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1.
Goiânia; SES-GO; 12 ago 2020. 1-18 p. ilus, tab, graf, mapas.(Boletim Epidemiológico Covid-19, 19).
Monography in Portuguese | LILACS (Americas), ColecionaSUS, CONASS, SES-GO | ID: biblio-1117152

ABSTRACT

A Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica, apresentam neste boletim a distribuição de casos confirmados, óbitos e taxa de crescimento de COVID-19 no mundo, no Brasil, no período compreendido entre 31 de dezembro de 2019 a 08 de agosto de 2020. Quanto ao Estado de Goiás apresenta a distribuição dos casos notificados de COVID-19 segundo classificação e critério de confirmação, no período de 04 de fevereiro a 08 de agosto de 2020, a distribuição dos casos confirmados por data de início de sintomas, do acumulado de casos confirmados, dos casos confirmados e média móvel segundo a data de início de sintomas, do acumulado de óbitos, dos óbitos confirmados e média móvel segundo a data de ocorrência do óbito, da distribuição proporcional dos casos confirmados por municípios integrantes da Região metropolitana, do interior e capital, dos casos confirmados e taxa de incidência por município de residência, de casos confirmados por Semana Epidemiológica nas Macrorregiões, distribuição de casos confirmados de COVID-19 por Semana Epidemiológica segundo a região de saúde, número de casos confirmados segundo gênero, faixa etária e taxa de incidência, percentual de casos confirmados segundo raça/cor, casos confirmados segundo evolução, percentual de casos confirmados segundo ocupação, distribuição por município de residência dos óbitos confirmados segundo taxa de letalidade, percentual dos óbitos confirmados por sexo, óbitos confirmados e letalidade segundo faixa etária, casos confirmados que necessitaram de hospitalização segundo a evolução, perfil de gestantes com COVID-19, distribuição dos casos confirmados em gestantes segundo a necessidade de hospitalização, dos casos confirmados em gestantes segundo o local de internação, dos casos confirmados em gestantes segundo evolução, casos confirmados que necessitaram de hospitalização segundo o tempo médio de internação, percentual de casos confirmados por critério laboratorial segundo o método diagnóstico e positividade dos testes RT-PCR liberados pelo LACEN-GO segundo identificação de SARS-CoV-2


The Goiás State Department of Health, through the Health Surveillance Superintendence and Epidemiological Surveillance Management, presents in this bulletin the distribution of confirmed cases, deaths and growth rate of COVID-19 in the world, in Brazil, in the period between 31 from December 2019 to August 8, 2020. As for the State of Goiás, it presents the distribution of notified cases of COVID-19 according to classification and confirmation criteria, in the period from February 4 to August 8, 2020, the distribution of cases confirmed by date of onset of symptoms, cumulative number of confirmed cases, confirmed cases and moving average according to date of symptom onset, accumulated number of deaths, confirmed deaths and moving average according to date of occurrence of death, proportional distribution of confirmed cases by municipalities in the metropolitan region, inland and capital, confirmed cases and incidence rate by municipality of residence, d and confirmed cases by Epidemiological Week in Macroregions, distribution of confirmed cases of COVID-19 by Epidemiological Week according to health region, number of confirmed cases according to gender, age group and incidence rate, percentage of confirmed cases according to race / color, cases confirmed according to evolution, percentage of confirmed cases according to occupation, distribution by municipality of residence of deaths confirmed according to lethality rate, percentage of deaths confirmed by sex, confirmed deaths and lethality according to age group, confirmed cases that required hospitalization according to evolution, profile of pregnant women with COVID-19, distribution of confirmed cases in pregnant women according to the need for hospitalization, confirmed cases in pregnant women according to the place of hospitalization, confirmed cases in pregnant women according to the evolution, confirmed cases that required hospitalization according to the average length of hospitalization , percentage of trusted cases according to laboratory criteria according to the diagnostic method and positivity of the RT-PCR tests released by LACEN-GO according to the identification of SARS-CoV-2


Subject(s)
Humans , Male , Female , Pregnancy , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Brazil/epidemiology , Incidence , Coronavirus Infections/epidemiology , Public Health Surveillance , Epidemiological Monitoring , Health Surveillance , Mortality , Disease Notification , Clinical Laboratory Techniques , Pregnant Women , Continental Population Groups , Diagnosis , Hospitalization , Age Groups
2.
Enferm. foco (Brasília) ; 11(2): 139-145, jul. 2020. graf, tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1104395

ABSTRACT

Objetivos: identificar e analisar os principais desfechos secundários dos pacientes com insuficiência cardíaca, no período de 2009 a 2019, em Juiz de Fora, região da zona mata mineira. Metodologia: estudo epidemiológico a partir de dados coletados de julho a agosto de 2019 no site do Departamento de Informática do Sistema Único de Saúde (DATASUS), de domínio público no Brasil. Foram selecionados como principais desfechos secundários: taxa de hospitalização, mortalidade e custo econômico associado ao tratamento da insuficiência cardíaca. Resultados: no período houve 16.338 internações, 1.280 óbitos e custos com despesas hospitalares que ultrapassaram os 22 milhões de reais. Conclusão: os dados confirmam o impacto da insuficiência cardíaca como uma doença crônica de alta taxa de internação hospitalar, mortalidade e de elevado custo. (AU)


Objectives: To identify and analyze the main secondary outcomes of heart failure patients from 2009 to 2019 in Juiz de Fora, a Brazilian city of Minas Gerais. Methodology: Epidemiological study from data collected from July to August 2019 on the website of the Department of Informatics of the Unified Health System (DATASUS), in the public domain in Brazil. The main secondary outcomes were selected: hospitalization rate, mortality and economic cost associated with the treatment of heart failure. Results: In the period there were 16,338 hospitalizations, 1,280 deaths and costs with hospital expenses that exceeded 22 million reais. Conclusion: The data confirm the impact of heart failure as a chronic disease with high hospitalization rate, mortality and high cost. (AU)


Objetivos: Identificar y analizar los principales desfechos secundários dos pacientes con insuficiencia cardíaca en el período de 2009 a 2019 en Juiz de Fora, ciudad brasileña de la región de la zona minera. Metodología: Estudio epidemiológico basado en datos colectados de julio a agosto de 2019 en el sitio del Departamento de Informática del Sistema Único de Salud (DATASUS), del dominio público en Brasil. Se seleccionaron los principales resultados secundarios: tasa de hospitalización, mortalidad y costo económico asociado con el tratamiento de la insuficiencia cardíaca. Resultados: En el período hubo 16.338 hospitalizaciones, 1.280 muertes y costos con gastos hospitalarios que superaron los 22 millones de reales. Conclusión: Los datos confirman el impacto de la insuficiencia cardíaca como una enfermedad crónica con una alta tasa de hospitalización, mortalidad y alto costo. (AU)


