ABSTRACT
OBJECTIVE: The avoidable hospital admissions for heart failure are a problem for health systems worldwide, as they waste resources, generate additional morbidities and high mortality. The objective of this study was to determine the risk factors in patients hospitalized for heart failure. METHODS: A group of medical from Hospital and Primary Care was established. We realized an audit of a sample of 110 patients from Aljarafe towns with highest hospital admissions for heart failure. The analysis used Student T test and Mann Whitney for quantitative variables; Chi-square test and Fisher exact test for qualitative variables. RESULTS: Patients admitted for HF had a mean age of 78.1 years (SD: 9.56); 73 (66.4%) were women; Barthel Index was 45.0 on average; 53.5% had New York Health Association (NYHA) class III and 17 (15.5%) were institutionalized, 70% had between 3 and 5 comorbidities, mainly hypertension (87.3%), dyslipidemia (60.0%), diabetes (57.3%), chronic kidney disease (56.4%), anemia (53.2% ) or atrial fibrillation (52.7%). During hospitalization, 23 patients (20.9%) died. They were mostly women, elderly, had a previous admission and without beta-blockers treatment. The admission in the last 12 months was associated with identification of the primary caregiver; ischemic HF; re-vascularization; inclusion in the COMPARTE Program; treatment change decompensation. CONCLUSIONS: The hospital admissions were more frequently an aging population with multiple diseases (hypertension, diabetes, COPD, renal disease) and low capacity for basic activities of daily life. The hospital mortality associated with elderly, women, less use of beta-blockers and the non-inclusion of the patient in the care process.
OBJETIVO: Los ingresos hospitalarios evitables por insuficiencia cardiaca (IC) son un problema para los sistemas de salud, consumen recursos, generan morbilidades adicionales y alta mortalidad. El objetivo del estudio fue conocer los factores de riesgo de las personas hospitalizadas por insuficiencia cardiaca. METODOS: Se constituyó un grupo con médicos de atención primaria y hospitalaria. Se realizaron auditorías de las historias clínicas de 110 pacientes de la poblacion de la comarca del Aljarafe con mayores tasas de ingreso por insuficiencia cardiaca y estudio descriptivo y comparativo con T-Student y U-Mann Whitney para cuantitativas y Chi2 y Fisher para cualitativas. RESULTADOS: Los pacientes que ingresaron por IC tenían 78,1 años (SD: 9,56) de media; 73 (66,4%) fueron mujeres; un Índice Barthel de 45,0 de media; un 53,5% con New Yorl Health Asosiation (NYHA) grado III y 17 (15,5%) institucionalizados. El 70% presentaban 3-5 comorbilidades, hipertensión (87,3%), dislipemia (60,0%) diabetes mellitus(57,3%), enfermedad renal crónica (56,4%),anemia (53,2%) o fibrilación auricular (52,7%). Fallecieron al ingreso 23 (20,9%) pacientes. CONCLUSIONES: Los ingresos se dieron en personas mayores con múltiples enfermedades (hipertensión, diabetes, EPOC, enfermedad renal) y escasa capacidad para actividades básicas de la vida diaria. El fallecimiento hospitalario se asoció a edad avanzada, ser mujer, menor uso de betablo¬queantes y la no inclusión del paciente en el proceso asistencial.
Subject(s)
Heart Failure/epidemiology , Hospitalization/statistics & numerical data , Aged , Atrial Fibrillation/epidemiology , Comorbidity , Diabetes Mellitus/epidemiology , Dyslipidemias/epidemiology , Female , Health Resources , Hospital Mortality , Humans , Hypertension/epidemiology , Male , Medical Audit , Risk Factors , Spain/epidemiology , Statistics, NonparametricABSTRACT
Fundamentos: Los ingresos hospitalarios evitables por insuficiencia cardiaca (IC) son un problema para los sistemas de salud, consumen recursos, generan morbilidades adicionales y alta mortalidad. El objetivo del estudio fue conocer los factores de riesgo de las personas hospitalizadas por insuficiencia cardiaca. Métodos: Se constituyó un grupo con médicos de atención primaria y hospitalaria. Se realizaron auditorías de las historias clínicas de 110 pacientes de la poblacion de la comarca del Aljarafe con mayores tasas de ingreso por insuficiencia cardiaca y estudio descriptivo y comparativo con T-Student y U-Mann Whitney para cuantitativas y λ2 y Fisher para cualitativas. Resultados: Los pacientes que ingresaron por IC tenían 78,1 años (SD: 9,56) de media; 73 (66,4%) fueron mujeres; un Índice Barthel de 45,0 de media; un 53,5% con grado III de la NYHA y 17 (15,5%) institucionalizados. El 70% presentaban 3-5 comorbilidades, hipertensión (87,3%), dislipemia (60,0%) diabetes (57,3%), enfermedad renal crónica (56,4%), anemia (53,2%) o fibrilación auricular (52,7%). Fallecieron al ingreso 23 (20,9%) pacientes. Conclusiones: Los ingresos se dieron en personas mayores con múltiples enfermedades (hipertensión, diabetes, EPOC, enfermedad renal) y escasa capacidad para actividades básicas de la vida diaria. El fallecimiento hospitalario se asoció a edad avanzada, ser mujer, menor uso de betabloqueantes y la no inclusión del paciente en el proceso asistencial (AU)
