Influencia de la vacunación antigripal y la comorbilidad en la evolución de los pacientes hospitalizados por COVID-19 / Influence of influenza vaccine and comorbidity on the evolution of hospitalized COVID-19 patients

Antecedentes y objetivo:El brote de la enfermedad COVID-19 está evolucionando en todo el mundo. El objetivo del estudio es evaluar la asociación entre la vacunación antigripal y el riesgo de mortalidad en pacientes con COVID-19 hospitalizados, así como otros factores de riesgo.Materiales y métodos:Estudio observacional retrospectivo. Se realizó entre pacientes hospitalizados con COVID-19 del Hospital La Mancha Centro entre el 5 y el 25 de marzo de 2020. Utilizamos una regresión logística multivariable para explorar la asociación entre la vacunación antigripal y la mortalidad por COVID y otros factores de riesgo.Resultados:Se incluyeron 410 pacientes. La vacunación antigripal no tuvo efecto entre los pacientes hospitalizados por COVID-19 (OR: 1,55 [IC 95%; 0,96-2,48; p = 0,071]). El aumento de la mortalidad intrahospitalaria se asoció con edad avanzada (OR: 1,05 [IC 95%; 1,02-1,07]), por cada aumento de año; p < 0,001, Charlson ≥ 3 (OR: 1,84 [IC 95%; 1,07-3,15, p = 0,027]) e insuficiencia cardíaca al ingreso (OR: 6 [IC 95%; 1,6-21,7; p = 0,007]).Conclusiones:La vacuna antigripal no tuvo efecto en la evolución de pacientes hospitalizados por COVID-19. Los factores de riesgo identificados fueron la edad avanzada, mayor comorbilidad e insuficiencia cardíaca al ingreso. (AU)

Background and objective:The COVID-19 coronavirus disease outbreak is evolving around the world. The aim of this study is to evaluate the association between influenza vaccination and the risk of mortality in hospitalized COVID-19 patients, as well as other risk factors.Materials and methods:Retrospective observational study. This study was conducted among hospitalized patients with COVID-19 at Hospital La Mancha Centro between March 5 and 25, 2020. Information on influenza vaccination was extracted from electronic medical records. We used a multivariate logistic regression to explore the association between influenza vaccination and mortality from COVID and other risk factors.Results:410 patients were included. Influenza vaccine had no effect among COVID-19 hospitalized patients [OR: 1.55 (95%CI: 0.96 – 2.48; p=0.071)]. Increasing hospital mortality was associated with older age [OR: 1.05 (95% CI 1.02–1.07), per year increase; p<0.001)], Charlson ≥3 [OR: 1.84 (95%CI: 1.07-3.15, p=0.027)] and heart failure on admission [OR: 6 (IC95%: 1.6 – 21.7; p=0.007)]Conclusions:Influenza vaccine had no effect among COVID-19 hospitalized patients. The risk factors identified were older age, higher comorbidity and heart failure on admission. (AU)

Influence of influenza vaccine and comorbidity on the evolution of hospitalized COVID-19 patients⋆.

Background and objective: The COVID-19 coronavirus disease outbreak is evolving around the world. Objective: To evaluate the associations between influenza vaccination and other factors and the risk of mortality in hospitalized COVID-19 patients. Materials and methods: Retrospective observational study. This study was conducted among hospitalized patients with COVID-19 at Hospital La Mancha Centro between March 5 and 25, 2020. Information on influenza vaccination was extracted from electronic medical records. We used a multivariate logistic regression to explore the association between influenza vaccination and mortality from COVID and other risk factors. Results: 410 patients were included. Influenza vaccine had no effect among COVID-19 hospitalized patients [OR: 1.55 (95%CI: 0.96-2.48; p = 0.071)]. Increasing hospital mortality was associated with older age [OR: 1.05 (95% CI 1.02-1.07), per year increase; p < 0.001)], Charlson ≥3 [OR: 1.84 (95%CI: 1.07-3.15, p = 0.027)] and heart failure on admission [OR: 6 (IC95%: 1.6-21.7; p = 0.007)]. Conclusions: Influenza vaccine had no effect among COVID-19 hospitalized patients. The risk factors identified were older age, higher comorbidity and heart failure on admission.

