title: A cohort study of accidents occurring in mentally handicapped patients living in institutions.
abstract: 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.
authors.affiliation: Uliazpi, Gipuzkoa, San Sebastián, Spain.
authors.forename: Paul
authors.initials: P
authors.lastname: Zubillaga
authors.affiliation: Donostia Hospital Gipuzkoa, CASPe, CIBER-ESP, San Sebastián, Spain.
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Emparanza
authors.affiliation: Gorabide, Bizkaia, Bilbao, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Guinea
authors.affiliation: Uliazpi, Gipuzkoa, San Sebastián, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mendizábal
authors.affiliation: Hospital Ramón y Cajal, CASPe, CIBER-ESP, Madrid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Muriel
authors.affiliation: Uliazpi, Gipuzkoa, San Sebastián, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ruiz
authors.affiliation: Fuentes Blancas, Burgos, Spain.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Sánchez
authors.affiliation: Uliazpi, Gipuzkoa, San Sebastián, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Sistiaga
authors.affiliation: Fuentes Blancas, Burgos, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Viguria
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