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1.
Esc. Anna Nery Rev. Enferm ; 27: e20220138, 2023. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1404747

ABSTRACT

Resumo Objetivo analisar, na perspectiva da Integralidade, as internações de adolescentes por condições sensíveis à Atenção Primária em uma Regional de Saúde do Paraná. Método estudo de abordagem quantitativa, retrospectivo, realizado no período de janeiro a julho de 2018. Foram coletados dados públicos de internações de adolescentes de 10 a 19 anos disponíveis na base de dados do sistema de informações hospitalares do Ministério da Saúde, com Tabulador Oficial versão Tabwin 3.2. A análise dos dados ocorreu por estatística descritiva segundo número absoluto e frequência por ano investigado. Resultados das 82.016 internações, 9.029 (11,00%) foram por condições sensíveis à atenção primária. Entre as principais causas, destacam-se a infecção do rim e trato urinário (24,96%); epilepsias (19,27%); gastroenterites infecciosas e complicações (11,91%); doenças relacionadas ao pré-natal e parto (8,88%) e asma (7,39%). As internações do sexo feminino representaram 57,52%, prevalentes no subgrupo da faixa etária de 15 a 19 anos (66,64%). Conclusão e implicações para a prática é necessário avançar na perspectiva da construção da integralidade na atenção à saúde do adolescente, para responder às necessidades em saúde deste segmento populacional e reduzir hospitalizações por causas sensíveis à atenção primária.


Resumen Objetivo analizar, en la perspectiva de la Integralidad, las hospitalizaciones de adolescentes por condiciones sensibles a la Atención Primaria en una Regional de Salud de Paraná. Método estudio retrospectivo cuantitativo realizado de enero a julio de 2018. Se recolectaron datos públicos de hospitalizaciones de adolescentes de 10 a 19 años disponibles en la base de datos del sistema de información hospitalario del Ministerio de Salud, con Tabulador Oficial Tabwin versión 3.2. El análisis de los datos se realizó mediante estadística descriptiva según número absoluto y frecuencia por año investigado. Resultados de los 82.016 ingresos, 9.029 (11,00%) se debieron a condiciones sensibles a la atención primaria. Entre las principales causas destaca la infección del riñón y vías urinarias (24,96%); epilepsias (19,27%); gastroenteritis infecciosa y complicaciones (11,91%); enfermedades relacionadas con la atención prenatal y el parto (8,88%) y asma (7,39%). Las hospitalizaciones femeninas representaron el 57,52%, con prevalencia en el subgrupo de 15 a 19 años (66,64%). Conclusión e implicaciones para la práctica es necesario avanzar en la perspectiva de la construcción de la integralidad en la atención a la salud del adolescente, a fin de responder a las necesidades de salud de este segmento poblacional y reducir las hospitalizaciones por causas sensibles a la atención primaria.


Abstract Objective to analyze, from the perspective of integrality, the hospitalizations of adolescents due to conditions sensitive to primary care in a Regional Health unit in Paraná State. Method a quantitative retrospective study was carried out from January to July 2018. Public data were collected from hospitalizations of adolescents aged 10 to 19 years available in the database of the hospital information system of the Ministry of Health using the Official Tabulator (Tabwin, version 3.2). Data analysis was performed using descriptive statistics according to the absolute number and frequency per year investigated. Results out of the 82,016 admissions, 9,029 (11.00%) were due to conditions sensitive to primary care. Among the main causes, infection of the kidney and urinary tract (24.96%), epilepsies (19.27%), infectious gastroenteritis, and complications (11.91%) stood out, which are diseases related to prenatal care and childbirth (8.88%) and asthma (7.39%). Female hospitalizations accounted for 57.52%, prevalent in the 15- to 19-year-old subgroup (66.64%). Conclusion and implications for practice it is necessary to advance in the construction of integrality in adolescent health care to respond to the health needs of this population segment and reduce hospitalizations for causes sensitive to primary care.


Subject(s)
Humans , Male , Female , Adolescent , Primary Health Care , Adolescent Health , Integrality in Health , Ambulatory Care Sensitive Conditions/statistics & numerical data , Health Promotion , Hospitalization/statistics & numerical data , Retrospective Studies , Health Services Accessibility , Health Services Needs and Demand
2.
Rev. Univ. Ind. Santander, Salud ; 54: e337, Dec. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1407036

ABSTRACT

Resumen Introducción: La hospitalización de pacientes durante la pandemia de COVID-19 se incrementó de manera importante, y evidenció las carencias de los sistemas de salud, que no respondieron de forma adecuada y eficiente. Objetivo: Determinar la evolución de pacientes hospitalizados durante la pandemia de COVID-19 en Perú. Métodos: Investigación descriptiva, transversal, retrospectiva. Efectuada con una data de 115 306 pacientes, a quienes se valoró su última evolución, el ingreso a Unidad de Cuidados Intensivos, si recibieron oxígeno o ventilación, fallecidos por COVID-19 y vacunación contra esta enfermedad, según los datos de la plataforma nacional de datos abiertos del Ministerio de Salud del Perú. Para analizar los datos se usaron frecuencias absolutas y relativas y para la asociación comparativa de variables, el chi cuadrado de homogeneidad con una significancia estadística de p < 0,01. Resultados: De los pacientes que ingresaron a Unidad de Cuidados Intensivos, que recibieron oxígeno y ventilación, el 51,1 %, 59,1 % y 44,9 %, respectivamente, fueron dados de alta. Del 28,3 % de pacientes que fallecieron, el 90,2 % fue por COVID-19. La mayor proporción fueron adultos (51,1 %) y adultos mayores (31,2 %), de los cuales el 36,3 % y 62,4 % fallecieron por COVID-19. De los fallecidos por COVID-19, el 96,9 % no tenía ninguna dosis de vacuna contra la enfermedad. Conclusión: Más de la mitad de los pacientes que ingresaron a Unidad de Cuidados Intensivos y recibieron oxígeno fueron dados de alta, la mayoría de los fallecidos por COVID-19 fueron adultos, adultos mayores y no vacunados. Las diferencias entre todos los pares de variables comparadas fueron altamente significativas (p < 0,001).