Antecedentes y objetivo: El brote de la enfermedad COVID-19 está evolucionando en todo el mundo. Objetivo: Evaluar la asociación de la vacunación antigripal y otros factores y el riesgo de mortalidad en pacientes con COVID-19 hospitalizados. Materiales y métodos: Estudio observacional retrospectivo. Se realizó entre pacientes hospitalizados con COVID-19 del Hospital La Mancha Centro entre el 5 y el 25 de marzo de 2020. Utilizamos una regresión logística multivariable para explorar la asociación entre la vacunación antigripal y la mortalidad por COVID y otros factores de riesgo. Resultados: Se incluyeron 410 pacientes. La vacunación antigripal no tuvo efecto entre los pacientes hospitalizados por COVID-19 [OR: 1,55 (IC95%: 0,96­2,48; p = 0,071)]. El aumento de la mortalidad intrahospitalaria se asoció con edad avanzada [OR: 1,05, (IC95%: 1,02­1,07), por cada aumento de año; p < 0.001)], Charlson ≥ 3 [OR: 1,84 (IC95%: 1,07­3,15, p = 0,027)] e insuficiencia cardíaca al ingreso [OR: 6 (IC95%: 1,6­21,7; p = 0,007)]. Conclusiones: La vacuna antigripal no tuvo efecto en la evolución de pacientes hospitalizados por COVID-19. Los factores de riesgo identificados fueron la edad avanzada, mayor comorbilidad e insuficiencia cardíaca al ingreso.

Factores de riesgo de mortalidad en pacientes mayores de 65 años hospitalizados por COVID-19 / Risk factors for mortality in patients over 65 years old hospitalized by COVID-19

Antecedentes y objetivoCOVID-19 es una enfermedad causada por el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2), que ha provocado una pandemia que sufrimos en la actualidad.Objetivo:identificar factores asociados con la mortalidad en pacientes de 65 años o más hospitalizados por COVID-19.Materiales y métodos: Estudio observacional retrospectivo. Incluimos pacientes de edad ≥65 años ingresados por COVID-19 entre el 5 y el 25 de marzo del 2020. Utilizamos el análisis bivariante y la regresión logística multivariante para determinar los factores de riesgo asociados a la mortalidad hospitalaria.Resultados: Se incluyeron 277 pacientes en el presente estudio. El análisis bivariante mostró diferencias significativas (p<0,05) entre fallecidos y supervivientes: edad, mayor dependencia y comorbilidad, antecedentes de cardiopatía isquémica, insuficiencia renal y neoplasias no hematológicas, insuficiencia cardiaca durante el ingreso, leucocitosis, valores elevados de creatinina, PCR, GOT y troponina Ic, linfopenia, y disminución de SatO2 y pH sanguíneo. La regresión logística multivariante reveló que la edad ≥65 años [OR: 4,23 (IC 95%: 1,43-12,52); p=0,009], linfopenia <1.000/μl [OR: 2,36 (IC 95%: 1,07-5,20); p=0,033], creatinina>1,2mg/dl [OR: 3,08 (IC 95%: 1,37-6,92); p=0,006], SatO2 <90% [OR: 2,29 (IC 95%: 1,01-5,21); p=0,049] y la troponina Ic>11ng/ml [OR: 2,32 (IC 95%: 1,04-5,16); p=0,040] se asociaron independientemente con mayor mortalidad hospitalaria.Conclusiones: La edad avanzada, linfopenia, SatO2 <90%, valores elevados de creatinina y troponina Ic se asociaron independientemente con mayor mortalidad en pacientes hospitalizados con COVID-19, lo que podría ayudar a los médicos a identificar a los pacientes con mal pronóstico para su manejo y tratamiento. (AU)

Background and objectiveCOVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has caused a global pandemic that we are currently suffering from.Objective: to identify factors associated with the death of patients aged 65 years or older hospitalized for COVID-19.Materials and methods: Retrospective cohort study. We included patients aged 65 years or older who were hospitalized for COVID-19 and dead o discharged between March 5 and 25, 2020. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death.Results: 277 patients were included in this study. The bivariate analysis showed significant differences (p<0.05) between survivors and non survivors: age, increased dependence and comorbidity, history of ischemic heart disease, renal failure and non-hematological neoplasms, heart failure during admission, leukocytosis, elevated creatinine, PCR, GOT and troponin Ic values, lymphopenia, and decreased blood pH and SatO2. Multivariate logistic regression revealed that age ≥65 years (OR: 4.23 (95% CI: 1.43-12.52; p=0.009), lymphopenia <1000/μL (OR: 2.36 (95% CI: 1.07-5.20; p=0.033), creatinine>1.2mg/dL (OR: 3.08 (95% CI: 1.37-6.92; p=0.006), SatO2 <90% (OR: 2.29 (95% CI: 1.01-5.21; p=0.049) and troponin Ic>11ng/mL (OR: 2.32 (95% CI: 1.04-5.16; p=0.040) were independently associated with higher hospital mortality. Conclusions: Older age, lymphopenia, SatO2 <90%, elevated creatinine and troponin Ic values were independently associated with higher mortality in hospitalized patients with COVID-19, these factors could help clinicians to identify patients with poor prognosis. (AU)

