A cohort study of accidents occurring in mentally handicapped patients living in institutions.
BACKGROUND
Mentally handicapped patients who require extensive and generalised care and are resident in mental health institutions have certain characteristics that could mean that they suffer certain types of accidents. The aim of this study was to determine the number and type of accident-related injuries in this population in order to design appropriate preventative strategies.


METHODS
Accident-related injuries in patients resident in six institutions in the north of Spain were recorded prospectively over a period of 21 months. The characteristics of these injuries were recorded in a database linked to another in which patient data were recorded. A logistic regression model employing the generalized estimating equation (GEE) methodology was employed due to the repetition of patient accidents.


RESULTS
There was one death due to foreign body aspiration into the airways. A total of 1,671 injuries were recorded, 0.5% of which were classified as serious, 10% moderate and 89.5% minor. The serious injuries involved fractures (6) and cuts (2), the moderate injuries mainly cuts (57%), bruising (18%) and sprains (13%), and the minor injuries bruising (40%), cuts (35%) and scratches (20%). Falls were the main cause of these injuries (25.2%). The variables associated with serious accidents were self-harm (OR = 1.18), non-collaborative behaviour (OR = 1.21) and inpatient (OR = 1.37).


CONCLUSIONS
Accidents in mentally handicapped patients occur in different ways compared to those in the general population. The majority of injuries found were minor (an average of 0.8 to 3.4 accidents per year), with falls being the most common cause. Patients with behavioural disorders undergoing treatment with neuroleptic agents were found to be a risk group, therefore this finding should be taken into consideration when establishing care groups.
Zubillaga
Paul
P
Uliazpi, Gipuzkoa, San Sebastián, Spain.
Emparanza
José Ignacio
JI
Donostia Hospital Gipuzkoa, CASPe, CIBER-ESP, San Sebastián, Spain.
Guinea
Blanca
B
Gorabide, Bizkaia, Bilbao, Spain.
Mendizábal
Francisco
F
Uliazpi, Gipuzkoa, San Sebastián, Spain.
Muriel
Alfonso
A
Hospital Ramón y Cajal, CASPe, CIBER-ESP, Madrid, Spain.
Ruiz
Montserrat
M
Uliazpi, Gipuzkoa, San Sebastián, Spain.
Sánchez
Ana María
AM
Fuentes Blancas, Burgos, Spain.
Sistiaga
Fernando
F
Uliazpi, Gipuzkoa, San Sebastián, Spain.
Viguria
Fernando
F
Fuentes Blancas, Burgos, Spain.
Biometrics. 1986 Mar;42(1):121-30
3719049
J Intellect Disabil Res. 2002 Jan;46(Pt 1):6-16
11851852
Am J Ment Retard. 1989 Jan;93(4):444-51
2930660
J Intellect Disabil Res. 2004 Oct;48(Pt 7):639-45
15357683
Dev Med Child Neurol. 1983 Oct;25(5):656-9
6226553
Ment Retard. 2006 Jun;44(3):212-23
16677066
Ment Retard. 1983 Feb;21(1):23-9
6855568
Am J Ment Retard. 1997 Jul;102(1):37-44
9241406
J Intellect Disabil Res. 2001 Feb;45(Pt 1):76-82
11168779
Clin Orthop Relat Res. 1999 Sep;(366):217-20
10627738