Abstract Introduction: The hospitalization of patients during the COVID-19 pandemic increased significantly, and evidenced the shortcomings of the health systems, which did not respond adequately and efficiently. Objective: To determine the evolution of hospitalized patients during the COVID-19 pandemic in Peru. Methods: Descriptive, cross sectional, retrospective research. Done with a data of 115,306 patients, who were assessed their latest evolution, admission to the Intensive Care Unit, if they received oxygen or ventilation, died from COVID-19 and vaccination against this disease, according to data from the national data platform open from the Ministry of Health of Peru. To analyze the data, absolute and relative frequencies were used and for the comparative association of variables, the chi-square of homogeneity with a statistical significance of p <0.01. Results: Of the patients admitted to the Intensive Care Unit, who received oxygen and ventilation, 51.1%, 59.1% and 44.9%, respectively, were discharged. Of the 28.3% of patients who died, 90.2% were from COVID-19. The largest proportion were adults (51.1%) and older adults (31.2%), of which 36.3% and 62.4% died from COVID-19. Of those who died from COVID-19, 96.9% did not have any dose of vaccine against the disease. Conclusion: More than half of the patients who were admitted to the Intensive Care Unit and received oxygen were discharged, the majority of deaths from COVID-19 were adults, older adults and not vaccinated. The differences between all pairs of compared variables were highly significant (p <0.001).

3.
Rev. bras. cir. plást ; 37(4): 438-444, out.dez.2022. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1413158

ABSTRACT

Introdução: Queimaduras são consideradas problemas de saúde pública global e apresentam maior incidência nos países subdesenvolvidos. No Brasil, estima-se que anualmente aconteçam 1.000.000 de acidentes envolvendo queimaduras. No paciente pediátrico, as queimaduras são a segunda causa mais comum entre os incidentes que ocorrem na infância, sendo a terceira causa de morte nas mesmas. O presente estudo teve por objetivo analisar as taxas de internações hospitalares por queimadura em pacientes pediátricos nos estados da região Sul, no período de 2016 a 2020. Métodos: Estudo ecológico de séries temporais, com dados obtidos na Região Sul do Brasil, utilizando o banco de dados do Sistema de Informações Hospitalares do Sistema Único de Saúde, no período de 2016 a 2020. Para análise das tendências temporais, foram utilizados os coeficientes de morbidade padronizados e o método de regressão linear simples. Resultados: No período de 2016 a 2020, foram realizadas 8.256 internações de crianças e adolescentes vitimadas por queimadura na Região Sul do Brasil, tendo o estado do Paraná como o responsável pelos maiores índices durante todo o período estudado. A principal faixa etária envolve crianças pré-escolares de 1-4 anos (n=4748); quanto ao sexo, a maior parte da amostra infantil tem predominância do sexo masculino (n=5.205). Conclusão: Há tendência de estabilidade na taxa geral de internação. O sexo masculino e a faixa etária de 1-4 anos são os mais acometidos por queimaduras no Sul do Brasil. O Paraná tem maiores taxas de internação quando comparado aos outros dois estados.


Introduction: Burns are considered global public health problems and have a higher incidence in underdeveloped countries. In Brazil, it is estimated that 1,000,000 accidents involving burns occur annually. In pediatric patients, burns are the second most common cause among incidents that occur in childhood, being the third cause of death in them. This study aimed to analyze the rates of hospital admissions for burns in pediatric patients in the southern states, from 2016 to 2020. Methods: Ecological time series study, with data obtained in the southern region of Brazil, using the database of data from the Hospital Information System of the Unified Health System, from 2016 to 2020. To analyze temporal trends, standardized morbidity coefficients and the simple linear regression method were used. Results: From 2016 to 2020, there were 8,256 hospitalizations of children and adolescents victimized by burns in the southern region of Brazil, with the state of Paraná being responsible for the highest rates throughout the study period. The main age group involves preschool children aged 1-4 years (n=4748); regarding gender, most of the child sample is predominantly male (n=5.205). Conclusion: There is a trend towards stability in the overall hospitalization rate. Males and the age group of 1-4 years are the most affected by burns in southern Brazil. Paraná has higher hospitalization rates when compared to other states.

4.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 68(11): 1593-1598, Nov. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1406587

ABSTRACT

SUMMARY OBJECTIVES: The coronavirus disease 2019 pandemic, which began in 2020, disrupted healthcare services. Reports of changes in surgical activities coincide with the outbreak period. We aimed to identify if changes could be determined in hospitalization rates of ovarian cancer patients from 2016 to 2020, comparing pre-pandemic and pandemic levels. METHODS: Aggregated data were obtained from the State of São Paulo Secretary of Health regarding ovarian cancer clinical and surgical hospitalization, both Coronavirus disease-specific ICU and infirmary bed occupation rates, average social distancing rates, coronavirus disease 2019 incidence, mortality, and lethality rates. We performed the joinpoint analysis to verify if there were changes regarding hospitalization rates during this period. We also calculated hospitalization rate ratios and tested if they were correlated with pandemic-related variables. RESULTS: Hospitalization rates in the state fell, coinciding with the pandemic. Surgical hospitalization rate ratios were inversely correlated with Coronavirus disease-specific ICU bed occupation rates during the third trimester of 2020, with a Pearson's correlation coefficient of −0.50 (95%CI −0.78 to −0.05, p=0.03). CONCLUSION: These results demonstrate the impact of the coronavirus disease 2019 pandemic on the treatment of conditions that compete for the same healthcare resources.

