Incidência e fatores de risco para hospitalização no período de 12 meses em idosos institucionalizados

Abstract

The accelerated aging process of the Brazilian population is associated with an increase in non-transmissible chronic diseases, which in turn increases the demands for health services. The hospitalization rates of older adults are higher than what is observed in other age groups, especially in those that reside in Long Term Institutions for the Elderly (LTIE), due to inherent vulnerability and frailty of these individuals. The objective of the work presented herein was to verify the incidence and risk factors associated with the hospitalization of institutionalized older adults in the city of Natal/RN, Brazil. A prospective cohort study, conducted from october 2013 to january 2015, was carried out throughout a monitoring period of 12 months, with older adults over the age of 60, who resided in the 10 LTIE that accepted to participate in the study. Initial data collection included sociodemographic information related to the institution and health conditions. In the period of follow-up, was observed the incidence of hospitalization, and the incidence of falls and fractures, decline in cognitive ability, mobility, continence (urinary and / or fecal) and information relating to the medication. Data were collected from medical records and directly with the elderly or health professionals. The Stepwise Forward method was utilized for Multiple Logistic Regression Analysis, with a 5% significance level and confidence interval (CI) 95%. Of the participating 320 elderly, there was a predominance of females (75.3%), average age 81.4 years (Standard Deviation, SD: 9.0). Of these, 20.6% (CI 95%: 16,5-25,4) were hospitalized, with an average permanence time of 16,1 days (SD: 17.1). The main hospitalization cause was pulmonary disease (30.3%). The final model showed that malnutrition or risk of malnutrition (p=0.016) and the use of medication for the cardiovascular system (p=0.003) were risk factors for hospitalization, adjusted by age, sex and type of institution. These findings indicate a high incidence of hospitalization in institutionalized elderly. Malnutrition or risk of malnutrition and the use of cardiovascular medication were considered to be risk factors for hospitalization. There is a clear need for increased attention in multiprofessional evaluation, as well in interventions and services rendered to institutionalized elderly.