Subject(s)
Epidemiology , Brazil , Mortality , Heart Failure , Hospitalization
3.
Enferm. foco (Brasília) ; 11(2): 182-190, jul. 2020. graf, tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1116098

ABSTRACT

Introdução: A interação medicamentosa (IM) é caracterizada pela alteração de um medicamento decorrente da administração concomitante ou anterior de outro(s), gerando efeito sinérgico ou antagônico. Objetivo: Investigar na literatura científica as repercussões clínicas mais frequentes derivadas das interações medicamentosas, no cenário da terapia intensiva Método: Revisão integrativa, realizada em sete bases de dados. Os critérios de elegibilidade foram: estudos observacionais, descritivos, analíticos e/ou relato de caso; que envolvam seres humanos no âmbito da prática clínica. Artigos duplicados foram excluídos. Resultados: Foram selecionados 17 artigos, onde apontou-se a propensão de sangramentos e hematomas originados da interação entre Varfarina e Ácido Valpróico como mais evidente, seguido de síndromes associadas, como a síndrome do QT longo e a serotoninérgica. Discussão: Conhecer as possíveis repercussões clínicas torna-se importante para prática da equipe multidisciplinar, especialmente da enfermagem, principalmente pela necessidade de monitoramento terapêutico após a administração medicamentosa. Conclusão: Na ocorrência de uma interação medicamentosa, conhecer as repercussões clínicas, pode favorecer tomadas de decisões rápidas e assertivas, minimizando potenciais complicações associadas a segurança. (AU)


Introduction: Drug interaction is characterized by the alteration of one drug due to the concomitant or previous administration of another, which may cause a synergistic or antagonistic effect. Objective: To investigate in the scientific literature the most frequent clinical repercussions derived from drug interactions in the intensive care setting. Method: Integrative review, performed in seven databases. Eligibility criteria were: observational, descriptive, analytical and / or case report studies; involving human beings in the context of clinical practice. Duplicate articles have been deleted. Results: Seventeen articles were selected, which indicated the propensity of bleeding and bruising arising from the interaction between Warfarin and Valproic Acid as more evident, followed by associated syndromes, such as long QT syndrome and serotonergic syndrome. Discussion: Knowing the possible clinical repercussions becomes important for the multidisciplinary team practice, especially in nursing, especially due to the need for therapeutic monitoring after drug administration. Conclusion: In the event of a drug interaction, knowing the clinical repercussions may favor quick and assertive decision making minimizing potential complications associated with safety. (AU)


Introducción: la interacción farmacológica se caracteriza por la alteración de un fármaco debido a la administración concomitante o previa de otro, lo que puede causar un efecto sinérgico o antagonista. Objetivo: investigar en la literatura científica las repercusiones clínicas más frecuentes derivadas de las interacciones farmacológicas en el ámbito de cuidados intensivos Método: revisión integradora, realizada en siete bases de datos. Los criterios de elegibilidad fueron: estudios observacionales, descriptivos, analíticos y / o de informes de casos; involucrando seres humanos en el contexto de la práctica clínica. Se han eliminado artículos duplicados. Resultados: Se seleccionaron diecisiete artículos, que indicaban la propensión a sangrado y hematomas derivados de la interacción entre warfarina y ácido valproico como más evidentes, seguidos de síndromes asociados, como el síndrome de QT largo y el síndrome serotoninérgico. Discusión: Conocer las posibles repercusiones clínicas se vuelve importante para la práctica del equipo multidisciplinario, especialmente en enfermería, especialmente debido a la necesidad de monitoreo terapéutico después de la administración del medicamento. Conclusión: en el caso de una interacción farmacológica, conocer las repercusiones clínicas puede favorecer una toma de decisiones rápida y firme, minimizando las posibles complicaciones asociadas con la seguridad. (AU)


Subject(s)
Drug Interactions , Signs and Symptoms , Critical Care , Hospitalization
4.
5.
ABCS health sci ; 45: [1-5], 02 jun 2020. tab
Article in English | LILACS (Americas) | ID: biblio-1097538

ABSTRACT

INTRODUCTION: The current context of multiprofessional approach in health is based on quality of care and patient safety, with the key contribution of the dentist in the hospital team to improve the health of hospitalized patients. OBJECTIVE: To characterize the systemic and buccal profile of patients treated in a medical clinic of a University Hospital from the Brazilian Public Health System, aiming to provide information for guiding dental care in the multidisciplinary attendance in the hospital setting. METHODS: Retrospective observational study carried out on 104 clinical records with data collection about general characteristics, systemic alterations, habits, oral situation and dental treatments of hospitalized patients attended by the dentist. RESULTS: There was a high frequency of hypertensive patients (36.5%) and with cardiac problems (33.6%). A significant association between diabetes (60%) and hypertension (50%) in the age group from 60 to 75 years of age was observed. For most patients, the frequency of oral hygiene was less than three times a day (54.3%), without flossing (85.7%). Biofilm (73.3%), dental calculus (70.5%), prosthesis use (25.7%), with poor hygiene (14.3%) and prosthetic stomatitis (8.6%) were recorded. Among the treatments performed by dentist, basic periodontal therapy (71.4%) and exodontia (39%) were noteworthy. CONCLUSION: The high frequency of biofilm presence, dental calculus, prosthesis with poor hygiene and basic periodontal therapy performed during the hospitalization denote the need for dental care with preventive activities.


