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1.
Prensa méd. argent ; 108(2): 55-60, 20220000. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1368358

ABSTRACT

El certificado médico de defunción (CMD) es la fuente de las estadísticas de causas de muerte en nuestro país. La falta de precisión de los datos que allí se registran afecta al análisis de las estadísticas de mortalidad y al diseño de políticas sanitarias basadas en dicho examen. La calidad de la información sobre causas de muerte se verá más o menos comprometida en la medida que el médico realice el registro de las causas de muerte acorde a los estándares establecidos por las autoridades sanitarias. La pandemia por COVID 19 ha resaltado la importancia de generar estadísticas confiables en salud, al mismo tiempo que la elaboración de esa información se ha visto afectada por diversos motivos. Se analizó la calidad del registro de causas de fallecimiento de pacientes con COVID 19 en el Hospital de Clínicas "José de San Martín". Se revisaron 488 certificados médicos de defunción (CMD) correspondientes a todos los fallecidos en el Hospital de Clínicas entre 13/04/2020 al 10/09/2020 (n: 373) y desde el 07/05/2021 al 08/06/2021 (n: 115). De todos ellos, 127 CMD informaban en al menos una de sus causas a la COVID 19 (códigos U.7 y siguientes del CIE 10). Hubo un 74,02% (n: 94) de causas de muerte "poco útiles" entre las causas inmediatas, 18,9% (n:24) entre las mediatas y 0% (n:0) en las originales. c) Se registró en forma completa el intervalo entre la enfermedad y la muerte en el 4,72% (n:6); y se registró la Causa Contribuyente (parte 2 del CMD) en un 11,02% (n: 14). La calidad de los registros de mortalidad por COVID 19 está comprometida. Se observó una alta proporción de "causas poco útiles" como registro en las causas de fallecimiento, y un déficit en el llenado del intervalo entre la enfermedad y la muerte, y en la causa contribuyente del fallecimiento. Debemos trabajar en todos los niveles para contribuir al mejoramiento de la certificación de las defunciones y por ende, a la obtención de estadísticas de mortalidad y de causas de muerte más precisas, que apoyen la evaluación de políticas públicas y la toma de decisiones acertadas en pro de la salud de la población.


The medical death certificate (CMD) is the source of the statistics of causes of death in our country. The lack of precision of the data recorded there affects the analysis of mortality statistics and the design of health policies based on said examination. The quality of the information on causes of death will be more or less compromised to the extent that the physician registers the causes of death in accordance with the standards established by the health authorities. The COVID 19 pandemic has highlighted the importance of generating reliable health statistics, at the same time that the preparation of this information has been affected for various reasons. The quality of the registry of causes of death of patients with COVID 19 at the Hospital de Clínicas "José de San Martín" was analyzed. We reviewed 488 medical death certificates (CMD) corresponding to all those who died at the Hospital de Clínicas between 04/13/2020 and 09/10/2020 (n: 373) and from 05/07/2021 to 06/08/ 2021 (no.: 115). Of all of them, 127 CMDs reported COVID 19 in at least one of their causes (ICD 10 codes U.7 and following). There were 74.02% (n: 94) of "not very useful" causes of death among the immediate causes, 18.9% (n: 24) among the mediate ones, and 0% (n: 0) in the original ones. c) The interval between illness and death was fully recorded in 4.72% (n:6); and the Contributing Cause (part 2 of the CMD) was registered in 11.02% (n: 14). The quality of COVID 19 mortality records is compromised. A high proportion of "unhelpful causes" was observed as a registry in the causes of death, and a deficit in filling the interval between illness and death, and in the contributing cause of death. We must work at all levels to contribute to improving the certification of deaths and, therefore, to obtaining more accurate mortality statistics and causes of death, which support the evaluation of public policies and the making of sound decisions in favor of the population health.


Subject(s)
Death Certificates , Epidemiology, Descriptive , Cross-Sectional Studies/statistics & numerical data , Cause of Death , Evaluation Studies as Topic , Data Accuracy , COVID-19/mortality
2.
Rev. Hosp. Ital. B. Aires (2004) ; 42(1): 12-20, mar. 2022. graf, ilus, tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1368801

ABSTRACT

Introducción: determinar la causa de muerte de los pacientes internados con enfermedad cardiovascular es de suma importancia para poder tomar medidas y así mejorar la calidad su atención y prevenir muertes evitables. Objetivos: determinar las principales causas de muerte durante la internación por enfermedades cardiovasculares. Desarrollar y validar un algoritmo para clasificar automáticamente a los pacientes fallecidos durante la internación con enfermedades cardiovasculares Diseño del estudio: estudio exploratorio retrospectivo. Desarrollo de un algoritmo de clasificación. Resultados: del total de 6161 pacientes, el 21,3% (1316) se internaron por causas cardiovasculares; las enfermedades cerebrovasculares representan el 30,7%, la insuficiencia cardíaca el 24,9% y las enfermedades cardíacas isquémicas el 14%. El algoritmo de clasificación según motivo de internación cardiovascular vs. no cardiovascular alcanzó una precisión de 0,9546 (IC 95%: 0,9351-0,9696). El algoritmo de clasificación de causa específica de internación cardiovascular alcanzó una precisión global de 0,9407 (IC 95%: 0,8866-0,9741). Conclusiones: la enfermedad cardiovascular representa el 21,3% de los motivos de internación de pacientes que fallecen durante su desarrollo. Los algoritmos presentaron en general buena performance, particularmente el de clasificación del motivo de internación cardiovascular y no cardiovascular y el clasificador según causa específica de internación cardiovascular. (AU)


Introduction: determining the cause of death of hospitalized patients with cardiovascular disease is of the utmost importance in order to take measures and thus improve the quality of care of these patients and prevent preventable deaths. Objectives: to determine the main causes of death during hospitalization due to cardiovascular diseases.To development and validate a natural language processing algorithm to automatically classify deceased patients according to their cause for hospitalization. Design: retrospective exploratory study. Development of a natural language processing classification algorithm. Results: of the total 6161 patients in our sample who died during hospitalization, 21.3% (1316) were hospitalized due to cardiovascular causes. The stroke represent 30.7%, heart failure 24.9%, and ischemic cardiac disease 14%. The classification algorithm for detecting cardiovascular vs. Non-cardiovascular admission diagnoses yielded an accuracy of 0.9546 (95% CI 0.9351, 0.9696), the algorithm for detecting specific cardiovascular cause of admission resulted in an overall accuracy of 0.9407 (95% CI 0.8866, 0.9741). Conclusions: cardiovascular disease represents 21.3% of the reasons for hospitalization of patients who die during hospital stays. The classification algorithms generally showed good performance, particularly the classification of cardiovascular vs non-cardiovascular cause for admission and the specific cardiovascular admission cause classifier. (AU)


