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1.
Esc. Anna Nery Rev. Enferm ; 26: e20210232, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1350742

ABSTRACT

Resumo Objetivo identificar respostas comportamentais apresentadas por longevos no domicílio, após internação na Unidade de Terapia Intensiva e alta hospitalar. Método estudo qualitativo, realizado com pessoas de 80 anos ou mais. O cenário da coleta de dados foi a Unidade de Terapia Intensiva e o domicílio de longevos que estiveram internados na unidade, por meio de entrevista aberta. Para análise dos dados, utilizou-se o método de análise de conteúdo de Bardin, pautada na teoria de Adaptação de Callista Roy. Todos os cuidados éticos foram respeitados. Resultados emergiram-se duas categorias: Alterações do padrão de resposta às necessidades fisiológicas e perda de autonomia e Alterações psicossociais e comprometimento na realização de atividades cotidianas de lazer e laborais. Conclusão e implicações para a prática as respostas comportamentais foram relacionadas aos modos fisiológicos e psicossociais, que culminaram em dependência e perda de autonomia para realização das atividades básicas de vida. Perceberam-se dificuldades vivenciadas no retorno ao domicílio, que provocaram alterações significativas na realização de atividades cotidianas, evidenciando a necessidade de se iniciar o preparo para o retorno domiciliar, pela equipe multiprofissional, ainda durante a hospitalização. Espera-se que estratégias visando melhorias dos resultados de cuidados críticos sejam implementadas nessa população.


RESUMEN Objetivo identificar respuestas comportamentales presentadas por longevos en el domicilio después de internación en la Unidad de Cuidados Intensivos y alta hospitalaria. Método estudio cualitativo, realizado con personas de 80 años o más. El escenario de la recolección de datos fue la Unidad de Cuidados Intensivos y el domicilio de longevos que estuvieron internados en la unidad, por medio de entrevista abierta. Para el análisis de los datos se utilizó el método de análisis de contenido de Bardin, pautado en la teoría de Adaptación de Callista Roy. Todos los cuidados éticos fueron respetados. Resultados surgieron dos categorías: Alteraciones del patrón de respuesta a las necesidades fisiológicas y pérdida de autonomía y Alteraciones psicosociales y compromiso en la realización de actividades cotidianas de ocio y laborales. Conclusión e implicaciones para la práctica las respuestas comportamentales fueron relacionadas a los modos fisiológicos y psicosociales, que culminaron en dependencia y pérdida de autonomía en la realización de las actividades básicas de la vida. Se percibieron dificultades vividas en el retorno al domicilio, que provocaron alteraciones significativas en la realización de actividades cotidianas, revelando la necesidad de iniciar la preparación para el retorno domiciliar por el equipo multiprofesional aún durante la hospitalización. Se espera que estrategias que busquen mejoras de los resultados de cuidados críticos sean implementadas en esa población.


Abstract Objective to identify the behavioral responses presented by elderly people at home after hospitalization at the intensive care unit and hospital discharge. Method a qualitative study was conducted with people aged 80 years or older. The data collection setting was the intensive care unit and the homes of the elderly people hospitalized in the unit using open interviews. Data analysis consisted of Bardin's method of content analysis based on the Callista Roy adaptation model. All ethical aspects were respected. Results two categories emerged: changes in the pattern of response to physiological needs and loss of autonomy and psychosocial changes and impairment in performing daily leisure and work activities. Conclusion and implications for practice behavioral responses were related to physiological and psychosocial factors, culminating in dependence and loss of autonomy to perform basic life activities. Difficulties experienced in returning home were also noticed, which caused significant changes in daily activities, thereby evidencing the need for multidisciplinary teams to begin preparing for the return home during hospitalization. Strategies seeking to improve critical care outcomes are highly suggested to be implemented in this population.


Subject(s)
Humans , Male , Female , Aged, 80 and over , Patient Discharge , Health of the Elderly , Critical Care Outcomes , Personal Autonomy , Qualitative Research , Functional Status , Intensive Care Units , Length of Stay
2.
Esc. Anna Nery Rev. Enferm ; 26: e20210040, 2022. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1339880

ABSTRACT

Resumo Objetivo analisar a percepção dos pais sobre as práticas de educação em saúde desenvolvidas pelos enfermeiros na Unidade Neonatal que facilitaram a aquisição de competências parentais para uma tomada de decisão fundamentada. Método estudo exploratório e descritivo, com abordagem qualitativa. Participaram 13 pais com filhos internados, pela primeira vez, em uma Unidade Neonatal portuguesa. Os dados foram colhidos entre fevereiro e agosto de 2020, por meio de grupos focais, processados no software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires, através da Classificação Hierárquica Descendente e da Análise de Similitude. Resultados da Classificação Hierárquica Descendente, emergiram quatro classes: "Necessidades de informação", "Lacunas na informação", "Disponibilidade para informar"; "Práticas facilitadoras da educação em saúde". Conclusão e implicações para a prática os pais consideraram como práticas facilitadoras da educação em saúde a tecnologia digital aliada à disponibilidade dos enfermeiros para informar e explicar, bem como propiciar um ambiente empático e informal. Tal resultado pode subsidiar o desenvolvimento de intervenções de enfermagem de educação em saúde para pais na Unidade Neonatal, com recurso à tecnologia digital.


Resumen Objetivo analizar la percepción de los padres sobre las prácticas de educación en salud desarrolladas por enfermeras de la Unidad Neonatal que facilitaron la adquisición de habilidades parentales para la toma de decisiones informada. Método estudio exploratorio descriptivo, con abordaje cualitativo. Participaron 13 padres con hijos hospitalizados, por primera vez, en una Unidad Neonatal Portuguesa. Los datos fueron recolectados entre febrero y agosto de 2020, a través de grupos focales, procesados en el software Interface de R pour Multidimensionnelles de Textes et de Questionneires, a través de la Clasificación Jerárquica Descendente y el Análisis de Similitud. Resultados surgieron cuatro clases de la Clasificación Jerárquica Descendente: "Necesidades de información"; "Brechas de información"; "Disponibilidad para informar"; "Prácticas facilitadoras de la educación para la salud". Conclusión e implicaciones para la práctica los padres consideraron prácticas facilitadoras para la educación en salud la tecnología digital combinada con la disponibilidad de enfermeras para informar y explicar, además de brindar un ambiente empático e informal. Este resultado puede apoyar el desarrollo de intervenciones de enfermería de educación para la salud para los padres en Unidad Neonatal, con el uso de tecnología digital.


