ABSTRACT
Fundamento: Evaluar la utilidad diagnóstica del cuestionario AUDIT (Alcohol Use Disorders Identification Test) para detectar trastornos relacionados con el alcohol (TRA) en pacientes hospitalizados valorar las posibles diferencias en función del sexo o la edad y compararla con la de otros métodos utilizados habitualmente (CAGE y marcadores biológicos). Resultados: La sensibilidad del AUDIT para detectar TRA fue del 98 porciento, la especificidad del 94 porciento y el área bajo la curva ROC de 0,99 (IC 95 porciento: 0,98-1). Su sensibilidad fue menor en las mujeres (94 porciento frente a 99 porciento) y en los pacientes menores de 60 años (97 porciento frente a 100 porciento). El CAGE mostró una sensibilidad del 78 porciento y una especificidad del 99 porciento. Entre los marcadores biológicos destacaron la GGT y el VCM con sensibilidades del 83 y 74 porciento y especificidades del 53 y 74 porciento respectivamente. Conclusiones: El AUDIT es un cuestionario muy Efectivo y claramente superior a otros métodos utilizados habitualmente para detectar TRA en pacientes hospitalizados. Su utilidad diagnóstica es menor en mujeres, similar en los dos grupos de edad considerados y claramente superior a la de otros métodos utilizados habitualmente (AU)
Subject(s)
Female , Male , Middle Aged , Humans , Alcohol-Induced Disorders/diagnosis , Hospitalization , Surveys and Questionnaires , Cross-Sectional Studies , Sensitivity and SpecificityABSTRACT
OBJECTIVE: To evaluate the diagnostic usefulness of AUDIT (Alcohol Use Disorders Identification Test) for detection of alcohol-related problems (ARP) among hospitalized patients, to assess the potential differences according to age or sex and to compare its diagnostic value with that of some other conventionally used measures (CAGE questionnaire and biological markers). MATERIAL AND METHODS: This is a cross-sectional study for evaluation of diagnostic tests including 179 hospitalized patients in a Medicine Unit. Data about weekly alcohol intake were collected through a semistructured interview. AUDIT and CAGE questionnaires were administered and blood levels of GGT, MCV, AST, ALT, alkaline phosphatase, platelet count, trylicerides and uric acid were determined. RESULTS: AUDIT sensitivity in detecting ARP was of 98%, specificity was of 94% and area under ROC was 0.99 (95% CI: 0.98-1). Its sensitivity was shown to be lower both in the female group (94% vs. 99%) and in age group under 60 years (97% vs. 100%). CAGE showed a sensitivity of 78% and a specificity of 99%. Among biological markers GGT and MCV should be highlighted with sensitivities of 83% and 74% and specificities of 53% and 74% respectively. CONCLUSIONS: AUDIT is an effective tool for detection of ARP among hospitalized patients. Its diagnostic usefulness being lower for females, similar for both age groups considered and clearly higher than that of other commonly used measures.
Subject(s)
Alcohol-Induced Disorders/diagnosis , Hospitalization , Surveys and Questionnaires , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
OBJECTIVE: To determine functional social support in patients included in programme of care for chronic patients confined to their homes, and to compare rural area with urban area. DESIGN: Descriptive and crossover study. SETTING: Urban and rural health centres. PATIENTS: 103 patients were interviewed in their homes (41 of them were in a rural area and 62 in a urban area). All patients were included in programme of care for chronic patients confined to their homes. Patients with neurological o psychiatric disorders who were not able to answer coherently were excluded. MEASUREMENTS AND MAIN RESULTS: We used the DUKE-UNC questionnaire which measured the functional social support in two sub-scales: confidential support and affective support. We didn't find any relation between the functional social support and age, sex, civil condition or health problems. Patients of the rural area perceive less confidential support than patients of the urban area. We didn't find any difference in the perception of the affective support between both areas. CONCLUSIONS: In the rural area, the patients included in the programme of care for chronic patients confined to their homes perceive less possibility to communicate problems, important events or conflictive situations that require comprehension and help.
Subject(s)
Home Care Services/standards , Social Support , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Health Surveys , Humans , Male , Middle Aged , Perception , Program Evaluation , Rural Health , Spain , Urban HealthABSTRACT
OBJECTIVE: To determine the characteristics, family surrounding and place of death of terminal oncologic patients from 1991. DESIGN: Descriptive and retrospective study. We used Fisher's test. SITE. San Gregorio, Telde (Las Palmas province). PATIENTS: We worked with 27 patients in terminal disease (17 were men and 10 were women). MEASUREMENTS AND MAIN RESULTS: Average age was 66.7 +/- 17 years. The most frequent type was digestive (10), breast (5) and lung (3). Average time of survival was 17.5 +/- 26.5 months. Principal symptoms were: pain (23), anorexia (17), constipation (13) and depression (11). 23 received analgesia (11 with morphine), 17 laxatives and 13 benzodiazepines. The numbers of visit they received was 13.6 +/- 9.3 patients knew their diagnostic. 22 of the families were considered collaborators. 70% of patients in control by Primary Care Center died at home; whereas no one did so in control by hospital (p = 0.029). CONCLUSIONS: Half of the patients in terminal phase in our zone die in their home. Patients under control by Primary Care Center are significantly more likely to die in their own homes. We give special attention to the high percentage of patients who use opiates. Finally we consider that workers in Primary Care Centers are a vital element in handle these patients and their families.