Subject(s)
Humans , Artificial Intelligence/statistics & numerical data , Cerebrovascular Disorders/mortality , Myocardial Ischemia/mortality , Heart Failure/mortality , Hospitalization , Quality of Health Care , Algorithms , Reproducibility of Results , Factor Analysis, Statistical , Mortality , Cause of Death , Electronic Health Records
3.
Espaç. saúde ; 23: 1-12, 04/03/2022. ilus
Article in Portuguese | LILACS | ID: biblio-1359616

ABSTRACT

Considerando os altos coeficientes de mortalidade neonatal por causas evitáveis registrados nos serviços brasileiros de saúde, o presente estudo teve como objetivo analisar o perfil de mortalidade, nos últimos 5 anos, de crianças menores de 1 ano residentes no município de Criciúma (SC), utilizando banco de dados da vigilância epidemiológica de Santa Catarina. Estudo epidemiológico descritivo, retrospectivo, com base nos dados do Sistema de Informação sobre Nascidos Vivos (SINASC) e Sistema de Informação sobre Mortalidade (SIM), sendo estes dados de domínio público submetidos a uma análise crítica sobre associação com tipo de parto e causa evitabilidade. Destaca-se a necessidade de aprofundar a temática evitabilidade dentro do contexto causas óbitos e, através das declarações de nascimento, construir uma classificação mais específica das causas óbitos e assim elaborar mecanismos para melhorar a assistência à saúde dentro do município, não somente voltados à assistência imediata e sim à prevenção.


Considering the high coefficients of neonatal mortality from preventable causes registered in Brazilian health services, this study aimed to analyze the mortality profile in the last 5 years of children under 1 year old living in the city of Criciúma/SC using a database from the epidemiological surveillance of Santa Catarina. This is a descriptive, retrospective epidemiological study based on data from the Information System on Live Births and the Information System on Mortality. . We highlight the need to make an in-depth examination of the theme of preventability within the context of causes of death and, through birth certificates, to build a more specific classification of causes of death and thus develop mechanisms to improve health care within the municipality, not only focused on immediate care, but also on prevention.


Considerando los altos coeficientes de mortalidad neonatal por causas prevenibles registrados en los servicios de salud brasileños, el objetivo de ese estudio fue analizar el perfil de mortalidad en los últimos 5 años de los niños menores de 1 año residentes en la ciudad de Criciúma / SC utilizando una base de datos de la vigilancia epidemiológica de CS. Estudio epidemiológico descriptivo retrospectivo a partir de datos del Sistema de Información de Nacidos Vivos (SINASC) y del Sistema de Información de Mortalidad (SIM). Destacamos la necesidad de profundizar en el tema de la evitabilidad en el contexto de las causas de muerte y, a través de las partidas de nacimiento, construir una clasificación más específica de las causas de muerte y así desarrollar mecanismos para mejorar la atención de la salud dentro de la ciudad, no solo enfocada a la atención inmediata, y sí a la prevención.


Subject(s)
Humans , Infant Mortality , Cause of Death
4.
Arq. ciências saúde UNIPAR ; 26(1): 57-64, Jan-Abr. 2022.
Article in Portuguese | LILACS | ID: biblio-1362673

ABSTRACT

Objetivou-se analisar o perfil epidemiológico e as causas da mortalidade neonatal e infantil, em uma Regional de Saúde, de janeiro/2018 a agosto/2020. Trata-se de pesquisa exploratória, descritiva, transversal, retrospectivo, com abordagem quantitativa. A coleta de dados ocorreu em agosto de 2020, por meio de questionário elaborado pelas pesquisadoras, com base nas declarações de óbito disponibilizadas no Sistema de Informações de Mortalidade. O instrumento abordou as variáveis, sexo, raça, cor, idade da criança, idade materna, escolaridade materna, via de parto, idade gestacional, peso ao nascer, causa do óbito. Os dados foram submetidos à análise estatística descritiva e distribuição de frequência, por meio do Statistical Package for the Social Sciences (SPSS), versão 25.0. Constatou-se o predomínio de óbitos no sexo masculino (56,5%), de raça branca (87,8%), com equivalência entre extremo baixo peso e adequado (31,3%), com a principal causa de óbito por septicemia (13,9%). Quanto aos dados maternos, prevaleceram idade entre 21 e 30 anos de idade (45,2%) com gestação única (85,21%) e parto cesariano (65,2 %). Desses, 47,87% ocorreram no ano de 2018. Analisar os aspectos da mortalidade neonatal e infantil possibilita o planejamento e a readequação de ações no atendimento à saúde da criança, durante o período mais vulnerável e mais crítico dela, contribuindo, assim, para redução do número de óbitos.


This study analyzed the epidemiological profile and the causes of neonatal and infant mortality in a Health Regional Area between January 2018 and August 2020. This is an exploratory, descriptive, cross-sectional, retrospective study with a quantitative approach. Data collection took place during August 2020 through a questionnaire prepared by the researchers, based on the death certificates available in the Mortality Information System. The instrument included the variables of sex, race, color, child's age, mother's age, maternal education, childbirth mode, gestational age, birth weight, cause of death. The data were submitted to descriptive statistical analysis and frequency distribution using the Statistical Package for the Social Sciences (SPSS) version 25.0. There was a predominance of deaths among boys (56.5%), Caucasian (87.8%), with equivalence between extreme low and adequate weight (31.3%), with the main cause of death being septicemia (13.9%). As for maternal data, age between 21 to 30 years old (45.2%) prevailed, and 85.21% had a single pregnancy, with C-section childbirth (65.2%). From these, 47.87% occurred in 2018. It can be concluded that analyzing the aspects of neonatal and child mortality enables the planning and adjustment of actions in child health care during its most vulnerable and most critical period, thus contributing to reducing the number of deaths.