INTRODUÇÃO: O contexto atual de abordagem multiprofissional em saúde fundamenta-se na qualidade do atendimento e segurança ao paciente, com contribuição importante do cirurgião-dentista na equipe hospitalar para melhoria de saúde dos hospitalizados. OBJETIVO: Caracterizar o perfil sistêmico e bucal de pacientes atendidos em clínica médica de um Hospital Universitário do Sistema de Saúde Pública do Brasil, visando fornecer subsídios no direcionamento da assistência odontológica ao atendimento multidisciplinar em âmbito hospitalar. MÉTODOS: Foi realizado estudo observacional retrospectivo em 104 fichas clínicas com coleta de dados sobre características gerais, alterações sistêmicas, hábitos, situação bucal e tratamentos odontológicos de pacientes internados, atendidos pelo odontólogo. RESULTADOS: Verificou-se alta frequência de pacientes hipertensos (36,5%) e com problemas cardíacos (33,6%). Observou-se associação significativa de diabetes (60%) e hipertensão (50%) na faixa etária de 60 a 75 anos de idade. Para a maioria dos pacientes, a higiene bucal foi realizada menos que três vezes ao dia (54,3%), sem uso de fio dental (85,7%). Biofilme (73,3%), cálculo dental (70,5%), uso de próteses (25,7%), com higiene deficiente (14,3%), e estomatite protética (8,6%) foram registradas. Dentre os tratamentos realizados, destacam-se a terapia básica periodontal (71,4%) e exodontias (39%). CONCLUSÃO: A alta frequência de presença de biofilme, cálculo dental, próteses com higiene deficiente e a terapia básica periodontal executada durante o período de internação denotam a necessidade de atuação odontológica com atividades preventivas.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Health Profile , Oral Health , Comprehensive Dental Care , Hospitalization , Hospitals, University
6.
Brasília; IPEA; 20200500. 20 p. (Nota Técnica / IPEA. Diset, 65).
Monography in Portuguese | LILACS (Americas), ECOS | ID: biblio-1102191

ABSTRACT

Esta nota técnica tem o objetivo de analisar, de modo exploratório, algumas vantagens e desvantagens da eventual adoção de uma fila única, conforme vem sendo proposto, para organizar as internações, inclusive em unidades de terapia intesiva (UTIs), em todos os hospitais públicos e privados brasileiros, no contexto da atual pandemia do novo coronavírus (Sars-COV-2), causador da Covid-19. A análise utiliza elementos teóricos, e de resultados práticos, observados em economia da saúde e, de modo complementar, em teoria das filas (Queueing Theory). Essa análise se justifica em função da gravidade da situação atual e da possibilidade de que a fila única seja adotada na presente pandemia, ou que venha a ser novamente objeto de debate, em eventuais futuras pandemias, ou em epidemias que ocorram no país.


Subject(s)
Systems Theory , Beds , Unified Health System , Coronavirus Infections , Coronavirus , Pandemics , Health Facilities, Proprietary , Hospitalization
8.
Av. enferm ; 38(1): 46-54, ene.-abr. 2020. tab, graf
Article in Portuguese | LILACS (Americas), BDENF, COLNAL | ID: biblio-1089009

ABSTRACT

Resumo Objetivo: Analisar a evolução temporal das hospitalizações, de crianças menores de cinco anos, por condições sensíveis à atenção primária em Teresina-PI, Brasil, de 2003 a 2012. Método: Trata-se de estudo retrospectivo, descritivo e quantitativo, realizado a partir de dados secundários extraídos da Rede Interagencial de Informações para a Saúde, disponíveis no sítio eletrônico do Departamento de Informática do Sistema Único de Saúde. As hospitalizações foram analisadas em dois grupos etários: crianças menores de um ano de idade e crianças entre um e quatro anos de idade. Resultados: Apesar das flutuações no período analisado, a taxa de hospitalizações teve um decréscimo de 71,88 %. Em crianças menores de um ano, o declínio foi de 7149 % e, com idade entre um e quatro anos, a redução foi de 72,30 %. A maioria das hospitalizações ocorreu no sexo masculino, e as causas que predominaram foram gastroenterites infecciosas e pneumonias bacterianas. Conclusões: As hospitalizações por condições sensíveis à atenção primária tiveram um declínio ao longo da década analisada, entretanto houve um predomínio de condições sensíveis que poderiam ser evitadas ou até mesmo solucionadas se fossem aplicadas as medidas disponíveis e de baixo custo nos serviços primários de saúde.


Resumen Objetivo: Analizar la evolución temporal de las hospitalizaciones de niños menores de cinco años por condiciones asociadas a la atención primaria en Teresina-PI, de 2003 a 2012. Método: Estudio retrospectivo, descriptivo y cuantitativo basado en datos secundarios extraídos de la Red Interagencial de Información para la Salud, disponibles en el sitio web del Departamento de Informática del Sistema Único de Salud de Brasil. Se analizaron las hospitalizaciones en dos grupos de edad: niños menores de un año y niños entre uno y cuatro años. Resultados: A pesar de las fluctuaciones en el periodo de estudio las tasas de hospitalización se redujeron en un 71,88 %. En niños menores de un año la disminución fue del 71,49 % y en la edad entre uno y cuatro años fue del 72,30 %. La mayoría de las hospitalizaciones ocurrieron en hombres y las causas predominantes fueron la gastroenteritis infecciosa y la neumonía bacteriana. Conclusiones: Las hospitalizaciones por condiciones asociadas a la atención primaria tuvieron una reducción a lo largo de la década analizada. Sin embargo, hubo predominio de condiciones que se podrían evitar o incluso solucionar si se aplicaran las medidas disponibles y de bajo costo en los servicios de atención primaria.


Abstract Objective: To analyze a temporal evolution of hospitalizations of children under five years of age, affected by conditions associated with primary care in Teresina-PI, from 2003 to 2012. Method: This is a retrospective, descriptive and quantitative study, based on extracted secondary data of the Interagency Network of Health Information, available on the website of the Department of Informatics of the Unified Health System. The hospitalizations were analyzed in two age groups: children under one year of age and children between one and four years of age. Results: Despite fluctuations in the analyzed period, hospitalization rates decreased by 71.88 %. In children under one year the decrease was 71.49 % and the age between one and four years the reduction was 72.30 %. Most hospi-talizations occurred in males, and the causes that prevailed were infectious gastroenteritis and bacterial pneumonia. Conclusions: Hospitalizations for conditions associated with primary care presented a decline over the analyzed decade. However, there was a predominance of conditions that could have been avoided or even resolved by applying available and low-cost measures in primary health services.