Abstract Objective to analyze parents' perception of health education practices developed by nurses in a Neonatal Unit that facilitated the acquisition of parenting skills for an informed decision-making. Method this is an exploratory, descriptive and qualitative study. We included 13 parents with children hospitalized for the first time in a Portuguese Neonatal Unit. Data were collected between February and August 2020, through focus groups, processed in the software Interface de R pour Multidimensionnelles de Textes et de Questionneires, through Descending Hierarchical Classification and Similitude Analysis. Results four classes emerged from the Descending Hierarchical Classification: "Information needs"; "Information gaps"; "Availability to inform"; "Facilitating health education practices". Conclusion and implications for practice parents considered digital technology combined with nurses' availability to inform and explain, as well as provide an empathetic and informal environment as facilitating practices for health education. These results can support health education nursing interventions for parents at the Neonatal Units using digital technology.


Subject(s)
Humans , Male , Female , Infant, Newborn , Adult , Parents/psychology , Intensive Care Units, Neonatal , Health Education , Health Literacy , Nurses , Pamphlets , Communication , Decision Making , Qualitative Research , Digital Technology , Length of Stay , Nurse-Patient Relations , Nursing Care/psychology
3.
Esc. Anna Nery Rev. Enferm ; 26: e20210203, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1339876

ABSTRACT

RESUMO Objetivo analisar as características individuais, clínicas e os fatores associados à mortalidade de pacientes com COVID-19, em hospital público do estado do Paraná, Brasil. Métodos estudo seccional, retrospectivo, documental (n= 86), com pacientes adultos internados, de março a junho de 2020. Resultados a mortalidade foi de 12,8%, o grupo de maior risco foi de idosos com comorbidades, especialmente, cardiovasculares. A chance de óbito foi 58 vezes maior em idosos, comparada aos adultos, e oito vezes maior naqueles com comorbidades, comparadas aos hígidos. A maioria dos pacientes apresentou sintomatologia respiratória, febre e mialgia. Tratamento à base de antibióticos, anticoagulantes e antivirais, associado ao suporte ventilatório. As principais complicações foram hipóxia, insuficiência renal aguda e infecção secundária. Conclusão e implicações para a prática idosos com comorbidades cardiovasculares que necessitaram de cuidados intensivos apresentaram maior chance de óbito. Os resultados de um dos centros de referência na pandemia possibilitam discutir medidas epidemiológicas adotadas, com ênfase em conceitos restritivos nos primeiros meses.


RESUMEN Objetivo analizar las características individuales, clínicas y los factores asociados a la mortalidad en pacientes con COVID-19 en un hospital público del estado de Paraná. Métodos estudio transversal, retrospectivo, documental (n = 86), con pacientes adultos hospitalizados, de marzo a junio de 2020. Resultados la mortalidad fue del 12,8%, grupo de mayor riesgo para los ancianos con comorbilidades, especialmente enfermedades cardiovasculares. La probabilidad de muerte fue 58 veces mayor en los ancianos en comparación con los adultos y ocho veces mayor en aquellos con comorbilidades en comparación con los sanos. La mayoría de los pacientes presentaban síntomas respiratorios, fiebre y mialgia. Tratamiento a base de antibióticos, anticoagulantes y antivirales, asociado al soporte ventilatorio. Las principales complicaciones fueron hipoxia, insuficiencia renal aguda e infección secundaria. Conclusión e implicaciones para la práctica los ancianos con comorbilidades cardiovasculares que requirieron cuidados intensivos tenían una mayor probabilidad de muerte. Los resultados de uno de los centros de referencia pandémica permiten discutir las medidas epidemiológicas adoptadas, con énfasis en conceptos restrictivos en los primeros meses.


ABSTRACT Objective to analyze the individual and clinical characteristics and the factors associated with mortality in patients with COVID-19, in a public hospital in the state of Paraná, Brazil. Methods a cross-sectional, retrospective, documentary study (n= 86), with adult inpatients, from March to June 2020. Results mortality was 12.8%, the highest risk group was the elderly with comorbidities, especially cardiovascular ones. The chance of death was 58 times higher in the elderly compared to adults, and eight times higher in those with comorbidities compared to the healthy ones. Most patients presented with respiratory symptoms, fever, and myalgia. Treatment was based on antibiotics, anticoagulants and antivirals, associated with ventilatory support. The main complications were hypoxia, acute renal failure, and secondary infection. Conclusion and implications for practice elderly people with cardiovascular comorbidities who required intensive care had a higher chance of death. The results from one of the reference centers in the pandemic make it possible to discuss epidemiological measures adopted, with emphasis on restrictive concepts in the first months.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Health Profile , Death , SARS-CoV-2 , COVID-19/mortality , Respiration, Artificial , Cardiovascular Diseases , Comorbidity , Medical Records , Retrospective Studies , Risk Factors , Azithromycin/therapeutic use , COVID-19/drug therapy , Intensive Care Units , Length of Stay
4.
Enferm. foco (Brasília) ; 12(4): 682-687, dez. 2021. tab, ilus
Article in Portuguese | LILACS, BDENF | ID: biblio-1353064

ABSTRACT

Objetivo: Analisar a sobrevida e os fatores associados à mortalidade de pacientes com internações de longa permanência. Método: Estudo transversal, a partir de registros dos pacientes que tiveram internação de longa permanência, em hospital de alta complexidade, pelo Sistema Único de Saúde, de 2014 a 2017, com exclusão das reinternações. Utilizou-se a Regressão de Cox para identificação dos fatores associados à mortalidade. Dentre os pacientes internados na Unidade de Terapia Intensiva aplicou-se a curva Roc para determinar o ponto de corte do dia de maior risco de óbito. Resultados: Foram identificadas 1.209 internações de longa permanência resultando em prevalência de 7,3%. Do total de pacientes de longa permanência, 50,3% foram a óbito, a maioria com idade superior a 60 anos, com doenças do aparelho circulatório (40%). Os fatores associados à mortalidade dos pacientes com internação de longa permanência foram: ser idoso (HR=2,31; IC95%:1,89-2,81; p<0,001); internação clínica (HR=1,82; IC95%: 1,54-2,15; p<0,001) e internação em UTI (HR=12,41; IC95%: 6,74-22,8; p<0,001). A mortalidade dos pacientes que foram internados na Unidade de Terapia Intensiva foi significativamente maior a partir do nono dia (p = 0,036). Conclusão: Verificou-se uma alta taxa de mortalidade em pacientes com internação de longa permanência, principalmente, entre idosos com doenças crônico-degenerativas e em cuidados paliativos. (AU)