Subject(s)
Humans , Infant, Newborn , Adult , Regional Health Planning , Infant Mortality , Early Neonatal Mortality , Birth Weight , Cause of Death , Death , Delivery of Health Care , Neonatal Sepsis/mortality , Health Services Research
5.
Rev. argent. salud pública ; 14 (Suplemento COVID-19), 2022;14: 1-6, 02 Febrero 2022.
Article in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1354567

ABSTRACT

INTRODUCCIÓN: El impacto de la pandemia por COVID-19 sobre la mortalidad abarca tanto sus efectos directos, las defunciones atribuidas al virus SARS-CoV-2, como indirectos sobre otras causas de muerte. "El objetivo del estudio fue determinar la variación sobre causas de muerte no COVID-19 en la provincia de Buenos Aires durante 2020. MÉTODOS: Se realizó un estudio descriptivo de base poblacional, utilizando fuentes secundarias. Se analizó la variación en la mortalidad por causas específicas codificadas según CIE-10, desagregadas a nivel de capítulo y grupos. Las variaciones entre las causas de muerte observadas y esperadas se compararon mediante el método de P-score respecto al quinquenio inmediato anterior (2015-2019). RESULTADOS: Todos los capítulos CIE-10 estudiados se ubican por debajo del promedio de la serie histórica. La mayor variación se registra en causas externas (-20,0%), enfermedades del sistema respiratorio (-9,1%), tumores (-8,1%), enfermedades nutricionales, endocrinas y metabólicas (-5,7%) y finalmente enfermedades del sistema circulatorio (-2,2%). DISCUSIÓN: Se observó la existencia de un reemplazo variable de otras causas de defunción por muertes COVID-19 durante 2020. El análisis de causas múltiples resultó de utilidad para reestimar, en el caso del grupo de influenza (gripe) y neumonías, la participación global de la COVID-19 en la cadena de eventos que contribuyeron al deceso.


Subject(s)
Argentina , Epidemiology , Cause of Death , COVID-19
6.
Ciênc. Saúde Colet ; 27(1): 287-298, jan. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356034

ABSTRACT

Abstract Using five cause-specific mortality data sourced by the Brazilian Ministry of Health, and over 17 years period, we applied Bayesian spatio-temporal models on 644 municipalities of the state of São Paulo, using logistic model to the binary outcome that specifies whether or not the death was from a specific cause. We modeled the temporal mortality effects using B-splines, while the spatial components were considered through Gaussian and Markov random field, and inference was based on Markov chain Monte Carlo simulation. The results demonstrate consistent downward trend in mortality from infectious and parasitic diseases and external causes, while those from neoplasms and respiratory are rising. Cardiovascular is the only cause-specific death that is kept constant in time. All the causes of death considered show heterogeneous spatial and temporal variations among the municipalities, which sometimes change considerably within successive years. Mortality from infectious diseases clustered around the Northwestern municipalities in 2000, but changes to the Southeastern part in 2016, a similar development as external death causes. The study identifies areas with increased and decreased odds mortality and could be useful in disease monitoring, especially if we consider small spatial units.


Resumo Usando dados do Ministério da Saúde do Brasil para cinco causa de mortes, e num período de 17 anos, aplicamos modelos espaço-temporais Bayesianos em 644 municípios do estado de São Paulo, utilizando um modelo logístico binário que especifica se o óbito foi (ou não) de uma determinada causa. Modelamos os efeitos temporais da mortalidade com B-splines, e os componentes espaciais foram estimados através de campos aleatórios de Gaussiano e Markov. Simulamos a inferência estatística com Monte Carlo via cadeias de Markov. Os resultados demonstraram tendência consistente de queda nas mortes por doenças infecciosas e causas externas, enquanto mortes por neoplasias e doenças respiratórias aumentaram no tempo. Cardiovascular foi a única causa de morte constante no tempo. As causas de morte apresentaram variações espaciais e temporais entre os municípios, com consideráveis mudanças em anos sucessivos. A mortalidade por doenças infecciosas se concentrou nos municípios do noroeste do estado em 2000, mas mudou para a parte sudeste em 2016, um desenvolvimento semelhante as causas externas de morte. Este estudo identificou áreas com maior e menor chances de morte entre diferentes causas, e pode ser útil no monitoramento de doenças, especialmente se considerarmos pequenas unidades espaciais.


Subject(s)
Humans , Cause of Death , Brazil/epidemiology , Bayes Theorem , Cities , Spatio-Temporal Analysis
8.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 500-509, 01-dic-2021. grap, map
Article in Spanish | LILACS | ID: biblio-1355278

ABSTRACT

Introducción: la diabetes mellitus (DM) y las enfermedades del corazón, entre las que se incluye la hipertensión arterial sistémica (HTA), se han posicionado entre las primeras causas de mortalidad en México, lo que plantea retos importantes para las diferentes instituciones de salud. Objetivo: analizar la tendencia espacio-temporal de DM e HTA con base en las detecciones realizadas en unidades de primero y segundo nivel del Instituto Mexicano del Seguro Social (IMSS), durante el periodo 2004-2019. Material y métodos: estudio ecológico en el que se calcularon las tasas de detección de ambos padecimientos por mil derechohabientes según año, trienio y representación. La tendencia espacio-temporal se analizó mediante estadística espacial utilizando Sistemas de Información Geográfica. Resultados: de 2004 a 2019 hubo 9 399 889 y 11 862 069 detecciones en promedio de DM e HTA, respectivamente. Referente al primer padecimiento, la tasa de deteccion osciló de 203.4 (2004) a 384.4 (2019) por mil derechohabientes, cuya tendencia aumentó en Tamaulipas. Mientras que la HTA disminuyó de 1140.2 (2004) a 352 (2019) detecciones por mil derechohabientes en Veracruz Sur y Tamaulipas, respectivamente. Conclusiones: la tendencia espacio-temporal observada puede contribuir a organizar y orientar, según su representación y nivel de atención, los programas institucionales, protocolos de atención, guías de práctica clínica y demás instrumentos de políticia pública disponibles en el IMSS para mejorar la detección oportuna, atención, control y acceso a medicamentos para DM e HTA.