Subject(s)
Infant , Child, Preschool , Primary Health Care , Child , Child Health , Minors , Hospitalization
9.
Rev. colomb. obstet. ginecol ; 71(1): 42-55, Jan.-Mar. 2020. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1115619

ABSTRACT

RESUMEN Objetivo: evaluar la asociación entre parto por cesárea y hospitalización del neonato, y describir las indicaciones de cesárea según los grupos de Robson en el servicio de obstetricia de una institución general de alta complejidad. Materiales y métodos: estudio de corte transversal. Se incluyeron todos los nacimientos ocurridos entre marzo y julio de 2018 en un hospital general de enseñanza de alta complejidad en Bogotá, Colombia, mediante muestreo consecutivo. Tamaño muestral de 1040 gestantes. Se describe la frecuencia de cesárea, las indicaciones, los resultados neonatales por cada grupo de Robson y el riesgo de hospitalización neonatal por medio del odds ratio (OR) crudo y crudo y ajustado por análisis multivariado. Resultados: se incluyeron 1493 nacimientos, de los cuales 539 (36,3 %) fueron por cesárea. Las mujeres con antecedente de cicatriz uterina, programadas para cesárea electiva y las hospitalizadas para inducción aportan la mayoría de cesáreas. Las principales indicaciones para esta intervención fueron sospecha de estado fetal insatisfactorio y alteraciones del trabajo de parto. Ajustado por peso al nacer, la cesárea incrementó el riesgo global de hospitalización del neonato (OR ajustado [ORa] = 2,2; IC 99 %: 1,3-3,7). Conclusiones: en la institución se identificaron grupos de Robson susceptibles de intervención para disminuir la tasa de cesáreas ante la sospecha de estado fetal insatisfactorio y prolongación del trabajo de parto. Se encontró una asociación entre el parto por cesárea y la posterior hospitalización del recién nacido. Se requieren estudios controlados aleatorizados que determinen el beneficio de las estrategias para reducir la tasa de cesárea y validar la asociación encontrada.


ABSTRACT Objective: To evaluate the association between cesarean delivery and hospitalization of the newborn and describe the indications for cesarean according to Robson's groups in the obstetrics service of a highly complex general institution. Materials and methods: Cross-sectional study. All births occurred between March and July 2018 in a high complexity general teaching hospital in Bogotá, Colombia were included, by consecutive sampling up to a sample size of 1040 pregnant women. The frequency of caesarean section, indications, neonatal outcomes for each Robson group, and the risk of neonatal hospitalization are described using the crude and adjusted odds ratio (OR) using multivariate analysis. Results: 1,493 births were included, of which 539 (36.3 %) were by cesarean section. Women with a history of uterine scar scheduled for elective caesarean section and those hospitalized for induction provide the majority of caesarean sections. The main indications for cesarean section were suspicion of unsatisfactory fetal status and prolongued labor. Adjusted for birth weight, caesarean section increased the overall risk of neonatal hospitalization (adjusted OR [aOR] = 2,2; IC 99 %: 1,3-3,7). Conclusions: There are groups of Robson susceptible of intervention to decrease the rate of caesarean sections due to the suspicion of unsatisfactory fetal status and prolongation of labor. An association was found between cesarean delivery and subsequent neonatal hospitalization. Randomized controlled studies are required to determine the benefit of the strategies to reduce cesarean section rates and evaluate the association found.


Subject(s)
Humans , Infant, Newborn , Cesarean Section , Intensive Care, Neonatal , Risk Factors , Classification , Delivery, Obstetric , Hospitalization
10.
Rev. Hosp. Ital. B. Aires (2004) ; 40(1): 11-16, mar. 2020. ilus, tab
Article in Spanish | LILACS (Americas) | ID: biblio-1102183

ABSTRACT

Las Unidades de Mediana Estancia (UME) se definen como un recurso institucional con camas de hospitalización para pacientes ancianos, en donde ‒una vez superada la fase aguda de la enfermedad‒ sea posible efectuar un tratamiento a medio plazo, con recursos rehabilitadores, atención médica y cuidados de enfermería, todo ello con el propósito de conseguir la recuperación funcional y la reinserción en la comunidad. El objetivo de este trabajo fue efectuar un estudio cuasi experimental con propio individuo control antes-después con el fin de describir las características basales de los pacientes ingresados en la UME con objetivos de rehabilitación, así como su ganancia funcional luego de la intervención, medida como la diferencia entre el índice de Barthel al alta (valor final) y al ingreso en la UME (valor basal). Para ello se incluyeron 122 personas y se obtuvo como principal resultado una ganancia funcional positiva de 40 puntos y un parámetro de eficacia (ganancia funcional/días de internación) de 1,18. Los resultados obtenidos se consideran, de acuerdo con la literatura, como efectivos y eficaces. (AU)


Subacute Care Units are defined as an institutional resource with hospital beds where once a patient overcomes the acute phase of a disease, it is possible for him to undergo a rehabilitation treatment with the objective of achieving functional recovery and reintegration into the community. The purpose of this paper was to carry out a quasi-experimental before and after study where the subjects serve as their own controls, in order to describe the baseline characteristics of the patients admitted to the subacute care unit with rehabilitation objectives, as well as their functional gain after the intervention, measured as the difference between the Barthel index at discharge (final value) and admission to the EMU (baseline value). For this, 122 people were included, obtaining as main results a positive functional gain of 40 points (p <0.001) and an efficiency parameter (functional gain / days of hospitalization) of 1.18, considering the results obtained according to the literature as effective and efficient. (AU)


Subject(s)
Humans , Aged , Aged, 80 and over , Subacute Care/statistics & numerical data , Hospital Units/statistics & numerical data , Argentina/epidemiology , Rehabilitation/methods , Population Dynamics/statistics & numerical data , Frail Elderly/statistics & numerical data , Caregivers/psychology , Cost-Benefit Analysis , Patient-Centered Care , Homebound Persons/rehabilitation , Subacute Care/methods , Subacute Care/organization & administration , Medical Care/methods , Rehabilitation Services , Hospitalization/economics , Hospitalization/trends , Nursing Care/methods
11.
REME rev. min. enferm ; 24: e-1272, fev.2020.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1051246

ABSTRACT

Introdução: a hanseníase é uma doença secular mantida por muitos anos como incurável, levando à segregação do doente. Os mecanismos excludentes contra o leproso tinham a premissa de proteger a população sadia, ao mesmo tempo em que se constituíam como empecilhos à manutenção do vínculo familiar. Objetivo: analisar o efeito do tratamento compulsório da hanseníase em hospitais-colônias nas relações familiares, na perspectiva daquele que possui parentesco com um ex-doente. Método: estudo qualitativo, utilizando-se da história oral temática. A colônia foi composta pelos 52 familiares de ex-doentes de hanseníase e a rede por 10 colaboradores, de ambos os sexos, com idade de 44 a 76 anos. Utilizou-se a entrevista, com questões abrangentes, submetida à análise temática de conteúdo. A pesquisa foi aprovada com Parecer de nº 650.654/2014. Resultados: mediante a análise, emergiram três categorias: desestruturação da organização familiar, distanciamento familiar e alteração no suporte familiar, os quais abordam as consequências nas relações familiares, estabelecidas mediante a experiência de se ter um parente acometido pela lepra e vitimado pelo internamento compulsório em hospitais-colônias. O distanciamento modificou as relações e o vínculo familiar entre os ex-doentes de lepra tratados em ambiente asilar e seus familiares. Conclusão: as histórias narradas relatam danos vivenciados no passado como consequência da ruptura familiar sofrida pelos colaboradores do estudo frente à política adotada como profilaxia e controle da lepra. Diante dessa parte do histórico da doença relatada no presente estudo, e de suas características epidemiológicas, torna-se relevante considerar a subjetividade dos indivíduos com hanseníase, proporcionando cuidado integral.(AU)