Objective: To analyze the survival time and factors associated with the mortality of patients with long-stay hospitalizations in a hospital of high complexity. Methods: Cross-sectional study. We included records of patients who had long-term hospitalization for the Unified Health System between 2014 and 2017, excluding rehospitalizations. Cox Regression was used to identify the factors associated with mortality. Still, among the patients who were admitted to the intensive care unit, the Roc curve was used to determine the cutoff point to identify the day on which the patients had a higher risk of death. Results: 1,209 long-stay hospitalizations were identified, resulting in a prevalence of 7.3%. Of the total long-stay patients, 50.3% died. The majority were over 60 years old, with diseases of the circulatory system (40%). The factors associated with the mortality of patients with long-term hospitalization were: elderly (HR = 2.31; 95% CI: 1.89-2.81); clinical hospitalization (HR = 1.82, 95% CI: 1.54-2.15); ICU admission (HR = 12.41, 95% CI: 6.74-22.8). Mortality of patients admitted to the intensive care unit was significantly higher after the ninth day (p = 0.036). Conclusion: There was a high mortality rate in patients with long-term hospitalization, mainly among elderly people with chronic degenerative diseases and in palliative care. (AU)


Objetivo: Analizar la supervivencia y los factores asociados a la mortalidad en pacientes con hospitalizaciones de larga duración. Métodos: Estudio transversal, basado en registros de pacientes que tuvieron hospitalización de larga duración en un hospital de alta complejidad, a través del Sistema Único de Salud, de 2014 a 2017, excluyendo reingresos. Se utilizó la regresión de Cox para identificar los factores asociados con la mortalidad. Entre los pacientes ingresados en la Unidad de Cuidados Intensivos se aplicó la curva de Roc para determinar el punto de corte del día con mayor riesgo de muerte. Resultados: Se identificaron 1.209 hospitalizaciones de larga duración, lo que resultó en una prevalencia del 7,3%. Del total de pacientes de larga evolución falleció el 50,3%, la mayoría mayores de 60 años, con enfermedades del sistema circulatorio (40%). Los factores asociados a la mortalidad de los pacientes con hospitalización de larga duración fueron: anciano (HR=2,31; IC95%:1,89-2,81); hospitalización clínica (HR=1,82; IC95%: 1,54-2,15) e ingreso a una unidad de cuidados intensivos (HR=12,41; IC95%: 6,74-22,8). Conclusion: La mortalidad de los pacientes que ingresaron en la Unidad de Cuidados Intensivos fue mayor a partir del noveno día (p=0,036). Se identificó una alta tasa de mortalidad en pacientes con hospitalización de larga duración, especialmente entre personas mayores con enfermedades crónico-degenerativas y en cuidados paliativos. (AU)


Subject(s)
Hospital Mortality , Intensive Care Units , Length of Stay
5.
Medicina (B.Aires) ; 81(5): 703-714, oct. 2021. graf
Article in Spanish | LILACS | ID: biblio-1351041

ABSTRACT

Resumen Se realizó un registro multicéntrico que incluyó personas adultas internadas por COVID-19 en varias provincias de la Argentina, desde marzo a octubre de 2020. Los objetivos fueron describir las características epidemiológicas, manifestaciones clínicas, tratamientos, complicaciones y factores de riesgo, necesidad de admisión a unidades de cuidados críticos y mortalidad. El registro incluyó información de 4776 pacientes, en 37 centros de salud de Argentina. El 70.2% provenían de la ciudad de Buenos Aires y la provincia de Buenos Aires. El 52.3% eran hombres. La media de edad fue de 56 años (DE 20.3). Un 13.1% de pacientes manifestó ser personal de salud. La mediana de tiempo de síntomas al momento de la internación fue de 3 días (IC 1-6). Las comorbilidades más frecuentes fueron hipertensión arterial en 32.4% y diabetes mellitus en 15.8%. Los síntomas más frecuentes fueron: tos 58%, odinofagia 23.3%, mialgias 20.5% y fiebre/febrícula 19.9%. La estadía hospitalaria tuvo una mediana de internación de 8 días (IC 4-15). El 14.8% de los pacientes requirió cuidados críticos, en tanto que el 3.2%, que también lo requería, no pasó a unidad cerrada por adecuación del esfuerzo terapéutico. Las complicaciones más frecuentes en cuidados críticos fueron: eventos cardiovasculares (54.1%), shock séptico (33.3%), insuficiencia renal (9.7%) y neumonía asociada a la ventilación mecánica (12.5%). La mortalidad global fue del 12.3%. La edad avanzada, demencia y EPOC se comportaron como predictores independientes de mortalidad (p < 0.001, 0.007 y 0.002 respectivamente) en el análisis multivariado.


Abstract A multicenter registry that in cluded adults hospitalized for COVID-19 was carried out in various provinces of Argentina, from March to October 2020. The objectives were to describe the epidemiological characteristics, clinical manifestations, treatments, complications and risk factors, need for admission to critical care units and mortality. The registry included information on 4776 patients in 37 health centers in Argentina. Of them, 70.2% came from the city of Buenos Aires and from Buenos Aires Province; 52.3% were men. The mean age was 56 years (SD 20.3). Of them, 13.1% stated that they were health personnel. The median time of symptoms at the time of hospitalization was 3 days (CI 1-6). The most frequent comorbidities were hypertension in 32.4% and diabetes mellitus in 15.8%. The most frequent symptoms were: cough 58%, odynophagia 23.3%, myalgia 20.5% and fever / low-grade fever 19.9%. The hospital stay had a median of 8 days (CI 4-15). A 14.8% of the patients required critical care, while 3.2% who also required it, were not transferred to a closed unit due to adequacy of the thera peutic effort. The most frequent complications in critical care were: cardiovascular events (54.1%), septic shock (33.3%), renal failure (9.7%) and pneumonia associated with mechanical ventilation (12.5%). Overall mortality was 12.3%. Old age, dementia and COPD behaved as independent predictors of mortality (p < 0.001, 0.007 and 0.002 respectively) in the multivariate analysis.


