ABSTRACT
Introducción: Los pacientes con ictus isquémico (II) presentan riesgo de desarrollar complicaciones intrahospitalarias no neurológicas (CIHNN) durante la internación. El NIHSS es una escala utilizada y validada para determinar la gravedad, el tratamiento y el pronóstico del II. Evaluamos la relación entre el puntaje NIHSS obtenido al ingreso y el desarrollo de CIHNN durante la estancia hospitalaria.MétodosEstudio observacional, de cohortes prospectivas. Incluyó pacientes ingresados consecutivamente por II en una sala de cuidados intermedios entre el 1 de agosto de 2017 y el 29 de febrero de 2020 en Argentina. Se dividió a los pacientes en Grupo1 (con CIHNN) y Grupo2 (sin CIHNN).ResultadosLa n final constó de 78 individuos; 41% mujeres. Al comparar las medias de puntaje NIHSS se observaron diferencias entre los grupos para desarrollo de CIHNN en general (p=0,050) y para las siguientes complicaciones específicas: disfagia (p=0,014), neumonía aspirativa (p=0,006), neumonía intrahospitalaria (p=0,010) e infección urinaria intrahospitalaria (p=0,004). El punto de corte de 10,5 presentó el mejor desempeño predictivo de CIHNN (AUC=0,706; p=0,016).ConclusionesUn valor de NIHSS ≥10,5 se relacionó con el desarrollo de CIHNN en pacientes ingresados por II. (AU)
Introduction: Patients with stroke are at risk of developing non-neurological in-hospital complications (NNIHC) during hospitalization. The NIHSS is a scale used and validated to determine stroke severity, treatment, and prognosis. We evaluated the relationship between the NIHSS score obtained on admission and the development of NNIHC during hospital stay.MethodsObservational study of prospective cohorts. Patients admitted consecutively for stroke, to an intermediate care ward, in Argentina between 08/01/2017 and 02/29/20 were included. The patients were divided into Group1 (with NNIHC) and Group2 (without NNIHC).ResultsThe final n consisted of 78 individuals, 41% women. When comparing the means of the NIHSS score, differences were observed between the groups in the development of NNIHC in general (P=.050) and in the following specific complications: dysphagia (P=.014), aspiration pneumonia (P=.006), in-hospital pneumonia (P=.010) and intrahospital urinary infection (P=.004). The cut-off point of 10.5 presented the best predictive performance of NNIHC (AUC=.706; P=.016).ConclusionsAn NIHSS value ≥10.5 was related to the development of NNIHC in patients admitted for stroke. (AU)
Subject(s)
Humans , Brain Ischemia , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Nervous System Diseases , Stroke/complications , Stroke/diagnosis , Hospitals , Prospective StudiesABSTRACT
INTRODUCTION: Patients with stroke are at risk of developing non-neurological in-hospital complications (NNIHC) during hospitalization. The NIHSS is a scale used and validated to determine stroke severity, treatment, and prognosis. We evaluated the relationship between the NIHSS score obtained on admission and the development of NNIHC during hospital stay. METHODS: Observational study of prospective cohorts. Patients admitted consecutively for stroke, to an intermediate care ward, in Argentina between 08/01/2017 and 02/29/20 were included. The patients were divided into Group1 (with NNIHC) and Group2 (without NNIHC). RESULTS: The final n consisted of 78 individuals, 41% women. When comparing the means of the NIHSS score, differences were observed between the groups in the development of NNIHC in general (P=.050) and in the following specific complications: dysphagia (P=.014), aspiration pneumonia (P=.006), in-hospital pneumonia (P=.010) and intrahospital urinary infection (P=.004). The cut-off point of 10.5 presented the best predictive performance of NNIHC (AUC=.706; P=.016). CONCLUSIONS: An NIHSS value ≥10.5 was related to the development of NNIHC in patients admitted for stroke.
Subject(s)
Brain Ischemia , Deglutition Disorders , Nervous System Diseases , Stroke , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Female , Hospitals , Humans , Male , Predictive Value of Tests , Prospective Studies , Severity of Illness Index , Stroke/complications , Stroke/diagnosisABSTRACT
Objetivos: Describir la prevalencia de eventos de agresión laboral contra médicos en la ciudad de Rosario y alrededores ocurridos en el último año. Determinar las características de los hechos de violencia y analizar la relación entrelos mismos y las características de la población médica.Materiales y Métodos: Estudio observacional, descriptivo y analítico, prospectivo; elaborado a partir de encuestascerradas on-line, realizadas de manera consecutiva a médicos que ejercieran en Rosario, Villa Gobernador Gálvez yGranadero Baigorria; del 18/07/2017 al 24/07/2017. Muestreo de tipo consecutivo, probabilístico, aleatorio simple. Se calculó un tamaño muestra de 350 encuestas.Resultados: Se incluyeron 351 encuestas. Hombres en 33% (n=115) y mujeres en 67% (n=236). El 23,1% (n=81)pertenecía al medio privado; 35% (n=123) al público; 41,6% (n=146) ambos y 0,3% (n=1) NS/NC. El 80,1%(n=281) presentó un episodio de agresión en el último año, de los cuales 86,8% (n=244) fue verbal y 13,2%(n=37) física-verbal. La agresión, pudiendo identificarse más de un agresor, fue realizada por familiar del pacienteen 94%(n=237), paciente 66% (n=166), personal de salud no médico 33% (n=83) y 26% (n=67) por un colega.El sitio de agresión más frecuente fue la guardia externa. Las mujeres padecieron mayor cantidad de eventos deagresión. Las especialidades más agredidas fueron Obstetricia y Pediatría. Se identificaron como factores de riesgo:sexo femenino (p=0,01; OR=2; IC95%=1,1-3,4), ejercicio profesional en guardia externa (p<0,0001; OR=3,2;IC95%=1,8-5,8) y la especialidad pediatría (p=0,016; OR=1,2; IC95%=1,2-1,3)... (AU)
Purposes: Estimation of the prevalence of aggression events against physicians in the workplace in the city of Rosario and environmentsin last year. Description of the violence events and how they are related with the medical population characteristics.Materials and methods: This is an observational, descriptive and analytic, prospective research. Performed withphysicians working in Rosario, Villa Gobernador Gálvez and Granadero Baigorria cities, Santa Fe, Argentina in base ofclosed on line surveys in a consecutive way. The evaluation included the period from July 18th to July 24th, 2017. Thesample was consecutive, probabilistic and simply randomized. The calculated sample size was 350 surveys.Results: 351 surveys were included, 33% males (n=115) and 67% females (n=236). 23% (n=81) from privateinstitutions, 35% (n=236) public ones, 41,6% both (n=146) both and unknown / unanswered 0,3% (n=1). 80%(n=281) presented an episode of aggression in the previous year, of which 86% (n=244) was verbal and 13,2% (n=37)physical and verbal. The aggression was performed by a patient`s relative in 94% (n=237), the patient in 66% (n=166),non-medical health personnel 33% (n=83) and 26% (n=67) by a colleague. The most frequent place of aggression wasemergency room. The women suffered a higher frequency of aggression. Obstetrics and pediatrics were the specialties moreinvolved. The risk factors were: female sex (p=0.01; OR=2; CI95%=1,1-3,4); working in emergency room (p<0,0001;OR=3,2; IC95%=1,8-5,8 and the specialty of pediatrics (p=0,016; OR=1,2; CI95%=1,2-1,3)... (AU)
