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Hospitalization impact on postural balance and health related quality of life of adults and elderly inpatients in a tertiary level public hospital

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Author(s):
Patrícia Harry Lavoura
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
Defense date:
Examining board members:
Celso Ricardo Fernandes de Carvalho; Imperio Lombardi Junior; José Eduardo Pompeu
Advisor: Celso Ricardo Fernandes de Carvalho
Abstract

Background: Prolonged bed rest during hospitalization can trigger changes in different body systems and functional capacity. These changes can lead to impairment in postural balance and quality of life, but these effects are poorly understood. Objectives: To quantify possible changes in postural balance and health related quality of life of patients after a period of hospitalization and check the occurrence of falls and their predictors and hospital readmissions. Method: This was an observational cross-sectional study that included 250 patients admitted to wards of a tertiary public hospital. Were included patients of both genders aged >= 50 years and were excluded patients with cognitive deficits, delirium and those who were not able to perform the tests proposed. Clinical and sociodemographic data were obtained from medical records. Patients were evaluated by a maximum of 48 hours of hospital admission and reassessed at discharge. The Mini-BESTest was used to assess postural balance and the Short Form 12 for health related quality of life. To check the occurrence of falls and readmissions a telephone follow-up of 1, 3 and 6 months after discharge was conducted. Statistical analysis: A descriptive analysis was performed and comparison between the scores of hospital admission and discharge of Mini-BESTest and SF-12 through the paired t test and/or Wilcoxon Signed Rank Test. The Student\'s t-test and/or Mann-Whitney rank sum test were performed to compare the scores of Mini-BESTest between the groups with and without falls and readmissions. The Chi-square test was used to evaluate the ratio between falls and pre-hospital admission. Fall events and hospital re-admission are presented in absolute and percentage values (%) and Pearson correlation, stepwise regression and backward multiple logistic regression were used for analysis of falls predictors. P <= 0.05 was adopted. Results: There was no negative impact of hospitalization in the total study population however patients who lost balance presented a longer hospitalization. The health related quality of life showed an improvement assessed by the SF -12. There was a high incidence of falls and post-discharge rehospitalization and were predictors of these falls: previous fall, Mini-BESTest score at discharge, total number of comorbidities and age. Conclusion: Hospitalization was not able to generate negative changes in health related quality of life or in the postural balance of the patients and a high incidence of falls and their predictors was verified (AU)

FAPESP's process: 14/13303-4 - Impact of hospitalization on postural balance and quality of life of adults and elderly patients in a public tertiary care hospital
Grantee:Patricia Harry Lavoura
Support Opportunities: Scholarships in Brazil - Master