Queda de idosos que motiva atendimento hospitalar de emergência pelo SUS em Uberlândia - MG : epidemiologia e consequências para a saúde

Abstract

The fast increase in the proportion of elders in the world and Brazilian population opens a discussion about unabling events in this age, in which the occurence of falls stands out. This study aimed to evaluate epidemical and clinical aspects related to accidents caused by falls among the elders attended at Hospital de Clínicas de Uberlândia (HCU). For the data assessment, from September 01, 2003 to August 31, 2004, one day of the week was drafted to start the investigation and, in sequence, every six days, during twenty four hours, the elders victims of falls attended in the emergency hospital of HCU were interviewed. We also daily visited the nurses to interview every elder in internment because of falls. For such interviews, we used a questionnaire made specificaly to obtain data related to patients personal informations, health conditions before the fall, residence conditions, necessity and level of care they needed, causes and circumstances of the fall. In the period studied, 485 patients were attended at the hospital victims of falls, and the sample studied was composed of 177 of these patients who lived and fell in Uberlândia and were interviewed. The mean of the patients ages were 76, and 108 (61.o%) were female; prevailing the married or widowed (147; 83%) retired or pensioner (121; 68.3%); 76 (42.9%) had monthly income between 2 and 4 minimum wages. The kind of residence prevailing was house (135; 76.3%), with rugs (135; 76.8%), unlevellings (109; 61.0%) and stairs (69; 39.0%) These facts , associated with problems such as the kind of floor and luminosity, were the main difficulties reported by the elders to move in their houses. The prevailing deseases were hypertension (81; 45.8%), diabetes (57; 32.2%) and osteoporosis (24; 13.6%). Most of the patients reported daily use of medicines antihypertensives (47.5%), Hypoglycemic (32.2%) and benzodiazepinic (27.1%). Seventy five patients (42.3%) practised physical activities, being walking (62.0%) and hydrogymnastic (24.15) the most common. Ninety four (53.1%) had a leisure activity, mainly dance (36.7%) and sightseeing (29.2%). The falls presented little variation related to the months of the year, but were more common between 6 and 10 in the morning. The site of major occurence was in their own houses (135; 76.3%), mainly in the bathroom (51; 28.8%) and bedroom (28; 15.8%). The main causes were slippings (60; 37.8%) and stumbles (33; 20.8%). The major consequence was fracture (121;68.4%), mainly of femur (81; 45.8%) and radius (23; 13.0%). Fifty nine patients (33.3%) confirmed having fallen before, in the last twelve months, in their own houses (46; 78.0%), because of slipping (18; 32.1%); unbalance (11; 21.4%); 119 (67.2%) reported never have received any preventing oriantation against falls. Letality was of 3.5%. We can conclude that, in relation to elders falls attended in Hospital das Clínicas de Uberlândia that: they occur in a with little variability during the months of the year, but prevail between 6 and 10 in the morning; the frequency increases in the ages 70 to 74, is higher among women, retired and pensioners; about half of the victims had no stable union at the time of the fall; most of the residences were houses, with five to seven rooms, in which lived from 2 to 4 people; the bathrooms used by the elders were about 3.5 metres from their bedroom; the patients consider distance, lack of luminosity and the presence of rugs as the most common difficulties to reach the toilet; pre-existing health problems were mainly hypertension and diabetes; the most comons physical activities were walking and hydrogymnastics, and leisure activities were dance and sightseeing; most of the times the fall is due to slippings or stumbles; as a consequence, TCE is diagnosed for about 10% of the patients and fracture for more then half, being femur the most commonly broken bone; the great majority of the victims is helped in a few minutes after the fall; most of them consider not having received any information about avoiding falls; the percentage of deaths due to falls is less than 5%.