Introduction: leprosy is a secular disease maintained for many years as incurable, leading to segregation of the patient. The exclusionary mechanisms against the leper had the premise of protecting the healthy population, while they constituted obstacles to the maintenance of the family bond. Objective: to analyze the effect of compulsory leprosy treatment in hospital-colonies on family relationships, from the perspective of those who are related to a ex-patient. Method: qualitative study, using thematic oral history. The colony was composed of 52 relatives of ex-leprosy patients and the network of 10 collaborators, of both sexes, aged 44 to 76 years. The interview was used, with comprehensive questions, submitted to thematic content analysis. The survey was approved with Opinion No. 650,654/2014...(AU)


Introducción: la lepra es una enfermedad secular considerada durante muchos años como incurable, segregando al paciente. Los mecanismos de exclusión contra el leproso tenían la premisa de proteger a la población sana, al mismo tiempo que constituían obstáculos para el mantenimiento del vínculo familiar. Objetivo: analizar el efecto del tratamiento obligatorio de la lepra en hospitales-colonias sobre las relaciones familiares, desde la perspectiva de alguien relacionado con un ex paciente. Método: estudio cualitativo, utilizando historia oral temática. La colonia estaba compuesta por 52 familiares de ex pacientes de lepra y la red de 10 colaboradores, de ambos sexos, de 44 a 76 años. Se utilizó la entrevista con preguntas amplias, sometidas a análisis de contenido temático. La encuesta fue aprobada con el dictamen No. 650,654 / 2014. Resultados: a través del análisis surgieron tres categorías: desestructuración de la organización familiar, distanciamiento familiar y cambios en el apoyo familiar, que enfocan las consecuencias en las relaciones familiares, establecidas a través de la experiencia de tener un familiar afectado por la lepra y victimizado por la internación obligatoria en hospitalescolonias. El distanciamiento alteró las relaciones y el vínculo entre los ex pacientes con lepra tratados en un entorno de asilo y sus familiares. Conclusión: las historias narradas reportan daños sufridos en el pasado como consecuencia de la ruptura familiar de los participantes del estudio ante la política adoptada como profilaxis y control de la lepra. En vista de esta parte de la historia de la enfermedad reportada en el presente estudio, y de sus características epidemiológicas, resulta relevante considerar la subjetividad de las personas con lepra, brindando atención integral.(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Family Relations , Hospitalization , Leprosy , Life Change Events , Family Nursing
12.
REME rev. min. enferm ; 24: e-1291, fev.2020.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1053377

ABSTRACT

Objetivo: realizar o mapeamento cruzado dos cuidados de Enfermagem para a prevenção de quedas em pacientes no perioperatório encontrados na literatura com as intervenções/atividades propostas pela Nursing Interventions Classification para o diagnóstico de Enfermagem "risco de queda". Métodos: estudo descritivo desenvolvido em três etapas: busca na literatura dos cuidados de Enfermagem utilizados, levantamento das intervenções propostas pela NIC e o mapeamento cruzado com base na ligação NANDA-I/NIC. Resultados: os 214 cuidados encontrados na literatura foram mapeados com 84 atividades distribuídas em 26 intervenções NICs. A intervenção que apresentou mais correspondência com a literatura foi prevenção contra queda, que obteve 70 atividades mapeadas, seguida pelas intervenções identificação de risco e supervisão, com 35 e 19 atividades, respectivamente. Conclusão: todos os cuidados encontrados na literatura apresentaram correspondência com alguma intervenção/atividade NIC. Para a prevenção de quedas em pacientes durante o perioperatório são necessários segurança ambiental, consciência educativa dos pacientes, acompanhantes e profissionais, identificação precoce dos riscos e supervisão contínua da Enfermagem.(AU)


Objective: to identify nursing care intended to prevent falls among perioperative patients in the literature and cross-map them with interventions/activities proposed by the Nursing Interventions Classification for the nursing diagnosis "risk for falls". Methods: descriptive study conducted in three stages: search for nursing care reported in the literature; identification of NIC intervention; and cross-mapping based on linkage between NANDA-I/NIC. Results: the 214 care actions identified in the literature were mapped with 84 activities distributed in 26 NIC interventions. The intervention with the highest number of correspondences with the literature was prevention of falls, which resulted in 70 mapped activities, followed by the intervention risk identification and supervision, with 35 and 19 activities, respectively. Conclusion: all the care actions identified in the literature presented correspondences to some NIC intervention/activity. Preventing falls among perioperative patients requires ensuring environmental safety; that patients, companies and workers be educated and sensitized; the early identification of risks; in addition to continuous nursing supervision.(AU)


Objetivo: realizar el mapeo cruzado de cuidados de enfermería para la prevención de caídas en pacientes en el proceso perioperatorio encontrados en la literatura con las intervenciones/actividades propuestas por Nursing Interventions Classification (Clasificación de Intervenciones de Enfermería) para el diagnóstico de enfermería "riesgo de caída". Métodos: estudio descriptivo llevado a cabo en tres etapas: búsqueda en la literatura de los cuidados de enfermería utilizados, encuesta de las intervenciones propuestas por el NIC y mapeo cruzado basado en el enlace NANDA-I/NIC. Resultados: las 214 experiencias de cuidados encontrados en la literatura fueron mapeados con 84 actividades distribuidas en 26 intervenciones de NIC. La intervención que más correspondió con la literatura fue prevención de caídas, que contó con 70 actividades mapeadas, seguidas de intervenciones de identificación y supervisión de riesgos, con 35 y 19 actividades, respectivamente. Conclusión: todas las experiencias de cuidados de enfermería encontrados en la literatura mostraron correspondencia con alguna intervención/actividad NIC. Para la prevención de caídas en pacientes durante el período perioperatorio es necesario que haya seguridad ambiental, conciencia educativa de los pacientes, acompañantes y profesionales, identificación temprana de riesgos y supervisión continua de Enfermería. (AU)


Subject(s)
Humans , Perioperative Nursing , Accidental Falls , Perioperative Care , Standardized Nursing Terminology , Accident Prevention , Hospitalization
13.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 68-71, Jan.-Feb. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1055368

