Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis
ilustraciones, gráficas
- Autores:
-
Velasquez Quiroga, Jonatan Andres
- Tipo de recurso:
- Fecha de publicación:
- 2022
- Institución:
- Universidad Nacional de Colombia
- Repositorio:
- Universidad Nacional de Colombia
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unal.edu.co:unal/82381
- Palabra clave:
- 610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
Atención médica para ancianos
Geriatría
Enfermedades de los ancianos
Aged -- Medical care
Geriatrics
Aged - Diseases
Caídas accidentales
síntomas del tracto urinario bajo
fracturas óseas
Ancianos
- Rights
- openAccess
- License
- Atribución-NoComercial-SinDerivadas 4.0 Internacional
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dc.title.spa.fl_str_mv |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis |
dc.title.translated.eng.fl_str_mv |
Lower urinary tract symptoms, falls, and fractures in the Elderly: Associations and clinical outcomes. Systematic literature review and meta-analysis. |
title |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis |
spellingShingle |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis 610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología Atención médica para ancianos Geriatría Enfermedades de los ancianos Aged -- Medical care Geriatrics Aged - Diseases Caídas accidentales síntomas del tracto urinario bajo fracturas óseas Ancianos |
title_short |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis |
title_full |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis |
title_fullStr |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis |
title_full_unstemmed |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis |
title_sort |
Síntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. Revisión sistemática de la literatura y metaanálisis |
dc.creator.fl_str_mv |
Velasquez Quiroga, Jonatan Andres |
dc.contributor.advisor.none.fl_str_mv |
Donoso Donoso, Wilfredo |
dc.contributor.author.none.fl_str_mv |
Velasquez Quiroga, Jonatan Andres |
dc.contributor.educationalvalidator.none.fl_str_mv |
Castañeda, David Alzate, Juan Pablo |
dc.contributor.referee.none.fl_str_mv |
Lopez de Mesa, Byron |
dc.contributor.researchgroup.spa.fl_str_mv |
Grupo de Investigación e Innovación en Urología Universidad Nacional de Colombia |
dc.subject.ddc.spa.fl_str_mv |
610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología |
topic |
610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología Atención médica para ancianos Geriatría Enfermedades de los ancianos Aged -- Medical care Geriatrics Aged - Diseases Caídas accidentales síntomas del tracto urinario bajo fracturas óseas Ancianos |
dc.subject.lemb.spa.fl_str_mv |
Atención médica para ancianos Geriatría Enfermedades de los ancianos |
dc.subject.lemb.eng.fl_str_mv |
Aged -- Medical care Geriatrics Aged - Diseases |
dc.subject.proposal.spa.fl_str_mv |
Caídas accidentales síntomas del tracto urinario bajo fracturas óseas Ancianos |
description |
ilustraciones, gráficas |
publishDate |
2022 |
dc.date.accessioned.none.fl_str_mv |
2022-10-20T19:49:57Z |
dc.date.available.none.fl_str_mv |
2022-10-20T19:49:57Z |
dc.date.issued.none.fl_str_mv |
2022-01-15 |
dc.type.spa.fl_str_mv |
Trabajo de grado - Especialidad Médica |
dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/masterThesis |
dc.type.version.spa.fl_str_mv |
info:eu-repo/semantics/acceptedVersion |
dc.type.content.spa.fl_str_mv |
Text |
dc.type.redcol.spa.fl_str_mv |
http://purl.org/redcol/resource_type/TM |
status_str |
acceptedVersion |
dc.identifier.uri.none.fl_str_mv |
https://repositorio.unal.edu.co/handle/unal/82381 |
dc.identifier.instname.spa.fl_str_mv |
Universidad Nacional de Colombia |
dc.identifier.reponame.spa.fl_str_mv |
Repositorio Institucional Universidad Nacional de Colombia |
dc.identifier.repourl.spa.fl_str_mv |
https://repositorio.unal.edu.co/ |
url |
https://repositorio.unal.edu.co/handle/unal/82381 https://repositorio.unal.edu.co/ |
identifier_str_mv |
Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia |
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spa |
language |
spa |
dc.relation.indexed.spa.fl_str_mv |
Bireme RedCol LaReferencia |
dc.relation.references.spa.fl_str_mv |
1. Soliman Y, Meyer R, Baum N. Falls in the Elderly Secondary to Urinary Symptoms. Rev Urol [Internet] 2016 [cited 2022 Jan 19];18(1):28–32. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859925/. doi: 10.3909/riu0686 2. Kellogg Parsons J, Mougey J, Lambert L, Wilt TJ, Fink HA, Garzotto M, et al. Urinary Symptoms and Risk of Falls in Older Men. BJU Int [Internet] 2009[cited 2022 Jan 19];104(1):63–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3031126/#:~:text=Lower%20urinary%20tract%20symptoms%20are%20a%20potential%20risk%20factor%20for,of%20falls%20in%20older%20men. doi: 10.1111/j.1464-410X.2008.08317.x 3. Abrams P. Nocturia: The effect on sleep and related health consequences. European Urology Supplements. Sleep Med Rev [Internet]. 2005 Jan 1 [cited 2022 Jan 19];3(6):1–7. Available from: http://www.eu-openscience.europeanurology. com/article/S1569905605800016 /fulltext. doi: 10.1016/S1569-9056(05)80001-6 4. Hogea B, Bardan R, Sandesc M, Patrascu JM, Cumpanas A, Andor B. Are night-time voiding and lower urinary tract symptoms significant risk factors for hip fractures caused by falling during the night in male subjects? Patient prefer and adherence [Internet]. 2019 [cited 2022 Jan 19];13:1191. Available from: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC6659779/#:~:text=This%20may%20lead%20us%20to,night%2C%20leading%20to%20hip%20fractures. doi: 10.2147/PPA.S205229 5. Kim KS, Nam JW, Choi BY, Moon HS. The association of lower urinary tract symptoms with incidental falls and fear of falling in later life: The Community Health Survey. Neurourol Urodyn. [Internet]. 2018 Feb 1 [cited 2022 Jan 19];37(2):775–84. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ nau.23345. doi: 10.1002/nau.23345 6. Hernández Fernández C., Ristol Pont J., Estivill E., Batista Miranda J.E., López Aramburu M.A.. “Importancia de la nocturia y su impacto en la calidad del sueño y en la calidad de vida en el paciente con hiperplasia benigna de próstata. Actas Urol Esp [Internet]. 2007 Mar [cited 2022 Ene 24] ; 31( 3 ): 262-269. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0210-48062007000300010&lng=es. 7. Gibson W, Hunter KF, Camicioli R, Booth J, Skelton DA, Dumoulin C, et al. The association between lower urinary tract symptoms and falls: Forming a theoretical model for a research agenda. Neurourol Urodyn. [Internet]. 2018 Jan 1 [cited 2022 Jan 19];37(1):501–9. Available from: https://pubmed.ncbi.nlm.nih.gov/28471525/ doi: 10.1002/nau.23295 8. Noguchi N, Chan L, Cumming RG, Blyth FM, Handelsman DJ, Seibel MJ, et al. Lower Urinary Tract Symptoms and Incident Falls in Community Dwelling Older Men: The Concord Health and Ageing in Men Project. J Urol. [Internet]. 2016 Dec 1 [cited 2022 Ene 24];196(6):1694–9. Available from: https://www.auajournals.org/doi/10.1016/j.juro.2016.06.085 doi: DOI: 10.1016/j.juro.2016.06.085 9. Marshall LM, Lapidus JA, Wiedrick J, Barrett-Connor E, Bauer DC, Orwoll ES, et al. Lower Urinary Tract Symptoms and Risk of Nonspine Fractures among Older Community Dwelling U.S. Men. J Urol [Internet]. 2016 [cited 2022 Ene 24];196(1):166–72. Available from: https://www.auajournals.org/ doi/10.1016/j.juro.2016.02.081 doi. 10.1016/j.juro.2016.02.081 10. Hwang TY, Kim SK, Kim KH, Kim JY. Association Between Lower Urinary Tract Symptoms and Falls in Adults Males: Based on the Korean Community Health Survey. Asia Pac J Public Health. [Internet]. 2019 [cited 2022 Ene 24];31(7):643–51. Available from: https://journals.sagepub.com/doi/10.1177/ 1010539519878361? url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200 pubmed. Doi. 10.1177/1010539519878361 11. Parsons JK, Mougey J, Lambert L, Wilt TJ, Fink HA, Garzotto M, et al. Lower urinary tract symptoms increase the risk of falls in older men. BJU Int. [Internet]. 