Acidentes por quedas em idosos: fatores demográficos, socioeconômicos, processo saúde-doença e características dos acidentes

Abstract

To analyze the influence of demographic, socioeconomic, health-illness and accident characteristics on the occurrence of fall accidents in the elderlies. METHODS: Quantitative observational, field and cross-sectional study, developed at the Hospital Epidemiology Center of Hospital de Base de São José do Rio Preto, SP. The population comprised 1,122 elderly patients who suffered accidents due to falls. A computerized database, a duty book and a case report book with information on notifications and investigations of accidents caused by falls were reviewed and, using a data collection instrument developed by the author, compiled information from specific samples of variables of demographic, socioeconomic, health-disease process and accident characteristics. The statistical analysis was descriptive. RESULTS: Mostly, the elderlies were female (59.63%), aged 70 to 79 years old (34.05%), had one to four years of study (53.81%), did not exercise paid activity (88.28%) and had a monthly family income of one to two minimum wages (31.70%). Most elderly had good or regular general health status (77.15%). However, 44.09% had difficulties with activities of daily living, 87.40% had preexisting diseases and 61.44% suffered pain. It was found that 89.37% of the elderly used prescribed medication and 89.52% had no change in the medication. As for the history of falls, 53.44% had suffered previous falls and 36.89% suffered falls in the last six months. Regarding accidents, 82.45% occurred at home and most happened in the morning (42.52%). In 85.84% of the accidents, the elderly was walking, sitting, getting up from a sitting position, leaning, turning or bending down. Fracture, dislocation, trauma, contusion or cut were consequences diagnosed in 84.76% of the cases, with 64.96% requiring conservative or surgical treatment, and 86.22% needed a companion during hospitalization. CONCLUSIONS: Demographic factors (gender, age and educational level), socioeconomic (paid activity and monthly family income), health-disease process (general health status, preexisting diseases, pain, difficulties in activities of daily living, use of prescribed medication, modification of the medication usually used and previous falls) and the characteristics of the accidents (motor activity at the time of the fall) influenced the occurrence of accidents due to falls in the elderly. In particular, the factors that have influenced the occurrence of accidents by falls in the elderly were: female gender, aged between 70 and 79 years, one to four years of schooling, not exercising any paid activity, monthly family income of one to two minimum wages, good or regular general health status, difficulties with activities of daily living, pre-existing diseases, pain in some region of the body, use of prescribed medication, no regular review of medication, and also had suffered previous falls. Additionally, falls have presented consequences for the elderly’s health, required care, impacted families and the capacity of the health service. This study has contributed to the advancement of scientific knowledge by elucidating the factors inherent to falls accidents in the elderly and, therefore, this has provided social impact as well as basis for actions to prevent this public health issue.