Study On Clinical Features And Nursing Countermeasures Of Syncope Related Falls

Purpose:To provide reference for prevention of falls in patients with syncope by investigating the clinical features and nursing countermeasures of syncope related falls.Method:Clinical data of 35 hospitalized patients with syncope related falls were collected retrospectively in adverse events management system during the period from January 1,2013 to July 31,2017,in a tertiary hospital.The data include age,gender,diagnosis,before the fall falls risk factor score,falls induced events,the degree of damage,syncope occurring with symptoms,the place of falls happed and caregiver status at that time etc,and than were analyzed.Exclusion criteria:incomplete clinical data,it is impossible to determine whether the fall of the patient was caused by syncope;children and adolescents younger than 18 years of age.Results:1.The incidence rate of the correlation of syncope falls mostly in younger elderly group(aged 60-74),reached 34.29%;in terms of gender,falls in young patients group(aged 18-44)all were female;aged(aged 45-59)male incidence rate is 77.78%;there is no difference in the proportion of male and female in elderly patients.2.According to the types of diseases in patients with syncope related falls,the higher incidence is respiratory system diseases(25.71%),cardiovascular diseases(22.86%)and digestive diseases(17.14%).Incidence rate of patients who have 4 or more complications accounted for 42.86%.3.The main cause of syncope associated fall is reflex syncope(42.86%),followed by cardiogenic syncope(22.86%).The incidence of reflex syncope(46.67%)was highest in the middle-aged group(aged 45-59);the incidence of syncope(75%)caused by cardiac syncope was higher in the elderly group(aged 60 and over).Etiology classification associated with age Spearman coefficient =0.337,P=0.048.4.Syncope related falls were most commonly caused by post active(25.17%)urination/defecation(17.14%),postural change(11.43%)and sedentary(11.43%);68.57%of the patients with prodromal symptoms in syncope,the most common is dizziness(37.14%)and amaurosis(25.71%).5.Syncope related falls were more likely to cause injury than non syncope related falls,P=0.043.The incidence rate of injury of syncope related falls in elderly group(aged 75-89),is the highest,up to 80%.6.The main sites for syncope related falls are toilets(57.14%),bedside(28.57%)and corridors(8.57%).73.52%of the caregivers were absent or asleep during the fall,and failed to find the fall event in time.Conclusion:1.Among the patients with syncope related falls,elderly patients account for a higher proportion and are more likely to cause injuries,and we should focus on the prevention of falls in elderly patients with syncope risk.2.Reflex syncope is the major cause of syncope associated with syncope,followed by cardiac syncope.Different and targeted interventions should be given to patients with syncope due to different causes.3.To reduce or avoid syncope related factors,timely identification of premonitory symptoms and effective intervention,can effectively reduce the incidence of syncope and fall.4.The relevant factors involving many aspects of syncope associated fall,including the patient's own health factors,patients and their caregivers cognition to the disease and medical education compliance,nurses on fall risk management ability.Comprehensive intervention from the aspects of patients,caregivers,nurses and systematic level is of great significance to the prevention of syncope in patients with falls.