2009 [cited 2022 Ene 24];104(1):63–8. Available from: https://bjui-journals. onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2008.08317.x doi: 10.1111/j.1464-410X.2008.08317.x 12. Nakagawa H, Niu K, Hozawa A, Ikeda Y, Kaiho Y, Ohmori-Matsuda K, et al. Impact of nocturia on bone fracture and mortality in older individuals: A Japanese longitudinal cohort study. J Urol. [Internet]. 2010 [cited 2022 Ene 24];184(4):1413–8. Available from: https://www.auajournals.org/doi/10.1016/j.juro. 2010.05.093 doi. 10.1016/j.juro.2010.05.093 13. Omae K, Kurita N, Takeshima T, Naganuma T, Takahashi S, Yoshioka T, et al. Significance of overactive bladder as a predictor of falls in community dwelling older adults: 1-Year followup of the Sukagawa study. J of Urol. [Internet]. 2021[cited 2022 Ene 24];205(1):219–25. Available from: https://www.auajournals.org/doi/ 10.1097/JU.0000000000001344. doi: 10.1097/JU.0000000000001344 14. Teo JSH, Briffa NK, Devine A, Dhaliwal SS, Prince RL. Do sleep problems or urinary incontinence predict falls in elderly women? Aust J Physiother [Internet]. 2006 [cited 2022 Ene 24];52(1):19–24. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0004-9514(06)70058-7 doi: 10.1016/s0004-9514(06)70058-7 15. Brown JS, Vittinghoff E, Wyman JF, Stone KL, Nevitt MC, Ensrud KE, et al. Urinary incontinence: Does it increase risk for falls and fractures? J Am Geriatr Soc. [Internet]. 2000 [cited 2022 Ene 24];48(7):721–5. Available from: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.2000. tb04744.x?sid=nlm%3Apubmed. doi: 10.1111/j.1532-5415.2000.tb04744.x 16. Hasegawa J, Kuzuya M, Iguchi A. Urinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities. Arch Gerontol Geriatr. [Internet]. 2010 [cited 2022 Ene 24];50(1):77–81. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0167-4943(09)00040-5 doi: 10.1016/j.archger.2009.02.001 17. Tromp AM, Pluijm SMF, Smit JH, Deeg DJH, Bouter LM, Lips P. Fall-risk screening test. J Clin Epidemiol. [Internet].2001 [cited 2022 Ene 24];54(8):837–44. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0895-4356(01)00349-3 doi: 10.1016/s0895-4356(01)00349-3 18. Berardelli M, de Rango F, Morelli M, Corsonello A, Mazzei B, Mari V, et al. Urinary Incontinence in the Elderly and in the Oldest Old: Correlation with Frailty and Mortality. Rejuvenation Res [Internet]. 2013, Jun, 11 [cited 2022 Ene 24];16(3):206–11. Available from: https://www.liebertpub.com/doi/abs/10.1089 /rej.2013.1417 doi. DOI: 10.1089/rej.2013.1417 19. Schluter PJ, Arnold EP, Jamieson HA. Falls and hip fractures associated with urinary incontinence among older men and women with complex needs: A national population study. Neurourol Urodyn. [Internet] 2018 [cited 2022 Ene 24];37(4):1336–43. Available from: https://www.auajournals.org/doi/10.1097/ 01.JU.0000557770.11905.53 doi: 10.1097/01.JU.0000557770.11905.53 20. Schluter PJ, Askew DA, Jamieson HA, Arnold EP. Urinary and fecal incontinence are independently associated with falls risk among older women and men with complex needs: A national population study. Neurourol Urodyn. [Internet] 2020 [cited 2022 Ene 24];39(3):945–53. Available from: https://onlinelibrary.wiley.com/doi/10.1002/nau.24266 doi: 10.1002/nau.24266 21. Moon S, Chung HS, Yu JM, Na HR, Kim SJ, Ko KJ, et al. Impact of urinary incontinence on falls in the older population: 2017 national survey of older Koreans. Arch Gerontol Geriatr [Internet]. 2020 [cited 2022 Ene 24];90:104158. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0167494320301527? via%3Dihub doi: 10.1016/j.archger.2020.104158 22. Hung CH, Wang CJ, Tang TC, Chen LY, Peng LN, Hsiao FY, et al. Recurrent falls and its risk factors among older men living in the veterans retirement communities: A cross-sectional study. Arch Gerontol Geriatr. [Internet]. 2017 [cited 2022 Ene 24];70:214–8. Available from: https://www.sciencedirect.com/science/article/abs /pii/S0167494317301024 ?via%3Dihub doi: 10.1016/j.archger.2017.02.001 23. Noguchi N, Chan L, Cumming RG, Blyth FM, Naganathan V. A systematic review of the association between lower urinary tract symptoms and falls, injuries, and fractures in community-dwelling older men. Aging Male. [Internet]. 