Background: The avoidable hospital admissions for heart failure are a problem for health systems worldwide, as they waste resources, generate additional morbidities and high mortality. The objective of this study was to determine the risk factors in patients hospitalized for heart failure to prevent further unplanned admissions. Methods: A group of medical from Hospital and Primary Care was established. We realized an audit of a sample of 110 patients from Aljarafe towns with highest hospital admissions for heart failure. The analysis used Student T test and Mann Whitney for quantitative variables; λ2 test and Fisher exact test for qualitative variables. Results: Patients admitted for HF had a mean age of 78.1 years (SD: 9.56); 73 (66.4%) were women; Barthel Index was 45.0 on average; 53.5% had NYHA class III and 17 (15.5%) were institutionalized, 70% had between 3 and 5 comorbidities, mainly hypertension (87.3%), dyslipidemia (60.0%), diabetes (57.3%), chronic kidney disease (56.4%), anemia (53.2% ) or atrial fibrillation (52.7%). During hospitalization, 23 patients (20.9%) died. They were mostly women, elderly, had a previous admission and without beta-blockers treatment. The admission in the last 12 months was associated with identification of the primary caregiver; ischemic HF; revascularization; inclusion in the COMPARTE Program; treatment change decompensation. Conclusiones: The hospital admissions were more frequently an aging population with multiple diseases (hypertension, diabetes, COPD, renal disease) and low capacity for basic activities of daily life. The hospital mortality associated with elderly, women, less use of beta-blockers and the non-inclusion of the patient in the care process (AU)
Subject(s)
Humans , Male , Female , Hospitalization/trends , Heart Failure/epidemiology , Heart Failure/prevention & control , Risk Factors , Management Audit/standards , Management Audit , Medical Audit/methods , Atrial Fibrillation/epidemiology , Primary Health Care , Primary Health Care/organization & administration , Patient Readmission/legislation & jurisprudence , Patient Readmission/standards , Ambulatory Care/methods , Hyperlipidemias/epidemiology , Anemia/epidemiologyABSTRACT
Examples of singly-metallated derivatives of 1,1'-bis(o-carborane) have been prepared and spectroscopically and structurally characterised. Metallation of [7-(1'-1',2'-closo-C2B10H11)-7,8-nido-C2B9H10](2-) with a {Ru(p-cymene)}(2+) fragment affords both the unisomerised species [1-(1'-1',2'-closo-C2B10H11)-3-(p-cymene)-3,1,2-closo-RuC2B9H10] (2) and the isomerised [8-(1'-1',2'-closo-C2B10H11)-2-(p-cymene)-2,1,8-closo-RuC2B9H10] (3), and 2 is easily transformed into 3 with mild heating. Metallation with a preformed {CoCp}(2+) fragment also affords a 3,1,2-MC2B9-1',2'-C2B10 product [1-(1'-1',2'-closo-C2B10H11)-3-Cp-3,1,2-closo-CoC2B9H10] (4), but if CoCl2/NaCp is used followed by oxidation the result is the 2,1,8-CoC2B9-1',2'-C2B10 species [8-(1'-1',2'-closo-C2B10H11)-2-Cp-2,1,8-closo-CoC2B9H10] (5). Compound 4 does not convert into 5 in refluxing toluene, but does do so if it is reduced and then reoxidised, perhaps highlighting the importance of the basicity of the metal fragment in the isomerisation of metallacarboranes. A computational study of 1,1'-bis(o-carborane) is in excellent agreement with a recently-determined precise crystallographic study and establishes that the {1',2'-closo-C2B10H11} fragment is electron-withdrawing compared to H.
Subject(s)
Bone Density , Lumbar Vertebrae/diagnostic imaging , Osteoporosis, Postmenopausal/complications , Osteoporosis, Postmenopausal/diagnostic imaging , Thoracic Vertebrae/diagnostic imaging , Aged , Bone and Bones/diagnostic imaging , Bone and Bones/pathology , Female , Humans , Lumbar Vertebrae/pathology , Middle Aged , Osteoporosis, Postmenopausal/pathology , Sensitivity and Specificity , Thoracic Vertebrae/pathology , UltrasonographyABSTRACT
No disponible
Subject(s)
Adult , Male , Female , Humans , Neoplastic Cells, Circulating , Illicit Drugs , Vasodilator Agents , Methemoglobinemia , Papillary Muscles , Stroke , Amyl Nitrite , Analgesics, Opioid , Fentanyl , Fibroma , Fibromyalgia , Heart NeoplasmsSubject(s)
Inappropriate ADH Syndrome/drug therapy , Urea/therapeutic use , Humans , Male , Middle AgedABSTRACT
No disponible