ABSTRACT

Objective: Circadian dysregulation plays an important role in the etiology of mood disorders. Evening chronotype is frequent in these patients. However, prospective studies about the influence of chronotype on mood symptoms have reached unclear conclusions in patients with bipolar disorder (BD). The objective of this study was to investigate relationship between chronotype and prognostic factors for BD. Methods: At the baseline, 80 euthymic BD patients answered a demographic questionnaire and clinical scales to evaluate anxiety, functioning and chronotype. Circadian preference was measured using the Morningness-Eveningness Questionnaire, in which lower scores indicate eveningness. Mood episodes and hospitalizations were evaluated monthly for 18 months. Results: Among the BD patients, 14 (17.5%) were definitely morning type, 35 (43.8%), moderately morning, 27 (33.7%) intermediate (neither) and 4 (5%) moderately evening. Eveningness was associated with obesity or overweight (p = 0.03), greater anxiety (p = 0.002) and better functioning (p = 0.01), as well as with mood episodes (p = 0.04), but not with psychiatric hospitalizations (p = 0.82). This group tended toward depressive episodes (p = 0.06), but not (hypo)mania (p = 0.56). Conclusion: This study indicated that evening chronotype predicts a poor prognostic for BD. It reinforces the relevance of treating rhythm disruptions even during euthymia to improve patient quality of life and prevent mood episodes.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Anxiety/physiopathology , Bipolar Disorder/physiopathology , Circadian Rhythm/physiology , Prognosis , Psychiatric Status Rating Scales , Quality of Life , Time Factors , Logistic Models , Prospective Studies , Surveys and Questionnaires , Statistics, Nonparametric , Chronobiology Disorders/physiopathology , Hospitalization/statistics & numerical data , Middle Aged
14.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 40-45, Jan.-Feb. 2020. tab
Article in English | LILACS (Americas) | ID: biblio-1055358

ABSTRACT

Objective: To describe and analyze data on self-injurious behavior (SIB) and related mortality in children under 10 years old in Brazil. Methods: A descriptive study was performed using secondary public health care data extracted from the Hospital Information System (Sistema de Informações Hospitalares, SIH) and Mortality Information System (Sistema de Informações sobre Mortalidade, SIM) in Brazil. The databases are available for online access at http://datasus.saude.gov.br/. Results: In Brazil, according to SIH data, 11,312 hospitalizations of patients under 10 years of age were recorded from 1998 to 2018 as resulting from SIB (ICD-10 X60-X84 codes). Of these, 65 resulted in death. According to the SIM, from 1996 to 2016, 91 deaths related to SIB were recorded, 81 (89%) in children aged 5 to 9 years, nine (9.9%) in children aged 1 to 4 years, and one (1.1%) in a child below 1 year of age. Conclusion: These results highlight the relevance of creating measures to better understand SIB and related mortality in this age group. They also reveal the vulnerability of children in Brazil and warrant further studies to address these issues.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Self-Injurious Behavior/mortality , Child Mortality/trends , Brazil , Retrospective Studies , Risk Factors , Hospital Mortality/trends , Sex Distribution , Age Distribution , Hospitalization/statistics & numerical data
15.
Fisioter. Pesqui. (Online) ; 27(1): 41-47, jan.-mar. 2020. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1090407

ABSTRACT

RESUMO As cardiopatias congênitas (CC) estão entre as principais causas de morbimortalidade na primeira infância e os lactentes com essa condição podem apresentar atrasos no desenvolvimento neuropsicomotor (DNPM). O objetivo deste estudo foi avaliar a influência da CC no DNPM de lactentes. Trata-se de um estudo observacional com avaliação do desenvolvimento neuropsicomotor realizada pela Bayley Scales of Infant and Toddler Development (BSID-III). As condições maternas e clínicas dos lactentes foram verificadas no relatório de alta médica e na caderneta de saúde da criança, e a condição socioeconômica das famílias pelo Critério da Classificação Econômica Brasil. Para associar as variáveis clínicas e o DNPM foram utilizados o coeficiente de correlação de Spearman e o teste de razão de verossimilhança. Foram avaliados 18 lactentes, com predomínio do sexo feminino (72,2%). A maioria das mães (47,1%) possuía ensino médio completo ou superior incompleto, com média da idade de 27,2±5,5 anos. Houve correlação das escalas do BSID-III com as variáveis quantitativas analisadas: escala motora com o peso (p=0,02 e r=0,54) e com uso de oxigenoterapia (p=0,009 e r=−0,591); já para as variáveis qualitativas as associações foram entre: escala motora e condição socioeconômica (p=0,015), escala motora e comunicação interatrial - (CIA) (p=0,023) e escala da linguagem e CIA (p=0,038). A CC influenciou o DNPM, principalmente no aspecto motor. Além disso peso, diagnóstico de CIA, uso de oxigenoterapia e condição socioeconômica foram considerados como principais fatores de risco para o atraso no DNPM.


RESUMEN Las cardiopatías congénitas (CC) se encuentran entre las principales causas de morbimortalidad en la primera infancia, y los lactantes con esta afección pueden tener retrasos en el desarrollo neuropsicomotor (DNPM). El presente estudio tuvo el objetivo de evaluar la influencia de las CC en el DNPM de los lactantes. Este es un estudio observacional en el cual se evaluó el desarrollo neuropsicomotor utilizando la Bayley scales of infant and toddler development (BSID-III). Las condiciones maternas y clínicas de los lactantes se obtuvieron en el informe de alta médica y en la libreta de salud del niño, y el estado socioeconómico de las familias en el Criterio de Clasificación Económica de Brasil. Para asociar las variables clínicas y el DNPM, se utilizaron el coeficiente de correlación de Spearman y la prueba de razón de probabilidad. Se evaluaron a 18 lactantes, con un predominio del sexo femenino (72,2%). La mayoría de las madres (47,1%) tenían la secundaria completa o la educación superior incompleta, con una edad promedio de 27,2±5,5 años. Hubo una correlación entre las escalas BSID-III y las variables cuantitativas analizadas: escala motora con el peso (p=0,02 y r=0,54) y con el uso de oxigenoterapia (p=0,009 y r=−0,591); para las variables cualitativas, las asociaciones fueron entre: escala motora y estado socioeconómico (p=0,015), escala motora y comunicación interauricular (CIA) (p=0,023) y escala de lenguaje y CIA (p=0,038). Las CC influyeron en el DNPM, principalmente en el aspecto motor. Además, el peso, el diagnóstico de CIA, el uso de oxigenoterapia y el estado socioeconómico fueron considerados los principales factores de riesgo para el retraso en el DNPM.