Background: Diabetes Mellitus (DM) and heart diseases, which include Systemic Arterial Hypertension (SAH), have been positioned as the two main causes of mortality in Mexico, which represents important challenges for the different health institutions. Objective: To analyze the spatio-temporal trend of DM and SAH based on the detections made in first and and second level units of the Instituto Mexicano del Seguro Social, during the period 2004-2019. Material and methods: Ecological study in which detection rates of both diseases were calculated per 1,000 persons according to year, triennium and representation. The spatio-temporal trend was analyzed by spatial statistics using Geographic Information Systems. Results: During 2004-2019 therere were 9 399 889 and 11 862 069 detections on average of DM and SAH, respectively. Regarding DM, the detection rate ranged from 203.4 (2004) to 384.4 (2019) per 1000 persons, this trend increased in Tamaulipas. While SAH decreased from 1140.2 (2004) to 352 (2019) per 1000 persons in Veracruz Sur and Tamaulipas, respectively. Conclusions: The observed spatio-temporal trend can contribute to organizing and guiding, according to representation and level of care, institutional programs, integrated care protocols, clinical practice guidelines and other public policy instruments available at the Instituto Mexicano del Seguro Social to improve early detection, care, control and access to medications for DM and SAH.


Subject(s)
Humans , Male , Female , Clinical Protocols , Diabetes Mellitus , Health Services Accessibility , Health Services Research , Hypertension , Social Security , Epidemiology , Cause of Death , Geographic Information Systems , Mexico
9.
Rev. enferm. Inst. Mex. Seguro Soc ; 29(3): 136-134, 04-oct-2021. tab
Article in Spanish | LILACS, BDENF | ID: biblio-1357685

ABSTRACT

Introducción: en la actualidad, el cáncer gástrico sigue ocupando un lugar importante entre las causas de muerte a nivel mundial. Objetivo: determinar las características sociodemográficas, ambientales y clínicas de los pacientes con cáncer gástrico en el municipio de San Gil, Colombia. Metodología: estudio descriptivo transversal. La muestra estuvo conformada por 13 casos de personas con diagnóstico clínico e histopatológico de cáncer gástrico del municipio de San Gil, Santander, residentes del área rural y urbana. El análisis estadístico fue realizado con el programa Statistical Product and Service Solutions, versión 24.0 Resultados: el género con mayor afectación fue el masculino con un 62%. La mediana de edad de los participantes fue de 51 años con una edad mínima de 36 años y una edad máxima de 87 años. En el 61.5% el nivel de escolaridad fue la educación primaria. En cuanto a los factores ambientales, se encontró que el 69.2% consumieron alimentos salados y condimentados. Conclusiones: se encontró que una gran proporción de los participantes fueron del género masculino y residentes del casco urbano. Entre las ocupaciones, las más frecuentes fueron amas de casa y conductores de transporte pesado. Los síntomas que presentaron los participantes en el momento del diagnóstico fueron: pérdida de peso, hematemesis, dolor epigástrico y sensación de plenitud abdominal


Introduction: At present, gastric cancer continues to occupy an important place among the causes of death worldwide. Objective: To determine the sociodemographic, environmental, and clinical characteristics of patients with gastric cancer in the municipality of San Gil, Colombia. Methods: Descriptive cross-sectional study. The sample consisted of 13 cases of people with clinical and histopathological diagnosis of gastric cancer from the municipality of San Gil, Santander, who were residents of rural and urban areas. Statistical analysis was carried out with the program Statistical Product and Service Solutions (SPSS), version 24.0. Results: Men were the most affected, with 61.5%. The median age of the participants was 51 years with a minimum age of 36 years and a maximum of 87 years. In 61.5% the level of education was primary education. Regarding environmental factors, it was found that 69.2% consumed salty and spicy foods. Conclusions: It was found that a large proportion of the participants were male, urban residents. Concerning occupations, the most frequent were housewives and heavy truck drivers. Symptoms that participants presented at the time of diagnosis were weight loss, hematemesis, epigastric pain and fullness in upper abdomen.


Subject(s)
Humans , Male , Female , Stomach Neoplasms , Epidemiologic Factors , Cross-Sectional Studies , Public Health , Cause of Death , Colombia
10.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(5): 360-367, 01-oct-2021. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-1357926

ABSTRACT

Introducción: el cáncer de mama es la primera causa de muerte en mujeres. Se espera que al incrementar el conocimiento sobre el autoexamen mamario se incremente su práctica. Objetivo: determinar el nivel de conocimiento, actitudes y prácticas y su relación con respecto a la autoexploración de cáncer de mama en mujeres de más de 20 años. Material y métodos: estudio transversal mediante encuesta a una muestra de 503 mujeres mayores de 20 años. Se recabó información sociodemográfica y datos requeridos para evaluar conocimiento, prácticas y actitudes sobre el autoexamen. Para identificar las relaciones se probó un modelo de ecuaciones estructurales. Resultados: la capacidad predictiva del modelo para variables endógenas fue baja. El nivel de conocimiento del autoexamen es básico en 81.9%, el 74% refirieron actitudes desfavorables y solo el 39.8% practican el autoexamen. Conclusiones: el estudio muestra una persistencia de bajos niveles de conocimiento sobre la finalidad de la autoexploración, una actitud desfavorable para realizarla y una práctica incorrecta de la técnica.


Background: Breast cancer is the first cause of death in women. Increasing knowledge about breast self-examination is expected to increase its practice. Objective: To determine the level of knowledge, attitudes and practices regarding breast self-examination in women over 20 years of age. Material and methods: Cross-sectional study through a sample survey of 503 women over 20 years of age. Sociodemographic information and data required to evaluate knowledge, practices and attitudes about self-examination were collected. To identify the relationships, a structured equation model was tested. Results: The predictive capacity of the model for endogenous variables was low. The level of knowledge of the self-examination is basic in 81.9%, 74% reported unfavorable attitudes and only 39.8% practice the self-examination. Conclusions: The study shows persistence of low levels of knowledge about the purpose of self-examination, an unfavorable attitude to carry it out and an incorrect practice of the technique.