Subject(s)
Humans , Male , Adult , Middle Aged , COVID-19 , Registries , SARS-CoV-2 , Hospitalization , Length of Stay
6.
Rev. patol. trop ; 50(2): 1-20, jun. 2021. ilus
Article in English | LILACS | ID: biblio-1254419

ABSTRACT

Myasthenia gravis (MG) is an autoimmune disease involving neuromuscular transmission and possible respiratory failure when concomitant with COVID-19. The aim of this study was to analyze the need for ventilatory support (VS), length of hospital stay (LOS) and mortality in patients diagnosed with MG and COVID-19. In this systematic review, PubMed, SciELO, LILACS, MEDLINE and IBECS databases were searched for primary studies published from January 2010 to March 2021, with no language restrictions. Fourteen eligible studies were identified. The main factor associated with the need for VS was the use of antibiotics other than azithromycin (AZM) for the treatment of COVID-19 (RR 1.60; 95% CI 1.20­2.91; p = 0.009). Patients who used hydroxychloroquine (HCQ) and AZM had almost twice the risk of needing invasive ventilatory support (IVS) (RR 1.94; 95% CI 1.07-3.52; p = 0.16). There were nonsignificant trends towards less need for IVS in patients who used intravenous immunoglobulin (IVIg) and corticosteroid therapy (RR 0.54; 95% CI 0.09­3.26; p = 0.60). There was a trend towards shorter LOS in patients who received therapy with IVIg and corticosteroid therapy [8 (5 - 8) vs 19 (12.2­23.7); p = 0.007]. 10.3% (n = 4/39) died and 100% did not use IVIg or IVIg and prednisone. There was a non-significant trend towards higher mortality in patients who used AZM (RR 2.55; 95% CI 0.26­30.02; p = 0.60). IVIg and corticotherapy presented themselves as a favorable alternative in relation to the outcomes. KEY WORDS: Coronavirus infections; length of stay; Myasthenia gravis; Respiratory insufficiency.


Subject(s)
Humans , Mortality , Coronavirus , Interactive Ventilatory Support , Length of Stay , Myasthenia Gravis
7.
Fisioter. Bras ; 22(2): 120-131, Maio 25, 2021.
Article in Portuguese | LILACS | ID: biblio-1284085

ABSTRACT

Introdução: A imobilidade no leito de pacientes em unidades de terapia intensiva (UTI) favorece o maior tempo de permanência na unidade. Objetivos: Comparar a funcionalidade na admissão e na alta da UTI segundo a especialidade médica e correlacionar a funcionalidade na alta com o tempo de internação na UTI. Métodos: Estudo exploratório, longitudinal, realizado na UTI Geral de um hospital escola. Os pacientes foram divididos em grupos de acordo com a especialidade de internação: neurologia, pneumologia, gastroenterologia, politrauma e outros. O estado funcional prévio à internação foi obtido por meio da medida de independência funcional (MIF). Na alta foi aplicada a escala de mobilidade funcional em UTI (EMU). Resultados: Amostra de 174 pacientes, 53% do sexo masculino. O grupo politrauma apresentou idade significativamente menor que os outros grupos (p < 0,0001). O tempo médio de internação para os grupos neurologia e pneumologia apresentou correlação inversamente proporcional com p = 0 ,02 / r = -0,5 e p = 0,009 / r = - 0,4 respectivamente. Não houve diferença significativa entre as médias da MIF na admissão (p = 0,11) e da EMU na alta (p = 0,24) entre as especialidades médicas em que os pacientes foram admitidos. Conclusão: Quanto maior o tempo de internação na UTI, menor a funcionalidade na alta em pacientes neurológicos e pneumopatas. (AU)


Introduction: Patients on bed rest in intensive care units (ICU) prolong length of stay in the unit. Objectives: To compare ICU admission and discharge functionality according to medical specialty, and to correlate ICU discharge functionality with ICU length of stay. Methods: Longitudinal exploratory study, performed at the General ICU of a teaching hospital. The patients were divided into groups according to the hospitalization specialty: neurology, pneumology, gastroenterology, polytrauma and others. The functional status prior to hospitalization was obtained through the functional independence measure (FIM). At discharge, the ICU functional mobility scale (FMS) was applied. Results: A sample of 174 patients, 53% male. The polytrauma group was significantly younger than the other groups (p < 0.0001). The mean length of stay for the neurology and pneumology groups was inversely proportional to p = 0.02 / r = -0.5 and p = 0.009 / r = -0.4, respectively. There was no significant difference between the mean FIM at admission (p = 0.11) and FMS at discharge (p = 0.24) between the medical specialties at which patients were admitted. Conclusion: The longer the patient stays in the IC, the lower functionality at discharge in neurological and lung disease patients. (AU)


Subject(s)
Humans , Intensive Care Units , Length of Stay , Patient Discharge , Physical Therapy Modalities , Mobility Limitation
8.
Rev. colomb. cardiol ; 28(2): 113-118, mar.-abr. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1341272

ABSTRACT

Resumen Introducción:: La falla cardiaca aguda es un motivo frecuente de consulta a urgencias, genera estancias hospitalarias prolongadas y altos costos para el sistema de salud. Objetivo: Determinar los factores asociados a estancia hospitalaria prolongada en pacientes hospitalizados por falla cardiaca aguda en un hospital universitario. Métodos: Estudio de cohorte retrospectivo, se incluyeron pacientes adultos con falla cardiaca aguda. Se obtuvieron variables demográficas, comorbilidades y resultados de laboratorios de rutina. Se definió hospitalización prolongada, como una estancia mayor a 5 y 10 días respectivamente. Resultados: Un total de 776 pacientes fueron incluidos en el análisis, 56% eran hombres, el promedio de edad fue de 71.5 años, fracción de eyección de 39.8%. Los factores asociados con estancia hospitalaria prolongada fueron: edad, elevación de troponina, hiperglucemia y albúmina < 3 g/dl. Para el corte de 10 días adicionalmente se identificaron: presión arterial sistólica, frecuencia cardiaca y elevación de péptidos natriuréticos. Conclusiones: La evaluación integral de variables clínicas y resultados de laboratorio es útil para identificar pacientes con mayor riesgo de estancias hospitalarias prolongadas.


Abstract Introduction: Acute heart failure is a frequent reason for consulting to emergency department, it generates long hospital stays and high costs for the health system. Objective: To determine the associated factors with prolonged hospital stay in patients hospitalized for acute heart failure in a teaching hospital. Methods: Retrospective cohort study, adult patients with acute heart failure were included. Demographic variables, comorbidities, and routine laboratory results were obtained. Prolonged hospitalization was defined as a stay greater than 5 and 10 days, respectively. Results: A total of 776 patients were included in the analysis, 56% were men, the mean age was 71.5 years, and ejection fraction was 39.8%. Factors associated with prolonged hospital stay were: age, elevated troponin, hyperglycemia, and albumin < 3 g/dl. For the 10-day cut-off, additionally, systolic blood pressure, heart rate and elevation of natriuretic peptides were identified. Conclusions: Comprehensive evaluation of clinical variables and laboratory results is useful to identify patients at increased risk for prolonged hospital stays.