5.
Arq. bras. cardiol ; 119(5): 691-702, nov. 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1403389

ABSTRACT

Resumo Fundamento O infarto do miocárdio com elevação do segmento-ST (IAMCSST) é definido por sintomas acompanhados por alterações típicas do eletrocardiograma. Entretanto, a caracterização dos sintomas isquêmicos não é clara, principalmente em subgrupos, como mulheres e idosos. Objetivos Analisar a tipificação dos sintomas isquêmicos, métricas temporais e observar a ocorrência de desfechos intra-hospitalares, em análise dos escores preditivos, em pacientes com IAMCSST, em estratégia fármaco-invasiva. Métodos Estudo envolvendo 2.290 pacientes. Tipos de apresentações clínicas pré-definidas: dor típica, dor atípica, dispnéia, sincope. Medimos o tempo entre o início dos sintomas à demanda pelo atendimento e o intervalo entre a chegada à unidade-médica e trombólise. Odds-ratios (OR; IC-95%) foram estimadas em modelo de regressão. Curvas ROCs foram construídas para preditores de mortalidade. Nível de significância adotado (alfa) foi de 5%. Resultados Mulheres apresentaram alta prevalência de sintomas atípicos; maior tempo entre o início dos sintomas e a procura por atendimento; atraso entre a chegada ao pronto-socorro e a fibrinólise. A mortalidade hospitalar foi de 5,6%. Predição de risco pela classificação Killip-Kimball: AUC: [0,77 (0,73-0,81)] em classe ≥II. Subgrupos estudados [OR (IC-95%)]: mulheres [2,06 (1,42-2,99); p=0,01]; insuficiência renal crônica [3,39 (2,13-5,42); p<0,001]; idosos [2,09 (1,37-3,19) p<0,001]; diabéticos [1,55 (1,04-2,29); p=0,02]; obesos 1,56 [(1,01-2,40); p=0,04]; acidente vascular cerebral prévio [2,01 (1,02-3,96); p=0,04] correlacionaram-se com maiores taxas de mortalidade. Conclusão Apesar das mais altas taxas de mortalidade em alguns subgrupos, disparidade significativa persiste nas mulheres, com atrasos no reconhecimento dos sintomas e trombólise imediata. Destaca-se a aplicabilidade do escore Killip-Kimball na predição, independentemente da apresentação clínica.


Abstract Background ST-segment elevation myocardial infarction (STEMI) is defined by symptoms accompanied by typical electrocardiogram changes. However, the characterization of ischemic symptoms is unclear, especially in subgroups such as women and the elderly. Objectives To analyze the typification of ischemic symptoms, temporal metrics and observe the occurrence of in-hospital outcomes, in the analysis of predictive scores, in patients with STEMI, in a drug-invasive strategy. Methods Study involving 2,290 patients. Types of predefined clinical presentations: typical pain, atypical pain, dyspnea, syncope. We measured the time between the onset of symptoms and demand for care and the interval between arrival at the medical unit and thrombolysis. Odds-ratios (OR; CI-95%) were estimated in a regression model. ROC curves were constructed for mortality predictors. The adopted significance level (alpha) was 5%. Results Women had a high prevalence of atypical symptoms; longer time between the onset of symptoms and seeking care; delay between arrival at the emergency room and fibrinolysis. Hospital mortality was 5.6%. Risk prediction by Killip-Kimball classification: AUC: [0.77 (0.73-0.81)] in class ≥II. Subgroups studied [OR (CI-95%)]: women [2.06 (1.42-2.99); p=0.01]; chronic renal failure [3.39 (2.13-5.42); p<0.001]; elderly [2.09 (1.37-3.19) p<0.001]; diabetics [1.55 (1.04-2.29); p=0.02]; obese 1.56 [(1.01-2.40); p=0.04]: previous stroke [2.01 (1.02-3.96); p=0.04] correlated with higher mortality rates. Conclusion Despite higher mortality rates in some subgroups, significant disparity persists in women, with delays in symptom recognition and prompt thrombolysis. We highlight the applicability of the Killip-Kimball score in prediction, regardless of the clinical presentation.

7.
Rev. enferm. Cent.-Oeste Min ; 12: 4423, nov. 2022.
Article in Portuguese | LILACS, BDENF | ID: biblio-1402272

ABSTRACT

Objetivo:compreender os significados do processo de hospitalização e da utilização da música como promotora da saúde, na percepção de familiares de crianças e adolescentes que se encontram em tratamento oncológico. Método: pesquisa do tipo exploratória, descritiva, de abordagem qualitativa, fundamentada nos pressupostos da Promoção da Saúde e do Interacionismo Simbólico, a qual teve como participantes dez familiares. A coleta de dados ocorreu por meio de entrevista semiestruturada e foram analisados conforme a análise de conteúdo. Resultados:emergiram três categorias, sendo que os familiares desvelaram os significados da hospitalização e suas mudanças, a música como instrumento de promoção da saúde, suas experiências de melhora e qualidade de vida proporcionada por essa ferramenta. Conclusão:os familiares significaram o processo de hospitalização como um misto de sentimentos e sensações, destacando a música como uma tecnologia de cuidado que promove bem-estar, alegria, esperança e que pode ser empregada no ambiente hospitalar, no setor oncológico


Objective:to understand the meanings of the hospitalization process and the use of music as a health promoter, in the perception of family members of children and adolescents undergoing cancer treatment. Method:exploratory, descriptive research, with a qualitativeapproach, based on the assumptions of Health Promotion and Symbolic Interactionism, which had ten family members as participants. Data collection took place through semi-structured interviews and were analyzed according to content analysis. Results:Threecategories emerged, in which family members present the meanings of hospitalization and its changes, music as a health promotion instrument, their experiences of improvement and quality of life provided by this tool. Conclusion:family members understood the hospitalization process as a mixture of feelings and sensations, highlighting music as a care technology that promotes well-being, joy, hope and that can be used in the hospital environment, in the oncology sector


Objetivo:comprender los significados del proceso de hospitalización y el uso de la música como promotora de la salud, en la percepción de los familiares de niños y adolescentes en tratamiento oncológico. Método:investigación exploratoria, descriptiva, con abordaje cualitativo, basado en los supuestos de Promoción de la Salud e Interaccionismo Simbólico, que contó con diez familiares como participantes. La recolección de datos se realizó a través de entrevistas semiestructuradas y se analizaron según análisis de contenido. Resultados:Surgieron tres categorías, en las que los familiares presentan los significados de la hospitalización y sus cambios, la música como instrumento de promoción de la salud, sus experiencias de mejora y la calidad de vida que brinda esta herramienta. Conclusión:los familiares entendieron el proceso de hospitalización como una mezcla de sentimientos y sensaciones, destacando la música como una tecnología asistencial que promueve el bienestar, la alegría, la esperanza y que puede ser utilizada en el ámbito hospitalario, en el sector oncológico


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Family/psychology , Health Promotion , Hospitalization , Music Therapy , Neoplasms/psychology , Qualitative Research
8.
Rev. medica electron ; 44(5): 876-891, sept.-oct. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409774