Subject(s)
Humans , Female , Breast Neoplasms , Public Health , Cross-Sectional Studies , Women's Health , Breast Self-Examination , Surveys and Questionnaires , Cause of Death , Methods , Mexico
11.
Rev. habanera cienc. méd ; 20(5): e3579, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1352078

ABSTRACT

Introducción: La morbimortalidad por enfermedad renal crónica (ERC) ha presentado en las dos últimas décadas un incremento desconcertante. En Cuba, aunque la mortalidad por esta causa ha tenido un comportamiento estable, la incidencia y la prevalencia se mantienen elevadas. Objetivo: Caracterizar los pacientes fallecidos con ERC según variables demográficas, causas de muerte y otras variables seleccionadas. Material y Métodos: Estudio descriptivo, transversal. El universo de estudio estuvo constituido por todos los fallecidos del país en el período, en cuyos certificados de defunción se incluyó entre una de las causas, la ERC. La información fue obtenida de las bases de datos de mortalidad de la Dirección Nacional de Registros Médicos y Estadísticos de Salud del MINSAP. Procesamiento de forma automatizada (SPSS versión 22.0). Fueron calculadas las frecuencias absolutas y relativas. Resultados: La frecuencia global de pacientes fallecidos se incrementó de forma mantenida y resultó mayor en la provincia La Habana (23,6 por ciento). La media de la edad fue de 70 años. Prevaleció el sexo masculino, el color de piel blanco y el grupo de edad de 80 años y más. Los porcentajes más altos según la causa básica de muerte correspondieron a enfermedad renal hipertensiva y Diabetes Mellitus. Conclusiones: Los fallecidos con ERC son mayormente hombres, de piel blanca, y con edades avanzadas. Las principales causas de muerte son la enfermedad hipertensiva y la Diabetes Mellitus(AU)


Introduction: Chronic kidney disease (CKD) has increased at an alarming rate worldwide over the last two decades. Although mortality due to CKD has registered stable behavior in Cuba, its prevalence and incidence are showing higher rates. Objective: To describe the main demographic features of deceased patients with CKD in Cuba, the causes of death and other variables during the period 2011-2016. Material and Methods: A descriptive cross-sectional study was conducted. The study universe included all deceased patients in Cuba during the period mentioned. CKD was listed on their death certificates as one of the causes of death. The information used was obtained from the mortality database available on the National Directorate of Medical Records and Health Statistics of the Cuban Ministry of Public Health. Data was processed using SPSS version 22.0. Absolute and relative frequencies were calculated. Results: The global frequency of deceased patients showed a steady increase. Havana was the city that presented the highest percentage (23,6 percent). Nonetheless, the rest of the cities showed an increased frequency rate. The median age was 70 years. The male gender prevailed over the female one as well as white ethnicity and the 80 years and over age group. Regarding the cause of death, the highest percentages corresponded to hypertensive kidney disease and Diabetes Mellitus. Conclusions: Most of the deceased patients with CKD are male, white and at advanced ages. The main causes of death are hypertensive disease and Diabetes Mellitus(AU)


Subject(s)
Humans , Aged , Indicators of Morbidity and Mortality , Cause of Death/trends , Renal Insufficiency, Chronic/mortality , Health Statistics , Epidemiology, Descriptive , Cross-Sectional Studies , Cuba , Diabetes Complications/mortality
12.
Ciênc. Saúde Colet ; 26(10): 4483-4496, out. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1345698

ABSTRACT

Resumo Em 2020, completamos 30 anos desde a publicação das Leis Orgânicas do Sistema Único de Saúde. Desde então, a mudança no perfil de morbimortalidade tem desafiado a gestão, para que o serviço de saúde consiga atender à grande heterogeneidade dos quase seis mil municípios. Para isso, é necessário monitorar os principais indicadores do país. O objetivo do presente estudo foi apresentar uma visão geral das tendências de mortalidade e morbidade no Brasil entre 1990 e 2019. Utilizamos os dados do Estudo de Carga Global de Doenças para descrever a morbimortalidade pelos grandes grupos (doenças infecciosas, doenças crônicas e causas externas), segundo sexo e grupos etários. Há redução da morbimortalidade no período, independente do grupo de causa ou faixa etária, com variada diferença entre sexo de acordo com o grupo de causas. A contribuição das doenças crônicas é crescente com a progressão da idade, com diferença substancial segundo o sexo. As curvas de mortalidade e de anos perdidos por incapacidade possuem padrão típico, com destaque ao padrão diferenciado para curvas de homens por causas externas, com marcada sobremortalidade em idades jovens. A tendência ratifica o declínio dos indicadores de forma linear no período.


Abstract In 2020, the 30th anniversary of the publication of the Organic Laws of the Unified Health System was celebrated. Since then, the change in the profile of morbidity and mortality has been a challenge to management to ensure that the health services can attend the significant heterogeneity of approximately 6,000 municipalities. To achieve this, it is necessary to monitor the leading indicators of the country. The scope of this study was to present an overview of trends in mortality and morbidity in Brazil between 1990 and 2019. Data from the Study on the Global Burden of Disease was used to describe morbidity and mortality by major groupings (infectious diseases, chronic diseases, and external causes), according to gender and age groups. There was a reduction in morbidity and mortality in the period, irrespective of the cause or age group, albeit with a varied difference between the sexes depending on the cause. The contribution of chronic diseases increases with age, with a marked difference according to gender. The curves for mortality and years lost due to disability have a typical profile, with a different pattern of curves for men due to external causes, with marked excess mortality at young ages. The trend confirms the decline of indicators in a linear manner over the period.


Subject(s)
Humans , Male , Communicable Diseases , Anniversaries and Special Events , Brazil/epidemiology , Morbidity , Mortality , Cause of Death
13.
Ciênc. Saúde Colet ; 26(9): 4069-4086, set. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1339610

ABSTRACT

Resumo Trata-se de análise de indicadores de mortalidade de brasileiros com idades entre 10 e 24 anos. Foram analisados os dados do Global Burden of Disease (GBD) 2019, utilizando números absolutos, proporção de óbitos e taxas de mortalidade específicas entre 1990 e 2019, segundo faixa etária (10 a 14, 15 a 19 e 20 a 24 anos), sexo e causas de morte para Brasil, regiões e estados brasileiros. Houve redução de 11,8% nas taxas de mortalidade de indivíduos com idades entre 10 e 24 anos no período investigado. Em 2019, ocorreram 13.459 mortes entre mulheres, correspondendo à redução de 30,8% no período. Entre homens ocorreram 39.362 óbitos, redução de apenas 6,2%. Houve aumento das taxas de mortalidade no Norte e Nordeste e redução em estados do Sudeste e Sul. Em 2019, entre mulheres a primeira causa de morte foram lesões por transporte, seguidas por violência interpessoal, mortes maternas e suicídio. Para os homens, a violência interpessoal foi a primeira causa de morte, em especial no Nordeste, seguida das lesões por transporte, do suicídio e dos afogamentos. Execuções policiais passaram do 77º para o 6º lugar. Este estudo revelou desigualdades na mortalidade de adolescentes e adultos jovens segundo sexo, causas de óbito, regiões e estados brasileiros.