Subject(s)
Humans , Animals , Male , Aged , Hospital Care , Heart Failure , Risk , Costs and Cost Analysis , Hospitalization , Length of Stay
9.
Rev. cuba. cir ; 60(1): e1033, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289375

ABSTRACT

Introducción: En el mundo moderno, el traumatismo es la primera causa de mortalidad y discapacidad en menores de 35 años. Múltiples son los esfuerzos para tratar de definir su pronóstico desde el momento en que se produce. Con el decurso de los años se han creado varias escalas, para describir la gravedad de las lesiones, las alteraciones fisiológicas que se producen, así como para evaluar los sistemas de atención. Objetivo: Describir el comportamiento de los lesionados en el Hospital "Calixto García" según variables. Métodos: Se realizó un estudio observacional descriptivo, prospectivo y longitudinal en 1582 lesionados atendidos en el servicio de Cirugía General. Resultados: El intervalo trauma/ingreso superó los 60 minutos en un número elevado y la mitad de ellos presentó parámetros clínicos de inestabilidad hemodinámica en la recepción; se logró su compensación en la primera hora de admitidos en 7 de cada 10 lesionados. Más de la mitad desarrolló alguna complicación y predominó la estadía hospitalaria entre 15 y 21 días. Conclusiones: Algunas de las variables estudiadas se comportaron similar a la literatura consultada. Los resultados sugieren la necesidad de implementar un programa de atención prehospitalaria al lesionado más efectivo para mejorar la atención y el índice de sobrevida en los mismos(AU)


Introduction: In the modern world, trauma is the leading cause of death and disability in people under 35 years of age. Multiple efforts are made to define its prognosis from the moment it occurs. Over the years, several scales have been created to describe the severity of injuries, the physiological changes that occur, as well as to assess care systems. Objective: To describe the behavior of injured patients in Calixto García Hospital according to variables. Methods: A observational, descriptive, prospective and longitudinal study was carried out with 1582 injured patients treated in the general surgery service. Results: The trauma/admission interval exceeded sixty minutes in a high number of cases. Half of them presented clinical parameters of hemodynamic instability at admission. Compensation was achieved at the first hour of admission in seven out of ten injured patients. More than half the patients developed some complication. There was a predomination of hospital stay between 15 and 21 days. Conclusions: Some of the variables studied behaved similarly to the way described in the consulted literature. The results suggest the need to implement a more effective prehospital care program for the injured patients to improve care and survival rate(AU)


Subject(s)
Humans , Wounds and Injuries/complications , Prehospital Care , Reference Parameters/methods , Length of Stay , Epidemiology, Descriptive , Survival Rate , Prospective Studies , Longitudinal Studies , Observational Studies as Topic
10.
Acta méd. colomb ; 46(1): 7-13, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1278149

ABSTRACT

Resumen Objetivo: analizar los factores asociados con estancia hospitalaria prolongada en una unidad geriátrica de agudos de un hospital general. Material y métodos: incluyó 2014 pacientes ≥60 años hospitalizados entre enero 2012 y septiembre 2015. La variable dependiente fue la estancia hospitalaria prolongada (>10 días vs ≤10 días). Variables independientes incluyeron las sociodemográficas, de laboratorio, comorbilidad, estado funcional y mental. Para análisis bivariado se empleó la prueba de chi 2 para variables categóricas y de Wilcoxon Two-Sample no-paramétrico para las cuantitativas. Se realizó un modelo multivariado de regresión logística. Resultados: el 51.1% fueron mujeres y la edad promedio fue 82.3 ± 7.2 años. El promedio de estancia fue 14.7 ± 14 días y la mediana fue de 10.6 días. El 50.6% tuvieron estancia prolongada. Aquellos con estancia hospitalaria prolongada se caracterizaron por presentar dependencia funcional, anemia, comorbilidad (Indice de Charlson ≥4), hipoalbuminemia, niveles elevados de reactantes de fase aguda (PCR), y ulceras por presión. Las mujeres tuvieron menos días de hospitalización. La estancia prolongada no se relacionó con las variables sociales. Conclusión: los principales factores independientes en aumentar la estancia hospitalaria son las ulceras por presión, la dependencia funcional, la hipoalbuminemia, la comorbilidad y los niveles elevados de PCR.


Abstract Objective: to analyze the factors associated with prolonged hospital stay in the Acute Geriatric Unit of a general hospital. Materials and methods: the study included 2,014 patients ≥60 years old who were hospitalized between January 2012 and September 2015. The dependent variable was prolonged hospital stay (>10 days vs ≤10 days). The independent variables included sociodemographic, laboratory, comorbidity, and functional and mental status variables. The Chi 2 test for categorical variables and the non-parametric two-sample Wilcoxon test for quantitative variables were employed for bivariate analysis. A multivariate logistic regression model was run. Results: 51.1% of the study subjects were women and the average age was 82.3 ± 7.2 years. The average length of stay was 14.7 ± 14 days, and the median was 10.6 days. Altogether, 50.6% had a prolonged stay. Those with prolonged hospital stay were characterized by having functional dependence, anemia, comorbidity (Charlson Index ≥4), hypoalbuminemia, high levels of acute phase reactants (CRP), and pressure sores. Women had fewer inpatient days. Prolonged length of stay was not related to the social variables. Conclusion: the main independent factors increasing hospital stay are pressure sores, functional dependence, hypoalbuminemia, comorbidity and elevated CRP levels.


Subject(s)
Humans , Female , Aged , Geriatrics , Patients , Aged , Homes for the Aged , Hospital Units , Length of Stay
11.
Int. braz. j. urol ; 47(1): 64-70, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1134304

ABSTRACT

ABSTRACT Purpose: We aimed to compare the success and complication rates of the anterograde and retrograde Ureterorenoscopy (URS) for impacted upper ureteral stones in patients > 65 years of age. Materials and Methods: Data of 146 patients >65 years of age and underwent anterograde URS (n=68) in supine position or retrograde URS (n=78) for upper ureteral impacted stones>10 mm between January 2014 and September 2018 were collected prospectively. The groups were compared for success and complication rates, duration of operation, hospital stay, and ancillary procedures. Results: Anterograde and retrograde URS groups were similar for demographic and stone related characteristics. The success rate of the anterograde URS group was significantly higher than the retrograde URS group (97.1% vs. 78.2%, p=0.0007). The complication rates were similar for the two groups (p=0.86). Clavien grade I and II complications were observed in 3 patients in each group. The mean hemoglobin drop was 0.5 g/dL in the anterograde URS group and blood transfusion was not performed in any of the patients. The mean duration of operation was 41.2±12.5 minutes in the mini-PNL group and 59.6±15.1 minutes in the RIRS group and the difference was statistically significant (p=0.02). The median duration of hospitalization was 1 day for both groups. Conclusions: Performing anterograde URS in supine position provided better success rates and similar complication rates compared to retrograde URS. Based on these results anterograde URS shall be considered as one of the primary treatment options for management of impacted upper ureteral stones in the elderly population.