ABSTRACT

RESUMEN La hospitalización inadecuada implica costos innecesarios a la familia del paciente y al centro de salud, congestión de los servicios hospitalarios y disminución del beneficio social, pudiendo llegar a exponer al paciente a riesgos como infecciones intrahospitalarias y a períodos de estrés. Asimismo, representa un problema social, debido a deficiencias en la formación de residentes en Medicina General Integral ante patologías que son de adecuado diagnóstico, tratamiento y seguimiento a nivel primario -que socavan la calidad e intersectorialidad entre el nivel secundario y el primario de atención-, y al uso racional de recursos en el sector de la salud. Este trabajo pretende abordar la situación de las hospitalizaciones inadecuadas, que se pueden solucionar a nivel de la atención primaria. Se realizó una revisión bibliográfica de artículos científicos relacionados con la temática, publicados en SciELO, LILACS, PubMed, EBSCO y Google Académico, lo cual contribuyó a recopilar textos con los más recientes aportes. Se necesita, a nivel primario, para la disminución de las hospitalizaciones evitables, reforzar acciones organizativas y un desempeño profesional de calidad, con estrategias dirigidas a la solución de las problemáticas de la población. Las deficiencias o irregularidades en la capacidad resolutiva del sistema de atención primaria, repercuten negativamente en la cantidad de atenciones hospitalarias a situaciones de salud prevenibles y, por ende, en la reducción de los costos hospitalarios.


ABSTRACT Inadequate hospitalization implies unnecessary costs to the patient's family and the health center, congestion of hospital services and reduction of social benefit, and may expose the patient to risks such as nosocomial infections and periods of stress. It also represents a social problem, due to deficiencies in the training of residents in Comprehensive General Medicine in pathologies that are adequately diagnosed, treated and monitored at the primary level-which undermine the quality and intersectorality between the secondary and primary levels of care-, and the rational use of resources in the health sector. This work aims to address the situation of inadequate hospitalizations, which can be solved at the primary care level. A bibliographic review was carried out of scientific articles related to the subject, published in SciELO, LILACS, PubMed, EBSCO and Google Scholar, which contributed to compile texts with the most recent contributions. In order to reduce preventable hospitalizations, it is necessary to reinforce organizational actions and quality professional performance at the primary level, with strategies aimed at solving the problems of the population. Deficiencies or irregularities in the resolution capacity of the primary care system have a negative impact on the amount of hospital care for preventable health situations and, therefore, on the reduction of hospital costs.

9.
Säo Paulo med. j ; 140(5): 676-681, Sept.-Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1410209

ABSTRACT

ABSTRACT BACKGROUND: Advanced age, multiple chronic diseases and frailty have been correlated with worse prognosis among coronavirus disease 2019 (COVID-19) inpatients. OBJECTIVE: To investigate potential risk factors for hospitalization and death due to COVID-19 among frail community-dwelling elderly people. DESIGN AND SETTING: Retrospective cohort study of patients followed up at a geriatric outpatient clinic in Belo Horizonte, Minas Gerais, Brazil. METHODS: The associations of demographic characteristics (age and sex) and clinical characteristics (frailty, multimorbidity, number of medications with long-term use, obesity, smoking, diabetes mellitus, pulmonary diseases, cardiovascular diseases, cerebrovascular disease, and chronic kidney disease) with the risk of hospitalization and death due to COVID-19 were explored using a multivariable logistic regression model. RESULTS: 5,295 patients (mean age 78.6 ± 9.4 years; 72.6% females) were included. After adjustments, the number of medications with long-term use was found to increase the odds of hospitalization due to COVID-19 (odds ratio, OR: 1.13; 95% confidence interval, CI: 1.06-1.22). Frailty, multimorbidity and diabetes mellitus also increased the odds of hospitalization (OR: 1.06, 95% CI: 1.02-1.09; OR: 1.17, 95% CI: 1.09-1.26; and OR: 2.27, 95% CI: 1.45-3.54, respectively) and the odds of death due to COVID-19 (OR: 1.07, 95% CI: 1.00-1.14; OR: 1.16, 95% CI: 1.03-1.32; and OR: 2.69, 95% CI: 1.79-6.14, respectively). CONCLUSIONS: Multimorbidity, frailty and diabetes mellitus increased the odds of hospitalization and death due to COVID-19 and the number of medications with long-term use increased the odds of hospitalization due to COVID-19 among frail community-dwelling elderly people.

10.
Säo Paulo med. j ; 140(5): 651-657, Sept.-Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1410214

ABSTRACT

ABSTRACT BACKGROUND: The frequency of coronavirus disease 2019 (COVID-19) cases among asthmatics has been reported to be reduced. However, the findings regarding the association between asthma and the risk of severe COVID-19 have been divergent. OBJECTIVE: To investigate whether asthma is associated with a reduced risk of development of severe COVID-19. DESIGN AND SETTING: Retrospective analysis on COVID-19 surveillance databases at two tertiary-level hospitals in São Paulo, Brazil. METHODS: The medical records of patients hospitalized due to COVID-19 between March and August 2020 were reviewed in accordance with the clinical, laboratorial, radiological and epidemiological criteria for COVID-19, and for comorbidities. RESULTS: Among the adult patients included (> 18 years of age) there were 52 asthmatics and 1,318 non-asthmatics. Their median ages and interquartile ranges (IQR) were, respectively, 54 (41-69) and 60 (44-72) years. At least one comorbidity was seen in 73% of asthmatics and 56% of the non-asthmatics. Among the asthmatics, most presented mild asthma (92%) and the prevalence of chronic obstructive pulmonary disease (COPD) was high (27%). The asthmatics presented an unadjusted odds ratio (OR) for severe COVID-19 of 0.89 (95% confidence interval, CI 0.5-1.56); and OR 0.88 (95% CI 0.5 -1.68) after multivariable adjustment. Age > 60 years, male sex, hypertension, diabetes, cancer and homelessness were covariates associated with increased odds for severe COVID-19. Kaplan-Meier estimated survival over hospitalization of up to 30 days did not differ between the groups (log-rank P = 0.09). CONCLUSIONS: The association between asthma and decreased risk of severe COVID-19 or increased survival was statistically non-significant.