2016 [cited 2022 Ene 24];19(3):168–74. Available from https://www.tandfonline.com/doi/full/ 10.3109/13685538.2016.1169399 doi: 10.3109/13685538.2016.1169399 24. Herzog AR, Diokno AC, Brown MB, Normolle DP, Brock BM. Two-year incidence, remission, and change patterns of urinary incontinence in noninstitutionalized older adults. J Gerontol. [Internet]. 1990 [cited 2021 Nov 28];45(2). Available from: https://pubmed.ncbi.nlm.nih.gov/2313045/ doi: 10.1093/geronj/45.2.m67 25. United Nations D of E. WHO Global Report on Falls Prevention in Older Age. Community Health [Internet]. 2007 [cited 2021 Nov 28];53. Available from: https://books.google.com/books/about/WHO_Global_Report_on_Falls_Prevention_in.html?id=ms9o2dvfaQkC 26. Zecevic AA, Salmoni AW, Speechley M, Vandervoort AA. Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature. Gerontologist. [Internet]. 2006 [cited 2021 Nov 28];46(3):367–76. Available from: https://pubmed.ncbi.nlm.nih.gov/16731875/ doi: 10.1093/geront/46.3.367 27. Dokuzlar O, Koc Okudur S, Soysal P, Kocyigit SE, Yavuz I, Smith L, et al. Factors that Increase Risk of Falling in Older Men according to Four Different Clinical Methods. Exp Aging Res. [Internet]. 2020 Jan 1 [cited 2022 Ene 24];46(1):83–92. Available from: https://pubmed.ncbi.nlm.nih.gov/31538539/ doi: 10.1080/0361073X.2019.1669284 28. Szabo SM, Gooch KL, Walker DR, Johnston KM, Wagg AS. The Association Between Overactive Bladder and Falls and Fractures: A Systematic Review. Adv Ther [Internet]. 2018 [cited 2022 Ene 24];35(11):1831–41. Available from: https://www.tandfonline.com/doi/abs/10.1080/0361073X.2019.1669284?journalCode=uear20 doi: 10.1007/s12325-018-0796-8. 29. Pesonen JS, Vernooij RWM, Cartwright R, Aoki Y, Agarwal A, Mangera A, et al. The Impact of Nocturia on Falls and Fractures: A Systematic Review and Meta-Analysis. J Urol [Internet]. 2020 [cited 2022 Ene 24];203(4):674–83. Available from: https://www.auajournals.org/doi/10.1097/JU.0000000000000459 doi: 10.1097/JU.0000000000000459 30. Batchelor FA, Dow B, Low MA. Do continence management strategies reduce falls? A systematic review. Australas J Ageing. [Internet]. 2013 [cited 2022 Ene 24];32(4):211–6. Available from: https://onlinelibrary.wiley.com/doi/10.1111/ajag.12047. doi: doi: 10.1111/ajag.12047 |
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http://purl.org/coar/access_right/c_abf2 |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional |
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http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ http://purl.org/coar/access_right/c_abf2 |
eu_rights_str_mv |
openAccess |
dc.format.extent.spa.fl_str_mv |
xiv, 36 páginas |
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application/pdf |
dc.publisher.spa.fl_str_mv |
Universidad Nacional de Colombia |
dc.publisher.program.spa.fl_str_mv |
Bogotá - Medicina - Especialidad en Urología |
dc.publisher.department.spa.fl_str_mv |
Departamento de Cirugía |
dc.publisher.faculty.spa.fl_str_mv |
Facultad de Medicina |
dc.publisher.place.spa.fl_str_mv |
Bogotá, Colombia |
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Universidad Nacional de Colombia - Sede Bogotá |
institution |
Universidad Nacional de Colombia |
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spelling |
Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Donoso Donoso, Wilfredo4fe3aec15df87b2e29396c9ba4b7fa66Velasquez Quiroga, Jonatan Andres1aaef7ee9e39155e97d5a00b7bb242feCastañeda, DavidAlzate, Juan PabloLopez de Mesa, ByronGrupo de Investigación e Innovación en Urología Universidad Nacional de Colombia2022-10-20T19:49:57Z2022-10-20T19:49:57Z2022-01-15https://repositorio.unal.edu.co/handle/unal/82381Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, gráficasLos síntomas del tracto urinario inferior (STUI) se presentan con frecuencia en la población adulta. Los viajes frecuentes al baño secundarios a los síntomas de vaciamiento y de llenado en pacientes con comorbilidades y de edad avanzada involucran el peligro de pérdida del equilibrio, caídas y lesiones graves. Esto puede perjudicar el funcionamiento motor posterior, la independencia, la calidad de vida y la supervivencia en los ancianos. El objetivo fue evaluar la asociación entre la presencia de síntomas urinarios en el adulto mayor y el riesgo de caídas y fracturas mediante una revisión sistemática y metaanálisis para establecer posibles relaciones causales. Realizamos una búsqueda sistemática de la literatura de artículos indexados en bases de datos (PubMed, Cochrane central, LILACS y EMBASE). Realizamos metaanálisis de efectos fijos de relación de probabilidades entre síntomas urinarios y caídas. De 45 estudios encontrados 15 artículos de 8 países fueron incluidos en la revisión sistemática, dos de ellos relacionaban la presencia de fracturas y síntomas urinarios y ningún estudio evaluaba el impacto del tratamiento. 3 estudios fueron meta-analizados logrando establecer una relación en la presencia de síntomas urinarios y las caídas (OR 2.10, 95% CI 1.55 - 2,84, I2: 99%) En conclusión, la presencia de síntomas urinarios en el adulto mayor se asocia un riesgo incrementado de caídas; esta asociación, desde la teoría, podría generar desenlaces óseos adversos en este grupo poblacional como fracturas. (Texto tomado de la fuente)Lower urinary tract symptoms (LUTS) occur frequently in the adult population. Trips to the bathroom involving emptying and filling symptoms in elderly and comorbid patients involve the danger of loss of balance, falls, and serious injury. This can impair later motor function, independence, quality of life, and survival in the elderly. The objective was to evaluate the association between falling urinary symptoms and fractures through a systematic review and meta-analysis to establish a causal risk factor. We carried out a systematic search of the literature for articles indexed in databases (PubMed, LILACS and EMBASE). We performed a meta-analysis of fixed effects of the odds ratio between urinary symptoms and falls. Of 45 studies found, 15 articles from 8 countries were included in the systematic review, two of them related the presence of fractures and urinary symptoms and no study evaluated the impact of treatment. 3 studies were meta-analyzed, establishing a relationship in the presence of urinary symptoms and falls (OR 2.10, 95% CI 1.55 - 2.84, I2: 99%) In conclusion, the presence of urinary symptoms is associated with the risk of falling, which can cause fractures in the elderly.Especialidades MédicasEspecialista en UrologíaSe realizó una revisión sistemática de la literatura utilizando los términos MeSH y Decs como: “Aged”, “Elderly”, “Lower Urinary Tract Symptoms”, “Urological Manifestations”, “Urination Disorders”, “Orthopedic Procedures”, “Accidental Falls”, “Falls”, “Accidents” y “Prognosis”. Utilizando como limites el año de publicación (2000 - actualidad) y humanos. La estrategia de búsqueda se muestra en el anexo 1. Los resúmenes fueron seleccionados y revisados por dos de los autores (JV y DC) para su inclusión; posterior al análisis de los estudios incluidos de ejecutó un metaanálisis. Se incluyeron en el universo a evaluar todos los estudios encontrados durante la búsqueda sistemática en bases de datos en inglés y español incluyéndose literatura gris, aplicándose los criterios PRISMA para revisiones sistemáticas.xiv, 36 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en UrologíaDepartamento de CirugíaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiologíaAtención médica para ancianosGeriatríaEnfermedades de los ancianosAged -- Medical careGeriatricsAged - DiseasesCaídas accidentalessíntomas del tracto urinario bajofracturas óseasAncianosSíntomas de tracto urinario inferior, caídas y fracturas en el hombre adulto: Asociaciones y desenlaces clínicos. 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