Subject(s)
Humans , Aged , Lithotripsy , Ureteral Calculi/surgery , Retrospective Studies , Treatment Outcome , Ureteroscopy , Length of Stay
12.
Arch. argent. pediatr ; 119(1): 25-31, feb. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1147076

ABSTRACT

Introducción: Los pacientes hospitalizados con altas dependencias tecnológicas respiratorias son cada vez más frecuentes y generan largas estadías en unidades de cuidados intensivos. Las estrategias que mitiguen su impacto han sido escasamente descritas. Objetivo: Describir 6 años de experiencia de una Unidad de Ventilación Mecánica Prolongada Pediátrica.Métodos: Estudio retrospectivo. Se incluyeron todos los niños ingresados a la Unidad entre 10-2012 y 12-2018. Se realizó estadística descriptiva e inferencial, analizando tiempos de hospitalización y reingresos. Se compararon distintas variables según tipo de patología y ventilación mecánica.Resultados: 113 pacientes registraron 310 ingresos a la Unidad. Edad de ingreso: 2,2 años (0,6-8,8); varones: el 60,2 %. Patologías: enfermedad neuromuscular (el 22,1 %), enfermedad pulmonar crónica (el 20,4 %), daño neurológico (el 34,5 %), obstrucción de vía aérea superior (el 9,7 %), cardiopatía (el 3,5 %), síndrome de Down (el 9,7 %). Se utilizaron 10 507 días/cama; con índice ocupacional del 92,6 %, el 54,8 % de traslados a la Unidad de Cuidados Intensivos y el 66,1 % de reingresos. Hospitalización media: 16 días (6,5-49,0); diferencias en edad de ingreso según patologías (p = 0,032). Hubo más reingresos en niños con daño neurológico y síndrome de Down (p = 0,004). Los niños con asistencia ventilatoria invasiva presentaron más días de hospitalización (p < 0,001) y reingresos (p < 0,001).Conclusión: El índice ocupacional fue superior al 90 %; permitió mayor disponibilidad de camas intensivas y egresar a todos los pacientes. Los niños con asistencia ventilatoria invasiva se hospitalizaron más tiempo y reingresaron más


Introduction: Hospitalized patients with high respiratory technology dependency are increasingly common and result in lengthy stays in intensive care units. Strategies mitigating its impact have been scarcely described.Objective: To describe a 6-year experience in a Pediatric Prolonged Mechanical Ventilation Unit.Methods: Retrospective study. All children admitted to the unit between October 2012 and December 2018 were included. Descriptive and inferential statistical methods were used, analyzing lengths of stay and readmissions. Different outcome measures were compared according to the type of pathology and mechanical ventilation.Results: A total of 113 patients had 310 admissions to the unit. Age at admission: 2.2 years (0.6-8.8); males: 60.2 %. Pathologies: neuromuscular disease (22.1 %), chronic lung disease (20.4 %), neurological damage (34.5 %), upper airway obstruction (9.7 %), heart disease (3.5 %), Down syndrome (9.7 %). A total of 10 507 bed-days were used; with a 92.6 % occupancy rate, 54.8 % of transfers to the intensive care unit, and 66.1 % of readmissions. Mean length of stay: 16 days (6.5-49.0); differences in age at admission observed by pathology (p = 0.032). More readmissions were observed in children with neurological damage and Down syndrome (p = 0.004). Children with invasive ventilation were observed to have a longer length of stay (p < 0.001) and more readmissions (p < 0.001).Conclusion: The occupancy rate at the PMVU was over 90 %, which allowed more available intensive care beds and discharging all patients. Children with invasive ventilation had a longer length of stay and more readmissions.


Subject(s)
Humans , Male , Female , Child, Preschool , Respiration, Artificial , Respiratory Care Units/statistics & numerical data , Respiratory Insufficiency , Pediatrics , Chile , Chronic Disease , Epidemiology, Descriptive , Retrospective Studies , Home Nursing , Length of Stay
13.
Rev. bras. cir. cardiovasc ; 36(1): 57-63, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1155802

ABSTRACT

Abstract Introduction: To determine predictors of length of stay (LOS) in the intensive care unit (ICU) after coronary artery bypass grafting (CABG) and to develop a risk scoring system were the objectives of this study. Methods: In this retrospective study, 1202 patients' medical records after CABG were evaluated by a research-made checklist. Tarone-Ware test was used to determine the predictors of patients' LOS in the ICU. Cox regression model was used to determine the risk factors and risk ratios associated with ICU LOS. Results: The mean ICU LOS after CABG was 55.27±17.33 hours. Cox regression model showed that having more than two chest tubes (95% confidence interval [CI] 1.005-1.287, Relative Risk [RR]=1.138), occurrence of atelectasis (95% CI 1.000-3.007, RR=1.734), and occurrence of atrial fibrillation after CABG (95% CI 1.428-2.424, RR=1.861) were risk factors associated with longer ICU LOS. The discrimination power of this set of predictors was demonstrated with an area under the receiver operating characteristic curve and it was 0.69. A simple risk scoring system was developed based on three identified predictors that can raise ICU LOS. Conclusion: The simple risk scoring system developed based on three identified predictors can help to plan more accurately a patient's LOS in hospital for CABG and can be useful in managing human and financial resources.