11.
Arq. ciências saúde UNIPAR ; 26(3): 862-877, set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1399484

ABSTRACT

O acesso limitado do atendimento ao trauma aumenta proporcionalmente à ruralidade, refletindo em uma maior mortalidade e invalidez a longo prazo. A pesquisa objetivou identificar os desfechos de pacientes internados por trauma em Unidades de Terapia Intensiva, acometidos em ambientes rurais. Trata-se de um estudo transversal observacional realizado em uma UTI geral de um hospital da região central do Estado do Paraná entre 2013 a 2019, através da análise de prontuários de 230 pacientes traumatizados em ambiente rural. Os dados foram analisados por meio de testes de Qui-quadrado de Pearson, exato de Fisher ou t de Student. Dentre os desfechos identificados, observou-se associação do sexo feminino com as comorbidades (p=0,024), das regiões mais afetadas de cabeça, pescoço e tórax com a gravidade do trauma (p=0,001), além de variáveis do primeiro atendimento, como suporte respiratório básico, PAS <90mmHg e Glasgow associados à pacientes cirúgicos e pupilas alteradas em pacientes clínicos. Para o desfecho, observou-se que as médias do tempo de permanência hospitalar foi significativamente menor para aqueles que foram a óbito. As características apresentadas assemelham-se às informações mencionadas na literatura, em que as lesões graves com a necessidade de intervenção cirúrgica e maior tempo de permanência hospitalar estão associados ao óbito em traumas rurais. Contudo, o trauma no ambiente rural, apesar de não refletir nem sempre em maior gravidade, apresenta desfechos impactantes para o paciente.


Limited access to trauma care increases proportionally to rurality, reflecting higher mortality and long-term disability. The research aimed to identify the outcomes of patients hospitalized for trauma in Intensive Care Units, affected in rural environments. This is an observational cross-sectional study carried out in a general ICU of a hospital in the central region of the State of Paraná between 2013 and 2019, through the analysis of medical records of 230 trauma patients in a rural environment. Data were analyzed using Pearson's chi-square, Fisher's exact or Student's t tests. Among the outcomes identified, there was an association between female sex and comorbidities (p=0.024), the most affected regions of the head, neck and chest with the severity of the trauma (p=0.001), in addition to variables of the first care, such as basic respiratory support, SBP <90mmHg and Glasgow associated with surgical patients and altered pupils in medical patients. For the outcome, it was observed that the average length of hospital stay was significantly lower for those who died. The characteristics presented are similar to the information mentioned in the literature, in which serious injuries requiring surgical intervention and longer hospital stays are associated with death in rural traumas. However, trauma in the rural environment, although not always reflecting greater severity, has impacting outcomes for the patient.


El acceso limitado a la atención traumatológica aumenta proporcionalmente a la ruralidad, lo que se refleja en una mayor mortalidad y discapacidad a largo plazo. La investigación tenía como objetivo identificar los resultados de los pacientes ingresados por traumatismos en las Unidades de Cuidados Intensivos, afectados en entornos rurales. Se trata de un estudio observacional transversal realizado en una UCI general de un hospital de la región central del Estado de Paraná entre 2013 y 2019, a través del análisis de las historias clínicas de 230 pacientes lesionados en el medio rural. Los datos se analizaron mediante las pruebas de chi-cuadrado de Pearson, exacta de Fisher o t de Student. Entre los resultados identificados, el sexo femenino se asoció con las comorbilidades (p=0,024), las regiones más afectadas de la cabeza, el cuello y el tórax con la gravedad del traumatismo (p=0,001), además de las variables de los primeros cuidados, como la asistencia respiratoria básica, la PAS <90mmHg y el Glasgow asociado a los pacientes quirúrgicos y las pupilas alteradas en los pacientes clínicos. En cuanto al resultado, se observó que la duración media de la estancia hospitalaria fue significativamente menor para los que murieron. Las características presentadas son similares a la información mencionada en la literatura, en la que las lesiones graves con necesidad de intervención quirúrgica y mayor estancia hospitalaria se asocian a la muerte en el trauma rural. Sin embargo, el traumatismo en el medio rural, a pesar de no reflejar siempre una mayor gravedad, presenta resultados impactantes para el paciente.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Wounds and Injuries/diagnosis , Rural Areas , Inpatients/statistics & numerical data , Intensive Care Units/statistics & numerical data , Length of Stay/statistics & numerical data , Surgical Procedures, Operative/statistics & numerical data , Medical Records/statistics & numerical data , Cross-Sectional Studies/methods , Hospitals/statistics & numerical data
12.
Int. j. cardiovasc. sci. (Impr.) ; 35(5): 635-642, Sept.-Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1405185

ABSTRACT

Abstract Fundament: Telemedicine for follow-up in heart failure (HF) patients is effective in reducing hospitalizations, total and cardiovascular mortality. However, few studies were conducted in low and middle income, where lower access to technology and illiteracy could impact the results. Objective: To assess the effectiveness of associating telemedicine strategies, when compared to usual care, in reducing hospitalizations related to HF in patients discharged from the hospital due to HF. Methods: Controlled, randomized, multicenter, parallel-arm clinical trial, with an allocation ratio of 1:1, blinded to outcome evaluation, in which 340 patients who were discharged from public hospitals in Belo Horizonte due to HF will be randomized. Patients will be followed for 6 months and the intervention group will receive, in addition to the usual care, Structured Telephone Support (STS) from a nurse, a doctor, and an educational program. Counseling will be according to a clinical decision tree. The level of significance in the statistical analysis will be 5%. Expected results: Reduction in the number of hospital readmissions and/or in hospitalization time, in addition to developing a software with a clinical decision tree for remote follow-up and patient education about HF adapted to local culture. Conclusions: The intention of this study is to develop a telemedicine strategy and assess whether or not, in addition to the usual care, it is effective in reducing hospitalizations and mortality from HF. If effective, the aforementioned strategy could reduce costs and hospital needs in the Unified Health System (SUS, in Portuguese) for patients with HF. These results will be even more relevant considering the pandemic of COVID-19.

13.
Medicina (B.Aires) ; 82(5): 684-688, Oct. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1405723

ABSTRACT

Resumen Se registraron datos de los 178 pacientes internados en la sala de Clínica Médica del Hospital Municipal Dr. Raúl Caccavo de Coronel Suárez, diagnosticados con COVID-19 en el primer año de pandemia, de marzo 2020 a marzo 2021, único efector de salud donde se hospitalizan los pacientes en nuestra ciudad. Se describe su perfil clínico-epidemiológico. Se realizó un estudio descriptivo, retrospectivo, de corte transversal. El promedio de edad fue de 61 años (rango:9 meses-96 años). El 90% de los internados fue por causa respiratoria y el 57% fueron mujeres. Las comorbilidades más prevalentes fueron: hipertensión arterial 40%, diabetes 17%, obesidad 16%, enfermedad cardiovascular 8%, EPOC 8%, cáncer 5%. El promedio de internación fue de 10 días. De los internados, 154 presentaron neumonía (86%). Requirió UTI el 14% y de ellos el 94% necesitó ventilación mecánica, fallecieron 26 (15%), pero de aquellos internados en UTI, falleció el 46%. La letalidad general en Coronel Suárez hasta el 31/03/2021 fue de 0.9%. Se realizó tomografía de tórax a todos los internados por causa respiratoria, el 69% presentó infiltrado bilateral en vidrio esmerilado. En los resultados de laboratorio, se observó leucopenia en el 15% de ellos y plaquetopenia en el 3%. Estos datos podrían ser elementos para el desarrollo de modelos clínicos de predicción de COVID-19, aunque se necesitará más evidencia para tal fin.


