Asociación entre colapso del cuidador y pronóstico de pacientes geriátricos hospitalizados en el servicio de Medicina Interna

Abstract

Background: The aging process is characterized by favoring the presence of chronic and degenerative diseases that cause disability. Mexico is no exception, the National Population and Housing (CONAPO) mentions that in 2000 lived in Mexico 6.9 million people over 60 years, equivalent to a rate of 7%; furthermore, in their estimation, disability increases with age, appearing around 5% in adults 60-64 years and affects more than 15% of those over 70 years. The concept of overload indicates mental exhaustion and anxiety about the care of the disabled elderly is associated with difficulties in physical health due to an accumulation of stressors compared to the caregiver is devoid of adequate coping and adapting strategies to the situation . The presence of primary caregiver overload is reflected in the prognosis of elderly patients in hospital. Objective: To determine how the presence influences collapse of the caregiver in the prognosis of elderly patients hospitalized in Internal Medicine. Material and Methods: Study design: Cases and controls nested in a cohort. A sample of 60 patients per group (men and women) in hospitalized geriatric patients with primary caregiver overload (CSSC) without overloading the primary caregiver (SSSC) syndrome was analyzed. A questionnaire consisting patient admission test Zarit, Barthel and Karnofsky was applied, and the general data of both patient and caregiver were collected. Statistical analysis: Fisher's exact test was used to determine relationship between caregiver collapse and mortality, as well as the relationship between collapse and the three outcomes: graduation within 7 days to 7 days post discharge or death during hospitalization. We considered statistical significance p?0.05 . Results: 60 patients were reviewed by Group: In the CSSC group were 33 female patients (55%) and 27 (45%) males; SSSC group in 20 (33.3%) females and 40 males (66.7%). Association between CSSC and the probability of death during hospitalization was found; in the CSSC group of 35% and 8.33% in the SSSC group with p = 0.001. In relation to the outcome and subgroups of the study found that the SSSC group was 13.3% less than one week expenses, 47% higher than one week and 8.3% mortality. In the group with mild collapse 2.78% of patients were discharged within 7 days, 88.9% higher than this time and mortality of 8.33%. Finally in the group with severe collapse was no lower expenditures than a week, only 25% studying here this past week and remaining 75% died. Was analyzed as a risk factor for both schooling collapse of the patient as the primary caregiver, finding that less than complete primary schooling patient is a protective factor with (p=0.008, OR: 0.32, CI: 0.12-0.81). Conclusions: We conclude that there is a relationship between the presence of primary caregiver overload and increased mortality syndrome.