Age and ageing
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The type of environmental hazards implicated in the aetiology of a consecutive series of 787 hip-fracture patients was prospectively studied. Most falls occurred between 09 h 00 and midday and there was no seasonal variation. Fifty-one different environmental hazards were implicated in the aetiology of the fall for 58% of patients. The nature of environmental hazards was diverse, implying that measures to reduce the risk of falls due to these factors are unlikely to lead to a significant reduction in the incidence of hip fractures.
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Delirium is a common and serious complication of acute illness in elderly patients. The aim of this study was to develop and validate a model for predicting development of delirium in elderly medical inpatients who did not have delirium on admission. Consecutive admissions to an acute geriatric unit underwent standardized cognitive assessment every 48 hours. ⋯ Independent predictors of delirium in a derivation group of 100 patients were determined using stepwise logistic regression analysis; the predictive model comprised dementia, severe illness and elevated serum urea. This model performed well in a validation group of 84 patients. We conclude that elderly medical patients can be stratified according to their risk for developing delirium using a simple clinical model.
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We sought the views of purchasers and provider managers in the South and West Region on the relative priorities of 15 possible performance measures of a geriatric medical service. Using a postal questionnaire, subjects were asked to rank the measures in order of priority. ⋯ The lowest priority was given to measurement of levels of activity and reducing mortality rates. Priorities were similar to those found with patients and geriatricians in a previous study, and supports the development and use of performance measures of disability and the quality of life of patients.