Subject(s)
Humans , Coronary Artery Bypass , Intensive Care Units , Retrospective Studies , Risk Factors , Length of Stay
14.
Article in Chinese | WPRIM | ID: wpr-879426

ABSTRACT

OBJECTIVE@#To analyze the short-term prognosis of elderly patients with hip fracture after operation, and to explore the main factors affecting the recovery of daily life function.@*METHODS@#From November 2015 to November 2016, 130 elderly patients with hip fracture were analyzed, including 43 males and 87 females, aged from 60 to 95 (77.54±8.49) years. The death, fall and complications were recorded 3 months after operation. The daily life function of the patients was followed up 3 months after operation with the functional recovery of daily life scale (FRS). T-test, analysis of variance and single factor linear regression analysis were used to analyze the general clinical data. The factors with @*RESULTS@#Among 130 patients, 7 died (5.4%), 4 fell (3.1%), 103 (79.2%) had postoperative complications, and the FRS score of 123 patients was 65.92±22.79. The results showed that gender, age, fracture site, pre fracture Basel rating, frailty index, postoperative hospital stay and total number of postoperative complications had significant differences in the recovery of daily life function (@*CONCLUSION@#The short term rehabilitation level of elderly patients with hip fracture after operation is poor. Basel rating before fracture, frailty index, postoperative hospital stay and total number of postoperative complications may be related risk factors affecting the recovery of daily life function of patients after operation.


Subject(s)
Activities of Daily Living , Aged , Female , Hip Fractures/surgery , Humans , Length of Stay , Male , Postoperative Complications , Postoperative Period , Risk Factors
15.
Article in Chinese | WPRIM | ID: wpr-878722

ABSTRACT

Objective To evaluate the efficacy and risks of autologous blood patch pleurodesis in patients with persistent air leak(PAL)after lung resection. Methods A total of 97 patients with PAL after lung resection in Beijing Shijitan Hospital from October 2014 to October 2019 were retrospectively reviewed,including 53 treated by autologous blood patch pleurodesis and 44 by the conventional way.The therapeutic effect,adverse reactions and complications were analyzed. Results All the patients with PAL were cured with autologous blood patch pleurodesis.Most air leaks(81.1%)ceased within 48 hours after treatment,and the left 18.9% patients got cured after a repeat.The mean tube retention time and the mean in-hospital stay were 8.4 days and 10.0 days in the autologous blood patch pleurodesis group and 13.5 days and 15.3 days in the conventional treatment group.A prolonged drainage time(P=0.00)and in-hospital stay(P=0.00)were observed in the conventional treatment group.No severe complications were observed except two patients developed slight fever and cutaneous emphysema. Conclusion In our experience,the autologous blood patch pleurodesis is an effective way with low risk of adverse reactions in the treatment of PAL.


Subject(s)
Drainage , Humans , Length of Stay , Lung , Pleurodesis , Retrospective Studies
16.
Chinese Medical Journal ; (24): 1209-1214, 2021.
Article in English | WPRIM | ID: wpr-878127

ABSTRACT

BACKGROUND@#The optimal treatment for large impacted proximal ureteral stones remains controversial. The aim of this study was to evaluate the efficacy, safety, and potential complications of mini-percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of impacted proximal ureteral stones with size greater than 15 mm.@*METHODS@#A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019. Data on surgical outcomes and complications were collected and analyzed.@*RESULTS@#Demographic and ureteral stone characteristics found between these two groups were not significantly different. The surgical success rate (139/142, 97.9% vs. 121/126, 96.0%, P = 0.595) and stone-free rate after 1 month (139/142, 97.9% vs. 119/126, 94.4%, P = 0.245) of RPLU group were marginally higher than that of the MPCNL group, but there was no significant difference. There was no significant difference in the drop of hemoglobin between the two groups (0.8 ± 0.6 vs. 0.4 ± 0. 2 g/dL, P = 0.621). The mean operative time (68.2 ± 12.5 vs. 87.2 ± 16.8 min, P = 0.041), post-operative analgesics usage (2/121, 1.7% vs. 13/139, 9.4%, P = 0.017), length of hospital stay after surgery (2.2 ± 0.6 vs. 4.8 ± 0.9 days, P < 0.001), double J stent time (3.2 ± 0.5 vs. 3.9 ± 0.8 days, P = 0.027), time of catheterization (1.1 ± 0.3 vs. 3.5 ± 0.5 days, P < 0.001), and time of drainage tube (2.3 ± 0.3 vs. 4.6 ± 0.6 days, P < 0.001) of MPCNL group were significantly shorter than that of the RPLU group. The complication rate was similar between the two groups (20/121, 16.5% vs. 31/139, 22.3%, P = 0.242).@*CONCLUSIONS@#MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm, while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.


Subject(s)
Humans , Laparoscopy , Length of Stay , Nephrolithotomy, Percutaneous/adverse effects , Retroperitoneal Space/surgery , Treatment Outcome , Ureteral Calculi/surgery
17.
Journal of Integrative Medicine ; (12): 226-231, 2021.
Article in English | WPRIM | ID: wpr-881014

ABSTRACT

OBJECTIVE@#To observe the early interventions of traditional Chinese Medicine (TCM) on the conversion time of nucleic acid in patients with coronavirus disease 2019 (COVID-19), and find possible underlying mechanisms of action.@*METHODS@#A retrospective cohort study was conducted on 300 confirmed COVID-19 patients who were treated with TCM, at a designated hospital in China. The patients were categorized into three groups: TCM1, TCM2 and TCM3, who respectively received TCM interventions within 7, 8-14, and greater than 15 days of hospitalization. Different indicators such as the conversion time of pharyngeal swab nucleic acid, the conversion time of fecal nucleic acid, length of hospital stay, and inflammatory markers (leukocyte count, and lymphocyte count and percentage) were analyzed to observe the impact of early TCM interventions on these groups.@*RESULTS@#The median conversion times of pharyngeal swab nucleic acid in the three groups were 5.5, 7 and 16 d (P < 0.001), with TCM1 and TCM2 being statistically different from TCM3 (P < 0.01). TCM1 (P < 0.05) and TCM3 (P < 0.01) were statistically different from TCM2. The median conversion times of fecal nucleic acid in the three groups were 7, 9 and 17 d (P < 0.001). Conversion times of fecal nucleic acid in TCM1 were statistically different from TCM3 and TCM2 (P < 0.01). The median lengths of hospital stay in the three groups were 13, 16 and 21 d (P < 0.001). TCM1 and TCM2 were statistically different from TCM3 (P < 0.01); TCM1 and TCM3 were statistically different from TCM2 (P < 0.01). Both leucocyte and lymphocyte counts increased gradually with an increase in the length of hospital stay in TCM1 group patients, with a statistically significant difference observed at each time point in the group (P < 0.001). Statistically significant differences in lymphocyte count and percentage in TCM2 (P < 0.001), and in leucocyte count (P = 0.043) and lymphocyte count (P = 0.038) in TCM3 were observed. The comparison among the three groups showed a statistically significant difference in lymphocyte percentage on the third day of admission (P = 0.044).@*CONCLUSION@#In this study, it was observed that in COVID-19 patients treated with a combination of Chinese and Western medicines, TCM intervention earlier in the hospital stay correlated with faster conversion time of pharyngeal swab and fecal nucleic acid, as well as shorter length of hospital stay, thus helping promote faster recovery of the patient. The underlying mechanism of action may be related to improving inflammation in patients with COVID-19.