Influence of influenza vaccine and comorbidity on the evolution of hospitalized COVID-19 patients. / Influencia de la vacunación antigripal y la comorbilidad en la evolución de los pacientes hospitalizados por COVID-19.

BACKGROUND AND OBJECTIVE: The COVID-19 coronavirus disease outbreak is evolving around the world. The aim of this study is to evaluate the association between influenza vaccination and the risk of mortality in hospitalized COVID-19 patients, as well as other risk factors. MATERIALS AND METHODS: Retrospective observational study. This study was conducted among hospitalized patients with COVID-19 at Hospital La Mancha Centro between March 5 and 25, 2020. Information on influenza vaccination was extracted from electronic medical records. We used a multivariate logistic regression to explore the association between influenza vaccination and mortality from COVID and other risk factors. RESULTS: 410 patients were included. Influenza vaccine had no effect among COVID-19 hospitalized patients [OR: 1.55 (95%CI: 0.96 - 2.48; p=0.071)]. Increasing hospital mortality was associated with older age [OR: 1.05 (95% CI 1.02-1.07), per year increase; p<0.001)], Charlson ≥3 [OR: 1.84 (95%CI: 1.07-3.15, p=0.027)] and heart failure on admission [OR: 6 (IC95%: 1.6 - 21.7; p=0.007)] CONCLUSIONS: Influenza vaccine had no effect among COVID-19 hospitalized patients. The risk factors identified were older age, higher comorbidity and heart failure on admission.

[Risk factors for mortality in patients over 65 years old hospitalized by COVID-19]. / Factores de riesgo de mortalidad en pacientes mayores de 65 años hospitalizados por COVID-19.

BACKGROUND AND OBJECTIVE: COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has caused a global pandemic that we are currently suffering from. OBJECTIVE: to identify factors associated with the death of patients aged 65 years or older hospitalized for COVID-19. MATERIALS AND METHODS: Retrospective cohort study. We included patients aged 65 years or older who were hospitalized for COVID-19 and dead o discharged between March 5 and 25, 2020. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. RESULTS: 277 patients were included in this study. The bivariate analysis showed significant differences (p<0.05) between survivors and non survivors: age, increased dependence and comorbidity, history of ischemic heart disease, renal failure and non-hematological neoplasms, heart failure during admission, leukocytosis, elevated creatinine, PCR, GOT and troponin Ic values, lymphopenia, and decreased blood pH and SatO2. Multivariate logistic regression revealed that age ≥65 years (OR: 4.23 (95% CI: 1.43-12.52; p=0.009), lymphopenia <1000/µL (OR: 2.36 (95% CI: 1.07-5.20; p=0.033), creatinine>1.2mg/dL (OR: 3.08 (95% CI: 1.37-6.92; p=0.006), SatO2 <90% (OR: 2.29 (95% CI: 1.01-5.21; p=0.049) and troponin Ic>11ng/mL (OR: 2.32 (95% CI: 1.04-5.16; p=0.040) were independently associated with higher hospital mortality. CONCLUSIONS: Older age, lymphopenia, SatO2 <90%, elevated creatinine and troponin Ic values were independently associated with higher mortality in hospitalized patients with COVID-19, these factors could help clinicians to identify patients with poor prognosis.

