80 The Effects of Predisposing and Precipitating Factors on Gravity of Falls

Abstract

Abstract During 14 months, on the Geriatric Department of HC of Loches were hospitalised for falls 97 patients with an average age of 82,2 years. We studied the effect of predisposing (neuro-sensitive deficiency; walking disabilities; cognitive disorders; depression; malnutrition; vitamin D deficiency; iatrogenic factors; abnormal feet) and precipitating (infections; stroke; confusion; ionic disturbances; toxic substances; anemia; rhythm and conduction heart disorders; orthostatic hypotension) factors on gravity of falls using ANOVA statistical analysis tests. Following the interrogation we found that from the 62,88% women and 37,12% men, 79,38% have fallen at home, in nursing homes 12,37% and in our department 8,25%. The falls have had as consequences in 45 cases no trauma, in 34 cases mild trauma and 18 fractures. The results showed that the most representatives predisposing factors were walking disabilities 76,28%; cognitive disorders 66% and iatrogenic 54,63%. Among the precipitating factors the most representatives were arhythmia and conduction heart disorders 62,88% and infections 56,7%. There was a significant difference (p<0,0001) between the predisposing factors and precipitating factors in no trauma and mild falls (p<0,001), showing that precipitating factors have less influence on falls without sever consequences. There was no difference (p=0,4) between the factors when a fracture was the consequence. In this case the precipitating factors have the same impact on gravity of falls as the predisposing factors. Iatrogenic factors (39,62% beta–blockers) and arrhythmias had significantly higher values in patients with falls and fractures than in those with falls without trauma (p<0,05) or mild trauma (p<0,001). The addition of some two types of factors influences the severity of falls in elderly people.