Abstract Mortality indicators for Brazilians aged between 10 and 24 years old were analyzed. Data were obtained from the Global Burden of Disease (GBD) 2019 Study, and absolute numbers, proportion of deaths and specific mortality rates from 1990 to 2019 were analyzed, according to age group (10 to 14, 15 to 19 and 20 to 24 years), sex and causes of death for Brazil, regions and Brazilian states. There was a reduction of 11.8% in the mortality rates of individuals aged between 10 and 24 years in the investigated period. In 2019, there were 13,459 deaths among women, corresponding to a reduction of 30.8% in the period. Among men there were 39,362 deaths, a reduction of only 6.2%. There was an increase in mortality rates in the North and Northeast and a reduction in the Southeast and South states. In 2019, the leading cause of death among women was traffic injuries, followed by interpersonal violence, maternal deaths and suicide. For men, interpersonal violence was the leading cause of death, especially in the Northeast, followed by traffic injuries, suicide and drowning. Police executions moved from 77th to 6th place. This study revealed inequalities in the mortality of adolescents and young adults according to sex, causes of death, regions and Brazilian states.


Subject(s)
Humans , Suicide , Maternal Death , Violence , Brazil/epidemiology , Mortality , Cause of Death , Global Burden of Disease
14.
Rev. cuba. pediatr ; 93(3): e1117, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347534

ABSTRACT

Introducción: La miocardiopatía hipertrófica es una enfermedad derivada de una alteración genética autosómica dominante que produce un aumento de la masa del ventrículo izquierdo, obstructiva o no. Es la principal causa de muerte súbita en adultos jóvenes. Objetivo: Mostrar la prevalencia de la miocardiopatía hipertrófica en la práctica del Cardiocentro Pediátrico "William Soler" y sus formas de presentación. Métodos: Estudio observacional longitudinal retrospectivo de serie de casos. Se resumieron variables demográficas y clínicas en los ingresos realizados durante 10 años de los pacientes con diagnóstico de miocardiopatía hipertrófica y se analizaron según correspondieran con pruebas para variables cualitativas y cuantitativas. Resultados: Se identificaron 21 pacientes; 12 con características obstructivas y 9 no obstructivas. No hubo predominio de sexo. La media de edad de diagnóstico y de debut clínico de los pacientes con enfermedad obstructiva fue significativamente menor que las edades de los pacientes sin obstrucción del tracto de salida izquierdo. El diagnóstico fue posible en más de 50 por ciento de los casos por sospecha por soplo o por pesquisa. El tratamiento quirúrgico permitió la reducción significativa del gradiente en el tracto de salida izquierdo. El propranolol fue el betabloqueador más usado acorde a consensos internacionales. No hubo fallecidos en la serie estudiada. Conclusiones: La miocardiopatía hipertrófica tiene una baja prevalencia en la práctica cardiopediátrica. Los síntomas tempranos se corresponden con la variedad obstructiva. Su diagnóstico temprano y el tratamiento específico, permite garantizar mejor calidad y expectativa de vida a los portadores de esta afección(AU)


Introduction: Hypertrophic cardiomyopathy is a disease derived from autosomal dominant genetic alteration that causes an increase in the mass of the left ventricle, and can be obstructive or not. It is the leading cause of sudden death in young adults. Objective: Show the prevalence of hypertrophic cardiomyopathy and its forms of presentation in the practice of the "William Soler" Pediatric Cardiocenter. Methods: Retrospective, observational, longitudinal study of a case series. Demographic and clinical variables were summarized in the admissions made during 10 years of patients diagnosed with hypertrophic cardiomyopathy whom were analyzed as appropriate with qualitative and quantitative variable testing. Results: 21 patients were identified; 12 with obstructive characteristics and 9 with non-obstructive ones. There was no predominance of sex. The average diagnostic age and clinical onset of patients with obstructive disease was significantly lower than the ages of patients without obstruction of the left outflow tract. Diagnosis was possible in more than 50 percent of cases by suspicion due to a murmur or by investigation. Surgical treatment allowed a significant reduction in the gradient of the left outflow tract. Propranolol was the most widely used beta-blocker according to international consensus. There were no deaths in the series studied. Conclusions: Hypertrophic cardiomyopathy has a low prevalence in cardiopediatric practice. Early symptoms correspond to the obstructive variety. Early diagnosis and specific treatment ensure better quality and life expectancy for carriers of this condition(AU)


Subject(s)
Humans , Young Adult , Propranolol/therapeutic use , Cardiomyopathy, Hypertrophic/epidemiology , Cause of Death/trends , Early Diagnosis , Patient Care/methods , Retrospective Studies , Life Expectancy , Longitudinal Studies , Observational Studies as Topic
15.
Rev. bras. ginecol. obstet ; 43(9): 662-668, Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1351777

ABSTRACT

Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.


Resumo Objetivo Determinar o perfil dos óbitos maternos ocorridos no período de 2000 a 2019 no Hospital de Clínicas de Porto Alegre (HCPA) e comparar com os óbitos maternos entre 1980 e 1999 na mesma instituição. Métodos Estudo retrospectivo que analisou 2.400 prontuários de mulheres entre 10 e 49 anos que morreram entre 2000 e 2019. O presente estudo foi aprovado pelo Comitê de Ética (CAAE 78021417600005327). Resultados Após revisão de 2.481 prontuários de mulheres que morreram em idade reprodutiva, 43 mortes ocorreram durante a gravidez ou no período pós-parto. Destas, 28 foram considerados óbitos maternos. A taxa de mortalidade materna foi de 37.6 por 100.000 nascidos vivos. Em relação às causas, 16 óbitos (57.1%) estiveram diretamente associados à gravidez, 10 (35.1%) estiveram indiretamente associados e 2 (7.1%) não estiveram relacionados. A principal causa de morte foi hipertensão na gravidez (31.2%) seguida de esteatose hepática aguda da gravidez (25%). No estudo anterior, publicado em 2003 na mesma instituição4, a taxa de mortalidade foi de 129 por 100.000 nascidos vivos, e a maioria dos óbitos estava relacionada a causas obstétricas diretas (62%). As principais causas de óbito neste período foram por complicações hipertensivas (17.2%), seguidas de infecção pós-cesárea (16%). Conclusão Em comparação com os dados anteriores à década de 2000, houve uma redução importante das mortes maternas por causas infecciosas.