Uso de sujeciones físicas en relación con el riesgo de caídas en una residencia de ancianos / Physical restraint use in relation to falls risk in a nursing home

ANTECEDENTES Y OBJETIVO: El uso de sujeciones físicas (SF) es común en el cuidado de los ancianos. Sin embargo, su eficacia y seguridad son cuestionadas por la evidencia científica. El objetivo de este estudio fue determinar el papel de las SF en la prevención de caídas. MATERIALES Y MÉTODOS: Se realizó un estudio de cohorte retrospectivo. Examinamos todas las caídas (n=575) que se produjeron en ancianos mayores de 65 años que residieron en una residencia entre febrero de 2009 y septiembre de 2013. Analizamos la asociación entre el uso de SF y riesgo de caídas mediante una regresión logística multivariable que ajusta las características de los residentes que se asociaron con el uso de SF según un análisis bivariado. RESULTADOS: Los factores de riesgo de caídas, teniendo en cuenta el uso de SF, fueron: riesgo de caída (Test de Tinetti) (OR 4,57; IC 95% 1,76-11,75); capacidad de caminar (OR 6,40; IC 95% 2,78-14,74); déficit auditivo (OR 2,12; IC 95% 1,05-4,29); y la historia de caídas (17,81; IC 95% 8,83-35,93). El riesgo de caídas fue mayor en los residentes sujetos ambulantes con deterioro cognitivo (OR 18,95; IC 95% 7,06-50,85). No encontramos diferencias en las lesiones entre las caídas que ocurrieron con y sin SF. CONCLUSIONES: El uso de SF no se asoció significativamente con menos caídas y lesiones. En los residentes ambulantes con deterioro cognitivo podrían aumentar el riesgo de caídas. Por tanto, habría que considerar si las SF proporcionan una protección adecuada contra el riesgo de caídas

BACKGROUNDS AND OBJECTIVES: The use of physical restraints (PR) is common in the care of the elderly. However, their efficacy and safety are not supported by scientific evidence. The aim of this study was to determine the role of PR in preventing falls. MATERIALS AND METHODS: A retrospective cohort study design was used, in which each fall incident (n=575) was examined in the residents over 65 years of age who resided at the one nursing homes from February 2009 to September 2013. An analysis was made of the association between the use of PR and risk of falls using a multivariate logistic regression, adjusting for the characteristics of residents that were associated with the use of PR according to a bivariate analysis. RESULTS: Risk factors for falls after accounting for PR use, include: risk of falling (Tinetti test) (OR 4.57; 95% CI 1.76-11.75); ability to walk (OR 6.40; 95% CI 2.78-14.74); hearing impairment (OR 2.12; 95% CI 1.05-4.29); and history of a previous fall (OR 17.81; 95% CI 8.83-35.93). The risk of falls was greater in restrained, ambulatory residents with cognitive impairment (OR 18.95; 95% CI 7.06-50.85). No differences were found in injuries between falls that occurred with and without PR. CONCLUSIONS: Restraint use was not significantly associated with fewer falls and injuries. The risk of falls could increase in ambulatory residents with cognitive impairment. The study results suggest the need to consider whether restraints provide adequate protection against the risk of falls

[Physical restraint use in relation to falls risk in a nursing home]. / Uso de sujeciones físicas en relación con el riesgo de caídas en una residencia de ancianos.

BACKGROUNDS AND OBJECTIVES: The use of physical restraints (PR) is common in the care of the elderly. However, their efficacy and safety are not supported by scientific evidence. The aim of this study was to determine the role of PR in preventing falls. MATERIALS AND METHODS: A retrospective cohort study design was used, in which each fall incident (n=575) was examined in the residents over 65 years of age who resided at the one nursing homes from February 2009 to September 2013. An analysis was made of the association between the use of PR and risk of falls using a multivariate logistic regression, adjusting for the characteristics of residents that were associated with the use of PR according to a bivariate analysis. RESULTS: Risk factors for falls after accounting for PR use, include: risk of falling (Tinetti test) (OR 4.57; 95% CI 1.76-11.75); ability to walk (OR 6.40; 95% CI 2.78-14.74); hearing impairment (OR 2.12; 95% CI 1.05-4.29); and history of a previous fall (OR 17.81; 95% CI 8.83-35.93). The risk of falls was greater in restrained, ambulatory residents with cognitive impairment (OR 18.95; 95% CI 7.06-50.85). No differences were found in injuries between falls that occurred with and without PR. CONCLUSIONS: Restraint use was not significantly associated with fewer falls and injuries. The risk of falls could increase in ambulatory residents with cognitive impairment. The study results suggest the need to consider whether restraints provide adequate protection against the risk of falls.

Insuficiencia tricúspide asociada a marcapasos: una causa desapercibida de insuficiencia cardiaca derecha en el anciano / Tricuspid insufficiency associated with a pacemaker: An unnoticed cause of right heart failure in an elderly patient

No disponible