Abstract To contribute to the study of the disease, data were recorded from all hospitalized patients in the Clinical Medicine room of Hospital Municipal Dr. Raúl Caccavo, Coronel Suárez, Buenos Aires province, diagnosed with COVID-19 in the first year of the pandemia (March 2020 to March 2021), the only health institution where patients were hospitalized in our city. A descriptive and retrospective transversal cut study was carried out with 178 patients (average age: 61 years old, range: 9 months -96 years), 90% of them hospitalized for a respiratory cause. The most prevalent co-morbilities were arterial hypertension (40%), diabetes (17%), obesity (16%), cardiovascular pathology (8%), COPD (8%), and cancer (5%). The average number of hospitalization days was 10. Out of the 178 COVID-19 diagnosed patients, 154 (86%) presented pneumonia and 14% required intensive care. Of the patients in the ICU, 94% needed MVA and 46% died. The overall number of deceased patients was 15%. The general lethality in the city of Coronel Suárez until 03/31/2021 was 0.9%. All patients hospitalized for respiratory causes were subjected to a thorax tomography, and 69% of them presented bilateral infiltration in ground glass. The laboratory tests revealed leucopenia in 15% of the patients and thrombocytopenia in 3% of them. These data could be an input for the development of COVID-19 clinical prediction models, although more evidence will be needed for that end.

14.
Rev. Ciênc. Méd. Biol. (Impr.) ; 21(2): 155-160, out.2022. tab
Article in Portuguese | LILACS | ID: biblio-1399774

ABSTRACT

Introdução: a desnutrição representa um problema clínico-nutricional frequente em pacientes hospitalizados, sendo que a detecção precoce do risco nutricional torna-se fundamental, pois possibilita à equipe multidisciplinar o início imediato de uma conduta dietética adequada, minimizando o sinergismo entre a desnutrição e os demais fatores clínicos. Objetivo: determinar o risco nutricional, associando com o estado nutricional, estilo de vida e variáveis clínicas de hospitalização de pacientes internados pelo SUS, comparando tais condições entre os sexos. Metodologia: trata-se de estudo transversal. Para avaliação do risco nutricional dos pacientes hospitalizados foi utilizado o protocolo de triagem nutricional Nutricional Risk Screening (NRS) 2002, além disso foram coletados dados antropométricos, clínicos, sociodemográficos e dietéticos para comparação com o risco nutricional. Resultados: a amostra foi composta por 100 pacientes, sendo 50% adultos e 50% idosos, com média de idade de 56,11±19 anos, sendo a maioria do sexo masculino (51%). O risco nutricional esteve presente em 34% dos pacientes avaliados, sendo 58,8% no sexo feminino e 41,2% no sexo masculino. Não houve diferença das demais variáveis quando comparadas entre os sexos (p>0,05). A maior prevalência de risco observada foi em idosos (27%). Conclusão: o risco nutricional obteve maior prevalência nos pacientes idosos, porém não houve diferença entre os sexos. Sabe-se que a presença de comorbidades e uma inadequada aceitação da dieta por parte dos mesmos pode levar a uma piora significativa do estado nutricional.


Malnutrition is a frequent clinical and nutritional problem in hospitalized patients, and early detection of nutritional risk is essential, as it allows the multidisciplinary team to immediately start an adequate dietary approach, minimizing the synergism between malnutrition and other clinical factors. Objective: to determine the nutritional risk, associating it with the nutritional status, lifestyle and clinical variables of hospitalization of patients hospitalized by the SUS, comparing such conditions between the sexes. Methodology: this are a cross-sectional study. To assess the nutritional risk of hospitalized patients, the Nutritional Risk Screening (NRS) 2002 protocol was used. In addition, anthropometric, clinical, sociodemographic and dietary data were collected for comparison with nutritional risk. Results: the sample consisted of 100 patients, 50% adults and 50% elderly, with a mean age of 56.11±19 years, the majority being male (51%). Nutritional risk was present in 34% of the patients evaluated, being 58.8% female and 41.2% male. There was no difference in the other variables when compared between the sexes (p>0.05). The highest prevalence of risk observed was in the elderly (27%). Conclusion: nutritional risk was more prevalent in elderly patients, but there was no difference between the sexes. It is known that the presence of comorbidities and an inadequate acceptance of the diet by them can lead to a significant worsening of the nutritional status.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Weight Loss , Malnutrition , Eating , Nutrology , Hospitalization , Comorbidity , Cross-Sectional Studies
15.
Rev. chil. neuro-psiquiatr ; 60(3)sept. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1407831

ABSTRACT

RESUMEN: Introducción: El Ataque Cerebro Vascular (ACV) es la segunda causa de muerte a nivel mundial y primera causa de discapacidad en el adulto. Su complejidad requiere de una atención integral a través de un equipo multiprofesional, implementado en las denominadas Unidades de Tratamiento del Ataque Cerebrovascular (UTAC). Considerando su relevancia e impacto en el pronóstico, es fundamental conocer las acciones desarrolladas en el ámbito de la rehabilitación neuromotora en estas unidades, información que actualmente es limitada. Método: Estudio descriptivo de corte transversal, la muestra fue por conveniencia, participaron 5 kinesiólogos de establecimientos públicos de salud. La recolección de información se realizó con una encuesta en línea enfocada a las acciones que se realiza en la UTAC. El análisis de datos se realizó con STATA 15 y ATLAS TI 8.0. Resultados: El inicio y frecuencia de la rehabilitación neuromotora es variable, ocurre entre las 24 y 48 horas posterior al diagnóstico. Diariamente se realizan entre una a tres sesiones por usuario, su duración varía desde 25 a 90 minutos. Las acciones neuromotoras son de carácter integral y multiprofesional, el abordaje incluye el componente neuromotor, respiratorio y estado cognitivo. Las acciones neuromotoras incorporan técnicas de facilitación de la postura más alta lograda por el usuario y estimulación sensorial, entre otras. Conclusiones: La rehabilitación neuromotora en las UTAC de Chile muestra realidades diferentes en cuanto a la identificación, funcionamiento y la intervención neuromotora.


