Survey of domestic accidents in the elderly in the Province of Genoa (northern Italy).
ABSTRACT Accidents in the home are a major public health issue in most industrialised countries, as they are a frequent cause of injury and death. Moreover, since a considerable portion of such accidents involve elderly people, it is important to assess their social impact in this population. In Italy, the available data indicate that well over 3 million people per year suffer accidents in the home, and that this number is rising. The aim of the present study was to evaluate the number, characteristics and causes of domestic accidents among the elderly.
The study population was made up of subjects of both sexes aged between 65 and 92 years admitted to first aid units and emergency departments of hospitals in Genoa. The investigation was conducted by means of an ad hoc questionnaire designed to record the circumstances of the accident, the functional capacity of the subject involved, any risky behaviour enacted and the safety profile of the subject's home.
The study enrolled 111 voluntary participants: 62 women and 49 men. At the time of the accident, subjects were engaged in the following activities: housework (36.9%) "rest" (14.5%), ablutions (10%), gardening (9%), leisure activities (8.1%), eating and drinking (2.7%). The most common injuries were bruises (39.6%), followed by fractures (23.4%) and cuts (23.4%); the frequency of other, some time more severe injures (burns, poisoning, asphyxia, crush injuries, etc.) was,fortunately, very low. Anyway, taking into account their consequences, their surveillance and prevention is very important. Most subjects were deemed to be in good health and, in 76% of cases, the safety profile of their houses proved to be satisfactory.
The data collected during this survey are in line with those yielded by national and international studies. They show that the elderly are very vulnerable to domestic accidents and that, even in the event of only slight injury, the management of elderly victims requires a strong organisational commitment on the part of relatives and considerable financial resources for healthcare services. Falling proved to be the main cause of injury. Clearly, efforts to reduce the cost of accidents in the home should aim to implement preventive intervention among elderly people, since the elderly population is destined to grow as a result of increasing life expectancy. In particular, preventive action should focus on reducing the incidence of falls by eliminating risk-related structural features in domestic settings as far as possible and by raising public awareness of the problem through health education campaigns.
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ABSTRACT: The Barthel Index is considered to be the best of the ADL measurement scales. However, there are some scales that are more sensitive to small changes in functional independence than the Barthel Index. The sensitivity of the Barthel Index can be improved by expanding the number of categories used to record improvement in each ADL function. Suggested changes to the scoring of the Barthel Index, and guidelines for determining the level of independence are presented. These modifications and guidelines were applied in the assessment of 258 first stroke patients referred for inpatient comprehensive rehabilitation in Brisbane, Australia during 1984 calendar year. The modified scoring of the Barthel Index achieved greater sensitivity and improved reliability than the original version, without causing additional difficulty or affecting the implementation time. The internal consistency reliability coefficient for the modified scoring of the Barthel Index was 0.90, compared to 0.87 for the original scoring.Journal of Clinical Epidemiology 02/1989; · 5.33 Impact Factor
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ABSTRACT: There is little current understanding of the risk for occurrence of unintentional injury in the home. The authors estimated the incidence of unintentional home injuries for an entire community, adjusting for actual time spent awake in the home and, in addition, analyzed the costs of these injuries. Cases of unintentional home injuries occurring from 1990 to 1993 among the residents of Stavanger, Norway (approximately 100,000 population) were identified through a prospective, ongoing injury registration system. Age- and sex-specific per-population incidence and incidence per time spent awake at home were estimated. Time exposure data for adults were obtained from the Norwegian Time Budget Survey and were estimated directly for children. The cost of injuries was estimated based on a random sample of 289 patients. A total of 8,580 persons received medical treatment for unintentional injuries in the home (22.0 per 1,000 population annually, 71.9 per 10 million hours awake at home). The per-population incidence was highest among children age 6 years or younger and among people aged 65 or older (51.0 and 32.7 respectively, per 1,000 population annually). The high population incidence for children was not accounted for by time spent awake at home. For people aged 65-74 years, however, increased incidence was primarily a function of greater time spent awake at home. For persons aged 75 years or older, the high population incidence was due to both high exposure-adjusted incidence and greater time spent awake at home. The male-female ratio of age-standardized per-population incidence was 1.07 (95% confidence interval 1.04-1.10), and the ratio of age-standardized exposure-adjusted incidence was 1.22 (95% confidence interval 1.17-1.28). The estimated cost (direct and indirect) per injury was $1,300 during the first year after injury. Persons aged 75 years or older accounted for 12% of the injuries but 50% of the total medical costs.American Journal of Epidemiology 10/1996; 144(5):456-62. · 4.78 Impact Factor
Article: [Significance of home accidents].[show abstract] [hide abstract]
ABSTRACT: Authors analyse the incidence, demographic relations and data of hospitalization of the home accidents. The significance of the home accidents is emphasized. It is stated that the home accident is the most frequent type of accidents and its ratio is increasing. The incidence was found 45 on 1000 inhabitants, the home accidents give nearly the half of all accidents and more than 1/3 of the hospitalized injured. Attention is called to the possibilities of unutilized possibilities of the prevention of home accidents.Magyar traumatológia, ortopédia, kézsebészet, plasztikai sebészet. 02/1994; 37(3):263-70.