RESUMEN
BACKGROUND: SARS-CoV-2 affects all age groups, but higher mortality rates are recorded in older people, men and with comorbidities, mainly hypertension, diabetes and obesity. Aim: To describe the main clinical characteristics, evolution and prognostic factors for death in older patients hospitalized for COVID-19. MATERIALS AND METHODS: Retrospective analysis of 128 patients aged 73 years, 66% men, hospitalized at a clinical hospital, with a diagnosis of COVID-19, admitted from May 1 to August 1, 2020. Data were collected from the clinical records, a description of the study population was made, and a univariate analysis and logistic regression were performed. Results: Seventy-two percent of patients had two or more comorbidities, mainly arterial hypertension in 66%, diabetes mellitus in 34% and cardiovascular disease in 19%. Forty-one percent were admitted to intensive care and 31% were connected to mechanical ventilation. In-hospital mortality was 26.6%. A multivariate analysis was performed in two blocks, finding in the first that arterial hypertension and older age significantly predict mortality. However, when previous institutionalization and immuno-suppression were included as variables in the second block, age ceased to be a significant predictor. CONCLUSIONS: Prognostic factors associated with death in this age group are arterial hypertension and previous institutionalization.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Diabetes Mellitus/epidemiología , COVID-19/epidemiología , Pronóstico , Comorbilidad , Estudios Retrospectivos , Mortalidad Hospitalaria , SARS-CoV-2 , Hospitalización , Hipertensión/epidemiologíaRESUMEN
En la actualidad, los procedimientos de radiología intervencional intracraneanos son cada vez más frecuentes. Sin embargo, la exposición a altas dosis de radiación durante la fluoroscopía puede inducir a complicaciones cutáneas como la alopecia transitoria post embolización, forma peculiar de radiodermatitis que afecta a las regiones del cuero cabelludo que reciben dosis más altas de radiación durante el proceso de embolización. El cuadro clínico se caracteriza por alopecia completa, no cicatricial, en parches con bordes bien delimitados y formas peculiares(rectángulos, círculos superpuestos), generalmente de localización occipital o en región temporo-parietal. Ocurre en promedio 2 a 4 semanas después del procedimiento endovascular, con repoblación del área alopécica a partir de las 4 a 5 semanas. Es de buen pronóstico y no requiere tratamiento específico. Es importante conocer este cuadro para poder orientar adecuadamente a los pacientes y alertar respecto a la incidencia de efectos adversos de la radiación terapéutica.
In the present, the neuroradiological procedures are more frequent. However, exposure to radiation can conduce to dermatological complication as transient alopecia after embolization, rare form of radiodermatitis that affect the areas of the scalp that receive highest doses of radiation. The clinical presentation is characterized by a complete alopecia, without any signs of inflammation of the scalp, with sharply defined patches in rare forms (rectangular, overlapped circles), generally located on occipital or temporo-parietal region. This phenomenon starts after 2 or 4 weeks since endovascular procedure, with hair re-growth after 4 or 5 weeks. It has good prognosis and no specific treatment is required. It is important to recognize this condition, in order to give adequate information to patients and warn about the incidence of adverse effects of therapeutic radiation.