ABSTRACT Background: Stroke is the second leading cause of death in the world and the first cause of disability in adults. Its complexity requires comprehensive care provided by a multiprofessional team, implemented in the so-called Stroke Treatment Units (STUs). In view of their relevance and impact on the prognosis, identifying activities developed in the framework of neuromotor rehabilitation is of fundamental importance, information which, at present, is not readily available. Methods: Cross-sectional descriptive study, convenience sampling with the participation of 5 kinesiologists from public health centers in Chile. Information was collected by means of an online survey focused on the work being carried out in the STUs. Data analysis was performed using STATA 15 and ATLAS TI 8.0 software. Results: Initiation and frequency of neuromotor rehabilitation is variable and occurs between 24 and 48 hours after diagnosis. Between one and three daily sessions per user are performed and their duration varies from 25 to 90 minutes. Neuromotor activities are integral and multiprofessional; the approach includes neuromotor, respiratory and cognitive components. Neuromotor activities incorporate facilitation techniques for the most advanced user posture achieved and sensory stimulation, among others. Conclusions: Neuromotor rehabilitation in Chile´s STUs shows different realities in terms of identification, functioning and neurokinetic intervention.

16.
BrJP ; 5(3): 258-264, July-Sept. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403665

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: Pain can be influenced by the period of hospital stay, causing different losses to the patient. Professionals must properly collect and record this data to treat pain. The aim of this study was to investigate the different characteristics of pain in hospitalized patients. METHODS: A systematic review was carried out in the Medline, LILACS and Pubmed databases, based on the descriptors "pain" AND "patients" AND "hospitalized" with their respective terms in Portuguese until October 2020. A total of 2,085 articles were found, of which 2,064 underwent careful evaluation and 20 were selected to compose this review based on the inclusion and exclusion criteria outlined. RESULTS: Pain is more common and more severe in postoperative (90.8%) and palliative care wards, above all, it is frequently reported by young women. It lasts for more than three months in many patients and interferes with activities of daily living. Adequate analgesia is of great importance in this scenario. One-dimensional instruments are most commonly used to assess pain in hospitals. Attention is drawn to the absence or omission of non-pharmacological therapies for pain management, which can be considered a safe alternative without increasing the use of drugs. CONCLUSION: Pain is very present and severe in hospitalized patients, demonstrating a failure in hospital analgesia protocols worldwide. Due to the work overload of professionals, pain is still under-evaluated. HIGHLIGHTS Pain still does not receive the proper attention in the hospital environment. There are failures in the requisites of systematized, appropriate assessment and the professionals' trust in the patients' reports, especially the record in medical charts and adequate analgesic treatment. Pain is very present in hospitalized patients, regardless of the cause for hospitalization and, as a result, it limits the quality of life and daily activities, besides resulting in biopsychosocial changes. Training for interprofessional hospital staf is strongly recommended to improve pain management in this scenario.


RESUMO JUSTIFICATIVA E OBJETIVOS: A dor pode ser infuenciada pelo período de internação hospitalar, acarretando diferentes prejuízos ao paciente. Os profissionais devem coletar e registrar adequadamente esse dado para tratar a dor. O objetivo deste estudo foi investigar as diferentes características da dor em pacientes hospitalizados. MÉTODOS: Foi realizada uma revisão sistematizada nas bases de dados Medline, LILACS e Pubmed, com base nos descritores "dor" AND "pacientes" AND "internados" com seus respectivos termos em inglês até outubro de 2020. Encontrou-se, no total, 2.085 artigos, dos quais 2.064 passaram por criteriosa avaliação e 20 foram selecionados para compor esta revisão com base nos critérios de inclusão e exclusão delineados. RESULTADOS: A dor é mais comum e mais intensa em alas de pós-operatórios (90,8%) e de cuidados paliativos, sobretudo, é frequentemente relatada por mulheres jovens. Tem duração superior a três meses em muitos pacientes e interfere nas atividades de vida diária. Uma adequada analgesia representa grande importância nesse cenário. Os instrumentos unidimensionais são mais utilizados para avaliar a dor em hospitais. Chama atenção a ausência ou omissão de terapias não farmacológicas para o manejo da dor, a qual pode ser considerada uma alternativa segura sem aumentar o uso de fármacos. CONCLUSÃO: A dor se mostrou muito presente e intensa em pacientes hospitalizados, demonstrando haver falha nos protocolos hospitalares de analgesia em todo o mundo. Por sobrecarga de trabalho dos profissionais, a dor ainda é subavaliada. DESTAQUES No ambiente hospitalar, a dor ainda não recebe a devida atenção. Há falhas nos quesitos de avaliação sistematizada, apropriada e confança dos profissionais nos relados dos pacientes, sobretudo o registro nos prontuários e tratamento analgésico adequado. A dor está muito presente nos pacientes internados, independentemente do motivo da hospitalização e, com isso, limita a qualidade de vida e as atividades diárias, além de causar alterações biopsicossociais. Recomenda-se fortemente a capacitação para equipe interprofissional dos hospitais para melhorar o manejo da dor nesse cenário.