ABSTRACT Congenital heart defects (CHD) are among the main causes of morbidity and mortality in infants who has this impairment may present delays in neuropsychomotor development (NPMD). This study assesses the influence of CHD on NPMD of infants. This is an observational study assessing neuropsychomotor development performed by Bayley Scales of Infant and Toddler Development - BSID-III. The Brazilian Economic Classification Criteria was used to verify the socioeconomic status of the families and also the maternal and infants' clinical conditions were verified in the medical discharge report and in the child's health handbook. For the association between the quantitative and qualitative variables with the NPMD, the Spearman's correlation coefficient and the likelihood ratio test were used. A total of 18 infants were assessed, with a predominance of females (72.2%). Most mothers (47.1%) had complete high school or incomplete higher education, with a mean age of 27.2±5.5 years. There was a correlation between the BSID-III scales and the quantitative variables analyzed: motor scale with weight (p=0.02 and r=0.54) and oxygen therapy (p=0.009 and r=−0.591); besides that, the qualitative variables correlation were: motor scale and socioeconomic condition (p=0.015), motor scale and Interatrial Communication - IAC (p=0.023) and language with IAC scales (p=0.038). CHD influences the delay of NPMD, mainly for motor aspect. Furthermore, weight, diagnosis of IAC, use of oxygen therapy and socioeconomic status were considered the main risk factors for the delay in NPMD.


Subject(s)
Humans , Infant , Psychomotor Disorders/etiology , Motor Skills Disorders/etiology , Neurodevelopmental Disorders/etiology , Heart Defects, Congenital/complications , Oxygen Inhalation Therapy/adverse effects , Psychomotor Disorders/diagnosis , Socioeconomic Factors , Child Development/physiology , Cross-Sectional Studies , Cognition Disorders/diagnosis , Cognition Disorders/etiology , Motor Skills Disorders/diagnosis , Neurodevelopmental Disorders/diagnosis , Hospitalization , Language Disorders/diagnosis , Language Disorders/etiology , Length of Stay , Neuropsychological Tests
16.
J. Health Biol. Sci. (Online) ; 8(1): 1-5, 01/01/2020. ilus
Article in Portuguese | LILACS (Americas) | ID: biblio-1103719

ABSTRACT

Objetivo: descrever os aspectos organizacionais e operacionais do processo de trabalho da gestão de leitos de um hospital polo da Região Ampliada de Saúde Jequitinhonha Métodos: trata-se de um estudo de abordagem qualitativa por meio de entrevista semiestruturada gravada, realizada com 90 funcionários. Os dados foram categorizados e discutidos conforme análise de conteúdo. Resultados: emergiram seis categorias, sendo elas: organização dos processos de entrada e saída dos pacientes, comunicação, direcionamento dos pacientes para a clínica certa; hotelaria hospitalar; organização do serviço hospitalar e organização das cirurgias eletivas. Conclusões: este estudo evidenciou que, no hospital pesquisado, a gestão de leitos proporcionou melhoria nos aspectos organizacionais e operacionais do processo de trabalho, aumentou a rotatividade, a ocupação e diminuiu as taxas de permanência dos leitos, melhorou a comunicação entre os profissionais e garantiu uma melhor assistência aos pacientes internados, sem o aumento do número de leitos hospitalares.


Objective: to describe the organizational and operational aspects of the bed management work process of a hospital in the Extended Health Region of Jequitinhonha. Methods: this is a qualitative approach study using a semi-structured recorded interview with 89 employees. The data were categorized and discussed according to content analysis. Results: Six categories emerged, namely: organization of patients' entry and exit processes, communication, directing the patients to the right clinic; hospital hospitality; organization of the hospital service and organization of elective surgeries. Conclusions: This study showed that, in the researched hospital, bed management provided improvement in the organizational and operational aspects of the work process, increased turnover, occupation and decreased bed permanence rates, improved communication among professionals and ensured better care for hospitalized patients, without increasing the number of hospital beds.


Subject(s)
Hospital Bed Capacity , Hospitalization
17.
Article in English | WPRIM (Western Pacific) | ID: wprim-782489

ABSTRACT

BACKGROUND: The purposes of this study were 1) to investigate the incidence of pneumonia during hospitalization in elderly hip fracture patients, 2) to evaluate the effect of pneumonia on 30 day to 1 year mortality and 3) to analyze the impact of age and gender on the mortality rate in the pneumonia patients using a nationwide cohort of Korea.METHODS: The Korean National Health Insurance Service (NHIS) database included approximately 5.5 million Korean enrollees > 60 years of age. A total of 588,147 participants were randomly selected for senior cohort using 10% simple random sampling. We identified senile (> 65 years old) patients who underwent hip fracture surgery from January 2005 to December 2014 and those who developed pneumonia during hospitalization from the NHIS-Senior cohort. The index date of hip fracture occurrence was defined as the date of admission to the acute care hospital. The last date of follow-up was defined as the date of death or 31 December 2015, whichever came first. A multivariable-adjusted Cox proportional hazards model was used to investigate the effects of pneumonia on all-cause mortality.RESULTS: During the enrollment period, a total of 14,736 patients, who were older than 65 years, underwent hip fracture surgeries. Among them, 1,629 patients (11.05%) developed pneumonia during the hospitalization. The pneumonia incidence was 16.39% (601/3,666) in men patients and 9.29% (1,028/10,042) in women patients. Compared to 13,107 non-pneumonia patients, adjusted relative risk (aRR) of death in pneumonia patients was 2.69 (95% confidence interval [CI], 2.14–3.38; P < 0.001) within postoperative 30-day, 3.40 (95% CI, 3.01–3.83; P < 0.001) within postoperative 90-day, 2.86 (95% CI, 2.61–3.15; P < 0.001) within postoperative 180-day and 2.31 (95% CI, 2.14–2.50; P < 0.001) within postoperative 1-year. According to patient's age, the aRR of death in pneumonia patients was 5.75 (95% CI, 2.89–11.43) in adults aged < 70 years, 5.14 (95% CI, 4.08–6.46) in those aged 70–79 years, 3.29 (95% CI, 2.81–3.86) in those aged 80–89 years and 2.02 (95% CI, 1.52–2.69) in those aged ≥ 90 years. The aRR was 3.63 (95% CI, 3.01–4.38) in men pneumonia patients, and 3.27 (95% CI, 2.80–3.83) in women pneumonia patients.CONCLUSION: The prevalence of pneumonia in elderly hip fracture patients was 11.05%. Men had higher incidence (16.39%) than women (9.29%). Compared to non-pneumonia patients, the pneumonia patients had higher 30-day to 1-year mortalities with aRR of 2.31 to 3.40. They had increased mortality in all age groups older than 65 years with aRR of 1.52 to 4.08. Both genders of pneumonia patients had higher risk of mortality (aRR, 3.63 in men and 3.27 in women) compared to non-pneumonia patients.


