Kuna, P.; Kvedariene, V.; Lepore, V.; Macnee, W.; Maggio, M.; Magnan, A.; Majer, I.; Manning, P.; Marcucci, M.; Marti, T.; Masoli, M.; Melen, E.; Miculinic, N.; Mihaltan, F.; Milenkovic, B.; Millot-Keurinck, J.; Mlinaric, H.; Momas, I.; Montefort, S.; Morais-Almeida, M.; Moreno-Casbas, T.; Moesges, R.; Mullol, J.; Nadif, R.; Nalin, M.; Navarro-Pardo, E.; Nekam, K.; Ninot, G.; Paccard, D.; Pais, S.; Palummeri, E.; Panzner, P.; Papadopoulos, N. K.; Papanikolaou, C.; Passalacqua, G.; Pastor, E.; Perrot, M.; Plavec, D.; Popov, T. A.; Postma, D. S.; Price, D.; Raffort, N.; Reuzeau, J. C.; Robine, J. M.; Rodenas, F.; Robusto, F.; Roche, N.; Romano, A.; Romano, V.; Rosado-Pinto, J.; Roubille, F.; Ruiz, F.; Ryan, D.; Salcedo, T.; Schmid-Grendelmeier, P.; Schulz, H.; Schunemann, H. J.; Serrano, E.; Sheikh, A.; Shields, M.; Siafakas, N.; Scichilone, N.; Siciliano, P.; Skrindo, I.; Smit, H. A.; Sourdet, S.; Sousa-Costa, E.; Spranger, O.; Sooronbaev, T.; Sruk, V.; Sterk, P. J.; Todo-Bom, A.; Touchon, J.; Tramontano, D.; Triggiani, M.; Tsartara, S. I.; Valero, A. L.; Valovirta, E.; Van Ganse, E.; Van Hage, M.; Van den Berge, M.; Vandenplas, O.; Ventura, M. T.; Vergara, I.; Vezzani, G.; Vidal, D.; Viegi, G.; Wagemann, M.; Whalley, B.; Wickman, M.; Wilson, N.; Yiallouros, P. K.; Zagar, M.; Zaidi, A.; Zidarn, M.; Hoogerwerf, E. J.; Usero, J.; Zuffada, R.; Senn, A.; De Oliveira-Alves, B. (2017)
    The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).
  • Brucoli, Matteo; Boffano, Paolo; Romeo, Irene; Corio, Chiara; Benech, Arnaldo; Ruslin, Muhammad; Forouzanfar, Tymour; Jensen, Thomas Starch-; Rodríguez-Santamarta, Tanía; de Vicente, Juan Carlos; Snäll, Johanna; Thorén, Hanna; Aničić, Boban; Konstantinovic, Vitomir S.; Pechalova, Petia; Pavlov, Nikolai; Daskalov, Hristo; Doykova, Iva; Kelemith, Kadri; Tamme, Tiia; Kopchak, Andrey; Shumynskyi, Ievgen; Corre, Pierre; Bertin, Helios; Goguet, Quentin; Anquetil, Marine; Louvrier, Aurélien; Meyer, Christophe; Dovšak, Tadej; Vozlič, David; Birk, Anže; Tarle, Marko; Dediol, Emil (2020)
    ABSTRACT Introduction: The progressive aging of European population seems to determine a change in the epidemiology, incidence and etiology of maxillofacial fractures with an increase in the frequency of old patients sustaining craniofacial trauma. The objective of the present study was to assess the demographic variables, causes, and patterns of facial fractures in elderly population (with 70 years or more). Materials and Methods: The data from all geriatric patients (70 years or more) with facial fractures between January 1, 2013, and December 31, 2017, were collected. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, etiology, site of facial fractures, synchronous body injuries, Facial Injury Severity Score (FISS). Results: A total of 1334 patients (599 male and 735 female patients) were included in the study. Mean age was 79.3 years, and 66% of patients reported one or more comorbidities. The most frequent cause of injury was fall and zygomatic fractures were the most frequently observed injuries. Falls were associated with a low FISS value (p<.005). Concomitant injuries were observed in 27.3% of patients. Falls were associated with the absence of concomitant injuries. The ninth decade (p <.05) and a high FISS score (p <.005) were associated with concomitant body injuries too. Conclusions: This study confirms the role of falls in the epidemiology of facial trauma in the elderly, but also highlights the frequency of involvement of females, and the high frequency of zygomatic fractures.
  • Sahraravand, Ahmad; Haavisto, Anna-Kaisa; Holopainen, Juha M.; Leivo, Tiina (2018)
    Purpose To describe epidemiology, causes, treatments and outcomes of all ocular injuries in southern Finland among people aged 61 and older. MethodsResultsAll new ocular trauma patients, admitted to the Helsinki University Eye Hospital, during 1year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3months. The incidence for ocular injuries among the elderly was 38/100000/year. From 118 patients 69% were men. The mean age was 70.9years old (median 67). The hospitalization rate was 14%. Injury types were minor traumas (48%), contusions (22%), chemical injuries (10%), eyelid wounds (8%), open globe injuries (OGI; 7%) and orbital fractures (5%). The injuries occurred at home (58%), institutions (12%) and in other public places (12%). The main causes of ocular injury were falls (22%), sticks (19%), superficial foreign bodies (18%) and chemicals (12%). All OGI and 88% of contusions needed a lifelong follow-up. A permanent visual or functional impairment occurred in 15 (13%) patients. Of these 53% were OGI, 40% contusions and 7% chemical injuries. The causes of permanent injuries were falls (seven cases, 47%), work tools, sports equipment, sticks, chemicals and eyeglasses. The incidence for legal blindness was 2.3/100000. ConclusionMinor trauma was the most frequent type, and home was the location of the most occurred eye injuries. Falls were the most frequent and serious cause, but behavioural causes were not significant. Preventive measures should be directed towards the main identified causes and risk factors of the eye injuries in the elderly.
  • Heikkilä, Anniina; Lehtonen, Lasse; Haukka, Jari; Havulinna, Satu; Junttila, Kristiina (2021)
    Purpose: The purpose of this study was to evaluate the validity and reliability of the Peninsula Health Fall Risk Assessment Tool (PHFRAT) in acute care in various medical specialties. The assessment has not been previously studied in acute care. Methods: The cross-sectional study was conducted in a large acute care hospital system. The retrospective medical data were used to explore the validity of the PHFRAT. The data consisted of all adult inpatients (>= 18 age) evaluated by the PHFRAT during 2014-2016 (n = 22,700). The Poisson regression, logistic regression, sensitivity, specificity, and the area under the ROC curve were evaluated. The data for the reliability study were collected in 2016 in twelve units by evaluating the patients (n = 359) twice using the PHFRAT. The prospective data were analyzed using Fleiss' Kappa, and the content validity index was also counted. Results: In the somatic data, the change in the risk level from low risk to high risk increases the probability of falls by a factor of 2.8 (p