17.
JBES ; 14(Suplemento 2)20220800.
Article in Portuguese, English | LILACS-Express | LILACS | ID: biblio-1412560

ABSTRACT

Objetivo: Avaliar os custos diretos na perspectiva hospitalar e do Sistema Único de Saúde (SUS), bem como os custos indiretos de pacientes hospitalizados por COVID-19. Métodos: Estudo observacional com coleta de dados por micro e macrocusteio, realizado com pacientes admitidos por COVID-19 em um hospital paulista (março a setembro de 2020). Custos indiretos foram obtidos pelos métodos de capital humano e de anos de vida ajustados pela incapacidade (DALY). Análises de Mann-Whitney e regressão linear foram realizadas. Resultados: Foram incluídos 158 indivíduos com mediana de idade de 57 anos (IIQ 42-68 anos). A mediana de custo da internação na perspectiva do SUS e hospitalar foi de, respectivamente, R$ 2.009,46 (IIQ: R$ 1.649,11; R$ 4.847,36), principalmente devido à unidade de terapia intensiva (UTI), e R$ 19.055,91 (IIQ: R$ 8.399,47; R$ 38.438,00), principalmente devido a recursos humanos. Tempo total de internação (p < 0,001), óbito (p < 0,001) e ventilação invasiva (p < 0,001) foram preditores de aumento de custo. Foi identificada perda de 381,5 DALY e perda de produtividade de 128 anos, equivalente a US$ 855.307. Conclusão: Os principais direcionadores de custo foram recursos humanos e UTI. Entretanto, na perspectiva da sociedade, foi identificado o maior impacto devido à perda de produtividade e DALY. Tempo de hospitalização foi um dos grandes contribuidores do custo, e esse fator pode estar atrelado a gravidade da doença e protocolos de cuidado ao paciente.


Objective: To evaluate the direct costs from the hospital and Unified Health System (SUS) perspective, as well as the indirect costs of patients hospitalized by COVID-19. Methods: Observational study with data collection by micro- and macro-costing, carried out with patients hospitalized in a hospital in São Paulo (March-September 2020). Indirect costs were obtained using human capital and disability-adjusted life years (DALY) methods. Mann-Whitney and linear regression analyzes were performed. Results: 158 individuals were included, with a median age of 57 years (IQR 42-68 years). The median cost of admission in the SUS and hospital perspective was, respectively, R$ 2,009.46 (IQR: R$ 1,649.11; R$ 4,847.36), mainly due to the intensive care unit (ICU) and R$ 19,055.91 (IQR: R$ 8,399.47; R$ 38,438.00), mainly due to human resources. The total length of stay in hospital (p < 0.001), death (p < 0.001) and invasive ventilation (p < 0.001) were predictors of cost increase.

18.
J. pediatr. (Rio J.) ; 98(5): 533-539, Sept.-Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1405482

ABSTRACT

Abstract Objective After the Covid-19 pandemics hit Brazil and sanitary measures were adopted to contain its dissemination, pediatric hospital admissions were apparently fewer than usual. The authors aimed to describe the time trends of public hospital admissions of children and adolescents due to respiratory infections (RIs) in São Paulo State, Brazil, before and after the adoption of sanitary measures to contain the dissemination of Covid-19. Methods Ecological, time-series study on the monthly average number of admissions per day of children and adolescents (< 16 years) admitted to public hospitals of São Paulo due to acute RIs between January 2008 and March 2021. Data from 2008 to 2019 were used to adjust the statistical model, while data from 2020 and 2021 were compared to the values predicted by the model. Results In 2020 and 2021, the number of hospital admissions was significantly lower than predicted by the time series. However, lethality was three times higher in these years, compared to the previous, and six times higher in patients with Covid-19, compared to those without the disease. Hospitalization costs in 2020 and 2021 were lower than in previous years. Conclusions These findings suggest that the sanitary measures adopted to contain the dissemination of Covid-19 also effectively reduce the transmission of other respiratory viruses. Policymakers and administrators can use this knowledge as a guide to planning preventative interventions that could decrease the number and severity of RIs and related hospital admissions in children and adolescents, decreasing the burden on the public health system.

19.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 68(8): 1073-1077, Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1406615

ABSTRACT

SUMMARY OBJECTIVE: Type 2 diabetes mellitus is associated with significant morbidity and mortality. The term "frailty in the elderly" has become increasingly important with the increase of the elderly population, especially in diabetic subjects. Frailty is established by various scoring scales, such as Edmonton, Frail, and Prisma-7 scores. We aimed to evaluate the association between frailty and clinical and laboratory parameters of the geriatric type 2 diabetic patients. METHODS: Diabetic patients over 65 years of age who presented to outpatient internal medicine clinics of our institution between June 2020 and January 2021 were enrolled to the study. Edmonton, Frail, and Prisma-7 scores were administered to the subjects. Study parameters were compared between well-controlled and poorly controlled diabetic groups according to diabetes control level and between frail and non-frail groups, according to each frailty scores. RESULTS: Frailty according to Edmonton score was associated with increased risks of hospitalization (p=0.005) and mortality (p=0.02). Frailty according to frail score was associated with increased risk of hospitalization (p=0.009). Frailty according to Prisma-7 score was associated with increased risk of mortality (p<0.001). CONCLUSION: We suggest that Edmonton frail score is superior to Frail and Prisma-7 scores in determining frailty in geriatric patients with type 2 diabetes mellitus, since it is associated with both increased risk of hospitalization and mortality within 6 months.

20.
Arch. endocrinol. metab. (Online) ; 66(4): 512-521, July-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403225

ABSTRACT

ABSTRACT Objective: To evaluate the association between obesity and hospitalization in mild COVID-19 adult outpatients in Brazil. Subjects and methods: Adults with signs and symptoms suggestive of acute SARS-CoV-2 infection who sought treatment in two hospital (public and private) emergency departments were prospectively enrolled. Patients with confirmed COVID-19 at inclusion were followed by phone calls at days D7, D14 and D28. Multivariable logistic regression models were employed to explore the association between obesity and other potential predictors for hospitalization. Results: A total of 1,050 participants were screened, and 297 completed the 28-day follow-up and were diagnosed with COVID-19 by RT-PCR. The median age was 37.2 (IQR 29.7-44.6) years, and 179 (60.0%) were female. The duration of symptoms was 3.0 (IQR 2.0-5.0) days, and 10.0 (IQR 8.0-12.0) was the median number of symptoms at inclusion. Ninety-five (32.0%) individuals had obesity, and 233 (78.5%) had no previous medical conditions. Twenty-three participants (7.7%) required hospitalization during the follow-up period. After adjusting, obesity (BMI ≥ 30.0 kg/m2) (OR = 2.69, 95% CI 1.63-4.83, P < 0.001) and older age (OR = 1.05, 95% CI 1.01-1.09, P < 0.001) were significantly associated with higher risks of hospitalization. Conclusion: Obesity, followed by aging, was the main factor associated with hospital admission for COVID-19 in a young population in a low-middle income country. Our findings highlighted the need to promote additional protection for individuals with obesity, such as vaccination, and to encourage lifestyle changes.

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