Subject(s)
Humans , Female , Pregnancy , Child , Adolescent , Adult , Young Adult , Pregnancy Complications/epidemiology , Maternal Death/etiology , Maternal Mortality , Retrospective Studies , Cause of Death , Postpartum Period , Live Birth , Middle Aged
16.
Rev. cuba. med. mil ; 50(3): e1284, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1357315

ABSTRACT

Introducción: El síndrome respiratorio agudo grave (por la COVID-19) es en la actualidad la primera causa de muerte en el Perú, por lo que se requiere de fármacos eficaces y seguros para mitigar la enfermedad. Se realizó una búsqueda bibliográfica en SciELO y PubMed/ Medline; se seleccionaron 37 de 58 artículos sobre el tema. Objetivos: Revisar e integrar la información sobre las interacciones farmacocinéticas de la azitromicina que se prescriben en el tratamiento ambulatorio de la COVID-19 en el Perú, y evaluar su implicación clínica. Desarrollo: La azitromicina es usada en la COVID-19, por su actividad antiinflamatoria, al inhibir a las interleucinas (IL1, 6, 8 y TNF-α), y a las moléculas de adhesión intracelular 1 (ICAM1); y por inducir la producción de interferón tipo I (IFN-α, IFN-β) y III (IFN-λ) en células de pacientes con enfermedad pulmonar obstructiva crónica. Los estudios de tres brazos, aleatorizado y abierto, indican que la azitromicina no genera cambios en los parámetros farmacocinéticos de la ivermectina, sildenafilo, rupatadina y desloratadina; los estudios de un solo centro, abierto, sin ayuno y de dos períodos, evidencian que la azitromicina influye en los parámetros farmacocinéticos de venetoclax y de los psicotrópicos. Conclusiones: Basado en la evidencia de los estudios clínicos revisados e integrados, se concluye que estas son limitadas y de poca relevancia clínica, sin embargo, se propone usar el antibiótico bajo el criterio científico del médico, para evitar las interacciones farmacocinéticas y las reacciones adversas de los fármacos(AU)


Introduction: The severe acute respiratory syndrome (due to COVID-19) is currently the leading cause of death in Peru, so effective and safe drugs are required to mitigate the disease. A bibliographic search was carried out in SciELO and PubMed/Medline; 37 of 58 articles on the topic were selected. Objectives: Review and integrate the information on the pharmacokinetic interactions of azithromycin that are prescribed in the outpatient treatment of COVID-19 in Peru, and evaluate their clinical implication. Development: Azithromycin is used in COVID-19, due to its anti-inflammatory activity, by inhibiting interleukins (IL1, 6, 8 and TNF-α), and intracellular adhesion molecules 1 (ICAM1); and by inducing the production of type I interferon (IFN-α, IFN-β) and III (IFN-λ) in cells of patients with chronic obstructive pulmonary disease. The three-arm, randomized and open-label studies indicate that azithromycin does not cause changes in the pharmacokinetic parameters of ivermectin, sildenafil, rupatadine, and desloratadine; single-center, open-label, non-fasting, and two-period studies show that azithromycin influences the pharmacokinetic parameters of venetoclax and psychotropics. Conclusions: Based on the evidence from the reviewed and integrated clinical studies, it is concluded that these are limited and of little clinical relevance, however, it is proposed to use the antibiotic under the scientific criteria of the doctor, to avoid pharmacokinetic interactions and adverse reactions of drugs(AU)


Subject(s)
Humans , Azithromycin/therapeutic use , Pulmonary Disease, Chronic Obstructive/complications , Severe Acute Respiratory Syndrome/prevention & control , COVID-19/drug therapy , Anti-Bacterial Agents , Cause of Death
17.
Rev. ecuat. pediatr ; 22(2): 1-8, 31 de agosto del 2021.
Article in Spanish | LILACS | ID: biblio-1284503

ABSTRACT

Introducción: El objetivo del presente estudio fue realizar un estudio de pruebas diagnósticas entre la escala PRISM III vs la escala PELOD para predecir mortalidad en pacientes que ingresan a la Unidad de Cuidados Intensivos (UCIP) del Hospital Pediátrico Baca Ortiz en el periodo de junio-diciembre 2019. Métodos: En el presente estudio observacional, retrospectivo, se registró la mortalidad y las variables que conforman cada una de las escalas predictivas. Se aplicó estadística descriptiva e inferencial, cálculo del área bajo la curva de ROC. La calibración, se calculó usando el chi2 de Hosmer Lemeshow y la tasa de mortalidad estandarizada mediante le paquete estadístico STATA v16. Resultados: Ingresaron al estudio 150 pacientes. 99 pacientes (66%) fueron hombres, tuvieron una media de edad de 3 años (P25 a P75) de 1 mes a 14 años. La patología de ingreso más frecuente fue la enfermedad posquirúrgica en 43 pacientes (28.6%), y la insuficiencia respiratoria en 31 pacientes (21.6%). La mortalidad fue 12.7%, con una media de estancia hospitalaria de 5 días (1 a 60). La escala de PRIMS III con área bajo la curva de 0.80 (IC 95% de 0.70 a 0.90), sensibilidad 79 % y especificidad 63 % con un puntaje PRISM III de 13 puntos. La escala de PELOD con área bajo la curva de 0.7 (IC 95% de 0.5 a 0.80), sensibilidad de 79 % y especificidad de 60 % con un puntaje PELOD de 21 puntos. Conclusiones: La escala de PRISM III predice la mortalidad mejor que la escala PELOD en este grupo de pacientes pediátricos en las primeras 24 horas.