Subject(s)
Adult , Aged , COVID-19/drug therapy , Female , Humans , Length of Stay , Male , Medicine, Chinese Traditional , Middle Aged , Retrospective Studies , SARS-CoV-2
18.
Article in English | WPRIM | ID: wpr-880988

ABSTRACT

OBJECTIVE@#Traditional Chinese medicine plays a significant role in the treatment of the pandemic of coronavirus disease 2019 (COVID-19). Tanreqing Capsule (TRQC) was used in the treatment of COVID-19 patients in the Shanghai Public Health Clinical Center. This study aimed to investigate the clinical efficacy of TRQC in the treatment of COVID-19.@*METHODS@#A retrospective cohort study was conducted on 82 patients who had laboratory-confirmed mild and moderate COVID-19; patients were treated with TRQC in one designated hospital. The treatment and control groups consisted of 25 and 57 cases, respectively. The treatment group was given TRQC orally three times a day, three pills each time, in addition to conventional Western medicine treatments which were also administered to the control group. The clinical efficacy indicators, such as the negative conversion time of pharyngeal swab nucleic acid, the negative conversion time of fecal nucleic acid, the duration of negative conversion of pharyngeal-fecal nucleic acid, and the improvement in the level of immune indicators such as T-cell subsets (CD3, CD4 and CD45) were monitored.@*RESULTS@#COVID-19 patients in the treatment group, compared to the control group, had a shorter negative conversion time of fecal nucleic acid (4 vs. 9 days, P = 0.047) and a shorter interval of negative conversion of pharyngeal-fecal nucleic acid (0 vs. 2 days, P = 0.042). The level of CD3@*CONCLUSION@#Significant reductions in the negative conversion time of fecal nucleic acid and the duration of negative conversion of pharyngeal-fecal nucleic acid were identified in the treatment group as compared to the control group, illustrating the potential therapeutic benefits of using TRQC as a complement to conventional medicine in patients with mild and moderate COVID-19. The underlying mechanism may be related to the improved levels of the immune indicator CD3


Subject(s)
Adult , Antiviral Agents/therapeutic use , COVID-19/pathology , Capsules , DNA, Viral/analysis , Drugs, Chinese Herbal/therapeutic use , Feces/virology , Female , Humans , Length of Stay , Lymphocyte Count , Male , Medicine, Chinese Traditional/methods , Middle Aged , Retrospective Studies , SARS-CoV-2/genetics , Severity of Illness Index , Treatment Outcome , Young Adult
19.
Article in English | WPRIM | ID: wpr-880733

ABSTRACT

Epidemiological evidence suggests that patients with hypertension infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at increased risk of acute lung injury. However, it is still not clear whether this increased risk is related to the usage of renin-angiotensin system (RAS) blockers. We collected medical records of coronavirus disease 2019 (COVID-19) patients from the First Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China), and evaluated the potential impact of an angiotensin II receptor blocker (ARB) on the clinical outcomes of COVID-19 patients with hypertension. A total of 30 hypertensive COVID-19 patients were enrolled, of which 17 were classified as non-ARB group and the remaining 13 as ARB group based on the antihypertensive therapies they received. Compared with the non-ARB group, patients in the ARB group had a lower proportion of severe cases and intensive care unit (ICU) admission as well as shortened length of hospital stay, and manifested favorable results in most of the laboratory testing. Viral loads in the ARB group were lower than those in the non-ARB group throughout the disease course. No significant difference in the time of seroconversion or antibody levels was observed between the two groups. The median levels of soluble angiotensin-converting enzyme 2 (sACE2) in serum and urine samples were similar in both groups, and there were no significant correlations between serum sACE2 and biomarkers of disease severity. Transcriptional analysis showed 125 differentially expressed genes which mainly were enriched in oxygen transport, bicarbonate transport, and blood coagulation. Our results suggest that ARB usage is not associated with aggravation of COVID-19. These findings support the maintenance of ARB treatment in hypertensive patients diagnosed with COVID-19.


Subject(s)
Aged , Aged, 80 and over , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme 2/blood , Antibodies, Viral/blood , Antihypertensive Agents/therapeutic use , Biomarkers , COVID-19/complications , China , Female , Humans , Hypertension/drug therapy , Intensive Care Units , Length of Stay , Male , Middle Aged , Retrospective Studies , Transcriptome , Viral Load
20.
Article in Chinese | WPRIM | ID: wpr-879882

ABSTRACT

OBJECTIVE@#To study the efficacy and safety of continuous renal replacement therapy (CRRT) in the treatment of neonates with inherited metabolic diseases and hyperammonemia.@*METHODS@#A retrospective analysis was performed on the medical records of neonates with inherited metabolic diseases and hyperammonemia who were hospitalized and underwent CRRT in the Department of Neonatology, Hunan Children's Hospital, from September 2016 to March 2020, including general conditions, clinical indices, laboratory markers, and adverse reactions.@*RESULTS@#A total of 11 neonates were enrolled, with 7 boys (64%) and 4 girls (36%). The neonates had a mean gestational age of (38.9±0.8) weeks, a mean body weight of (3 091±266) g on admission, and an age of (5.7±2.0) days at the time of CRRT. The main clinical manifestations were vomiting (100%), convulsions (100%), and coma (55%), and the main primary disease was urea cycle disorder (55%). The mean duration of CRRT was (44±14) hours, the medium duration of coma before CRRT was 2 hours, and the total duration of coma was 10 hours. The patients had a mean hospital stay of (18±10) days and a survival rate of 73%, and 2 survivors had epilepsy. After treatment, all patients had significant reductions in blood ammonia, lactic acid, and K@*CONCLUSIONS@#CRRT is safe and effective in the treatment of neonates with inherited metabolic diseases and hyperammonemia.


Subject(s)
Acute Kidney Injury , Child , Continuous Renal Replacement Therapy , Female , Humans , Hyperammonemia/therapy , Infant , Infant, Newborn , Length of Stay , Male , Metabolic Diseases/therapy , Retrospective Studies
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