Subject(s)
Adult , Aged , Cohort Studies , Female , Follow-Up Studies , Hip , Hospitalization , Humans , Incidence , Korea , Male , Mortality , National Health Programs , Pneumonia , Prevalence , Proportional Hazards Models
18.
Article in English | WPRIM (Western Pacific) | ID: wprim-782275

ABSTRACT

BACKGROUND: Firefighters are exposed to many dangerous working conditions. Many studies have identified the risk of disease for firefighters, but only a few studies have addressed the medical expenses of firefighters, which represents a concrete scale of disease. Our purpose in this study was to determine the medical expenditures of firefighters to assess the overall scale of disease in Korea. We focused on cancer, mental disorders, cardio-cerebrovascular disease, and musculoskeletal disease, the prevalence of which was expected to be high in firefighters.METHODS: This study utilized National Health Insurance Service data. We targeted firefighters, police officers, and government officials. We classified disease based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes. We compared prevalence by the age-standardized prevalence rate, considering standard distribution of the population. Medical expenditure of disease was defined as outpatient fees, hospitalization fees, and drug costs. Total medical expenditures were calculated by the sum of those 3 categories.RESULTS: The age-standardized prevalence of cancer, mental disorders, and cardiovascular disease in firefighters was slightly higher than or similar to that of government officials and police officers (no significant difference). However, medical expenditures for stomach cancer, mental disorders, and most cardio-cerebrovascular diseases were higher in firefighters than in others. In particular, firefighters spent 12 times more money for ischemic heart disease than did government officials. Of musculoskeletal diseases, lumbar disc disorder had the highest expenditures among firefighters.CONCLUSIONS: The age-standardized prevalence of most of diseases of firefighters was not as high as in the other groups, but the medical expenses of firefighters were much higher than those of government officials and police officers.


Subject(s)
Cardiovascular Diseases , Drug Costs , Fees and Charges , Firefighters , Health Expenditures , Hospitalization , Humans , International Classification of Diseases , Korea , Mental Disorders , Musculoskeletal Diseases , Myocardial Ischemia , National Health Programs , Occupational Groups , Outpatients , Police , Prevalence , Stomach Neoplasms
19.
Article in English | WPRIM (Western Pacific) | ID: wprim-782270

ABSTRACT

OBJECTIVES: The study aimed to develop and compare predictive models based on supervised machine learning algorithms for predicting the prolonged length of stay (LOS) of hospitalized patients diagnosed with five different chronic conditions.METHODS: An administrative claim dataset (2008–2012) of a regional network of nine hospitals in the Tampa Bay area, Florida, USA, was used to develop the prediction models. Features were extracted from the dataset using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Five learning algorithms, namely, decision tree C5.0, linear support vector machine (LSVM), k-nearest neighbors, random forest, and multi-layered artificial neural networks, were used to build the model with semi-supervised anomaly detection and two feature selection methods. Issues with the unbalanced nature of the dataset were resolved using the Synthetic Minority Over-sampling Technique (SMOTE).RESULTS: LSVM with wrapper feature selection performed moderately well for all patient cohorts. Using SMOTE to counter data imbalances triggered a tradeoff between the model's sensitivity and specificity, which can be masked under a similar area under the curve. The proposed aggregate rank selection approach resulted in a balanced performing model compared to other criteria. Finally, factors such as comorbidity conditions, source of admission, and payer types were associated with the increased risk of a prolonged LOS.CONCLUSIONS: Prolonged LOS is mostly associated with pre-intraoperative clinical and patient socioeconomic factors. Accurate patient identification with the risk of prolonged LOS using the selected model can provide hospitals a better tool for planning early discharge and resource allocation, thus reducing avoidable hospitalization costs.


Subject(s)
Bays , Chronic Disease , Cohort Studies , Comorbidity , Dataset , Decision Trees , Florida , Forests , Hospitalization , Humans , Inpatients , International Classification of Diseases , Learning , Length of Stay , Machine Learning , Masks , Patient Discharge , Resource Allocation , Sensitivity and Specificity , Socioeconomic Factors , Supervised Machine Learning , Support Vector Machine
20.
Yonsei Medical Journal ; : 48-55, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-782124

ABSTRACT

PURPOSE: Data on the comparative effectiveness of infliximab (IFX) or adalimumab (ADA) in patients with ulcerative colitis (UC) are extremely limited, especially in the Asian population. We compared clinically important outcomes [colectomy, UC-related emergency room (ER) visits, UC-related hospitalizations, and need for corticosteroids] for these two biologics in biologic-naïve Korean patients with UC.MATERIALS AND METHODS: Using National Health Insurance claims, we collected data on patients who were diagnosed with UC and exposed to IFX or ADA between 2010 and 2016.RESULTS: A total of 862 new users of biologics were included, of whom 630 were treated with IFX and 232 were treated with ADA. Over a median follow-up of 1.8 years after starting biologic therapy, there were no significant differences in the risk of colectomy [adjusted hazard ratio (aHR), 1.87; 95% confidence interval (CI), 0.30–11.63], ER visits (aHR, 1.58; 95% CI, 0.79–3.16), hospitalizations (aHR, 0.83; 95% CI, 0.59–1.17), and corticosteroid use (aHR, 1.16; 95% CI, 0.76–1.78) between IFX and ADA users. These results were stable even when only patients who used biologics for ≥6 months were analyzed. Additionally, these results were unchanged in patients treated with biologic monotherapy or combination therapy with immunomodulators.CONCLUSION: In this nationwide population-based study, there was no significant difference in the risk of colectomy, ER visits, hospitalizations, and corticosteroid use between IFX and ADA users. Our findings indicate that IFX and ADA have comparable effectiveness in biologic-naïve Korean patients with UC.


Subject(s)
Adalimumab , Asian Continental Ancestry Group , Biological Products , Biological Therapy , Colectomy , Colitis, Ulcerative , Emergency Service, Hospital , Follow-Up Studies , Hospitalization , Humans , Immunologic Factors , Infliximab , National Health Programs , Ulcer
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