Introduction: The aim of the present study was a study of diagnostic tests between the PRISM III scale vs the PELOD scale to predict mortality in patients admitted to the Intensive Care Unit (PICU) of the Baca Ortiz Pediatric Hospital in the period of June-December 2019. Methods: In this retrospective, observational study, mortality and the variables that make up each of the predictive scales were recorded. Descriptive and inferential statistics were ap-plied, calculation of the area under the ROC curve. The calibration was calculated using the Hosmer Lemeshow chi2 and the mortality rate standardized using the statistical package STATA v16. Results: 150 patients entered the study. 99 patients (66%) were men, had a mean age of 3 years (P25 to P75) from 1 month to 14 years. The most frequent admission pathology was postoperative disease in 43 patients (28.6%), and respiratory failure in 31 patients (21.6%). Mortality was 12.7%, with a mean hospital stay of 5 days (1 to 60). The PRIMS III scale with area under the curve of 0.80 (95% CI from 0.70 to 0.90), sensitivity 79% and specificity 63% with a PRISM III score of 13 points. The PELOD scale with area under the curve of 0.7 (95% CI from 0.5 to 0.80), sensitivity of 79% and specificity of 60% with a PELOD score of 21 points. Conclusions: the PRISM III scale predicts mortality better than the PELOD scale in this group of pediatric patients in the first 24 hours.


introdução: O objetivo do presente estudo foi realizar um estudo de testes diagnósticos entre a escala PRISM III vs a escala PELOD para predizer mortalidade em pacientes internados na Unidade de Terapia Intensiva (UTIP) do Hospital Pediátrico Baca Ortiz no período de junho a dezembro 2019. Métodos: Nesse estudo retrospectivo e observacional, foram registradas a mortalidade e as variáveis ​​que compõem cada uma das escalas preditivas. Foi aplicada estatística descritiva e inferencial, cálculo da área sob a curva ROC. A calibração foi calculada usando o Hosmer Lemeshow chi2 e a taxa de mortalidade padronizada usando o pacote estatístico STATA v16. Resultados: 150 pacientes entraram no estudo. 99 pacientes (66%) eram homens, com idade média de 3 anos (P25 a P75) de 1 mês a 14 anos. A patologia de admissão mais frequente foi doença pós-operatória em 43 pacientes (28,6%) e insuficiência respiratória em 31 pacientes (21,6%). A mortalidade foi de 12,7%, com tempo médio de internação de 5 dias (1 a 60). Escala PRIMS III com área sob a curva de 0,80 (IC 95% de 0,70 a 0,90), sensibilidade 79% e especificidade 63% com escore PRISM III de 13 pontos. A escala PELOD com área sob a curva de 0,7 (IC 95% de 0,5 a 0,80), sensibilidade de 79% e especificidade de 60% com escore PELOD de 21 pontos. Conclusões: A escala PRISM III prediz mortalidade melhor do que a escala PELOD neste grupo de pacientes pediátricos nas primeiras 24 horas.


Subject(s)
Humans , Child, Preschool , Child , Prognosis , Cause of Death , Critical Care , Child Mortality , Child
18.
Rev. ecuat. pediatr ; 22(2): 1-7, 31 de agosto del 2021.
Article in Spanish | LILACS | ID: biblio-1284504

ABSTRACT

Introducción: El trasplante renal en pediatría constituye el tratamiento de elección para la enfermedad renal crónica terminal (ERCT) con ventajas ampliamente comprobadas sobre los tratamientos dialíticos. El objetivo del presente estudio fue determinar los factores de riesgo relacionados con la sobrevida global y del injerto en un grupo de pacientes pediátricos con trasplante renal atendidos en un hospital de referencia nacional con observación de factores asociados al hiperparatiroidismo secundario. Métodos: En el presente estudio observacional, retrospectivo, se realizó en el Hospital Metropolitano de Quito - Ecuador desde el primero de enero del 2010 al treinta de junio del 2013. Se registró la mortalidad y la supervivencia del injerto, presencia de hiperparatiroidismo pre trasplante, variables demográficas, clínicas (compatibilidad). Se usa el método de Kaplan Meier para el análisis y se presentan riesgos relativos. Resultados: Ingresaron al estudio 33 pacientes, de edad 12±3.8 años. Donante cadavérico 21 casos (63.6%), donante vivo 12 pacientes 36.4%. 18 hombres (54.5%). La etiología de la ERCT fue indeterminada en 63.6%; nefropatías en 24.2% y uropatías en 12.1%. Rechazo agudo 1 paciente, rechazo tardío 10 pacientes. Las variables con significancia en la sobrevida del injerto fueron: hiperparatiroidismo RR= 6.0 (IC95%= 1.078-45.902) P=0.032. No recibir inmunosupresión completa RR=14.5 (IC95%= 3.807-55.225) P<0.001. La necesidad de diálisis pos trasplante la primera semana y biopsia temprana tuvieron RR=15 (IC95%= 3.9-57.2). Conclusiones: Este estudio demostró que el hiperparatiroidismo secundario es un factor de riesgo negativo para la sobrevida del injerto renal en pacientes pediátricos trasplantados


Introduction: Kidney transplantation in pediatrics is the treatment of choice for end-stage renal disease (ESRD) with widely proven advantages over dialysis treatments. The aim of the present study was to determine the risk factors related to global and graft survival in a group of pediatric kidney transplant patients treated at a national referral hospital with observation of factors associated with secondary hyperparathyroidism. Methods: In the present observational, retrospective study, it was carried out in the Hospital Metropolitano de Quito - Ecuador from January 1, 2010 to June 30, 2013. Mortality and graft survival, presence of hyperparathyroidism pre transplantation, demographic and clinical variables (compatibility). The Kaplan Meier method is used for analysis and relative risks are presented. Results: 33 patients, aged 12 ± 3.8 years, entered the study. Cadaveric donor 21 cases (63.6%), living donor 12 patients 36.4%. 18 men (54.5%). The etiology of ESRD was indeterminate in 63.6%; nephropathies in 24.2% and uropathies in 12.1%. Acute rejection 1 patient, late rejection 10 patients. Variables with significance in graft survival were: hyperparathyroidism RR = 6.0 (95% CI = 1.078-45.902) P = 0.032. Not receiving complete immunosuppression RR = 14.5 (95% CI = 3.807-55.225) P <0.001. The need for post-transplant dialysis the first week and early biopsy had RR = 15 (95% CI = 3.9-57.2). Conclusions: This study demonstrated that secondary hyperparathyroidism is a negative risk factor for kidney graft survival in pediatric transplant patients.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Parathyroid Diseases , Prognosis , Kidney Transplantation , Child , Cause of Death , Critical Care
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