[Risk of sarcopenia and malnutrition related to COVID-19 in an institutionalized population of Castilla-La Mancha (Spain): determined by R-MAPP.] / Riesgo de sarcopenia y desnutrición relacionado con COVID-19 en una población institucionalizada de Castilla-La Mancha: determinado por R-MAPP.

OBJECTIVE: Knowing the risk status of malnutrition and sarcopenia in institutionalized patients is essential to understand the current context after the impact of the coronavirus (COVID-19) pandemic. METHODS: This research used a retrospective, observational study. The results of the Remote Malnutrition APP test (R-MAPP) are described: risk factors for malnutrition (including COVID-19), the Malnutrition Universal Screening Tool (MUST) and the SARC-F, in a selected sample of 402 residents of Castilla-La Mancha (Spain) during 2021. An inferential analysis was performed to determine which factors were related to the MUST (≥2 points) and SARC-F (≥4 points) response measures. With the factors that obtained statistical significance, a multivariate regression model was performed, adjusting for each one. of those factors. RESULTS: Mean age was 84.2 years, 70.1% women. Most frequent risk factor for malnutrition was aging (85.1%). The mean body mass index was 26.5 (SD 11.6). MUST≥2 points was obtained in 16.2%, and a SARC-F≥4 in 69.9%. COPD (Chronic obstructive pulmonary disease / OR 0.35; 95% CI 0.13-0.92; p 0.03) was a protective factor against the risk of malnutrition. The risk of sarcopenia was related to aging (OR 8.16; 95% CI 4.13-16.20; p 0.00), COVID-19 (OR 1.96; 95% CI 1.17-3.29; p 0.01) and COPD (OR 2.44; 95% CI 1.21-4.89; p 0.01). CONCLUSIONS: No relationship is found between COVID-19 and high risk of malnutrition. Aging, COVID-19 and COPD are risk factors for sarcopenia.

OBJETIVO: Conocer el estado de riesgo de desnutrición y sarcopenia de las personas institucionalizadas es clave para entender el contexto actual tras la repercusión que ha tenido la pandemia por coronavirus (COVID-19). METODOS: Se realizó un estudio observacional retrospectivo. Se describen los resultados de la prueba Remote Malnutrition APP (R-MAPP): factores de riesgo de desnutrición (incluyendo la COVID-19), Malnutrition Universal Screening Tool (MUST) y la SARC-F, en una muestra seleccionada de 402 residentes de Castilla-La Mancha (España) durante 2021. Se llevó a cabo un análisis inferencial para determinar qué factores tenían relación con las medidas de respuesta MUST (≥2 puntos) y SARC-F (≥4 puntos). Con los factores que obtuvieron significación estadística se realizó un modelo de regresión multivariante ajustando por cada uno de esos factores. RESULTADOS: La edad media fue de 84,2 años, con un 70,1% de mujeres. El factor de riesgo de desnutrición más frecuente fue el envejecimiento (85,1%). El Índice de Masa Corporal medio fue 26,5 (DE 11,6). Se obtuvo un MUST mayor o igual a 2 puntos en un 16,2%, y un SARC-F igual o mayor de 4 en el 69,9%. Se observó, como factor protector, la EPOC (enfermedad pulmonar obstructiva crónica / OR 0,35; IC 95% 0,13-0,92; p 0,03) contra el riesgo de desnutrición. El riesgo de sarcopenia se relacionó con envejecimiento (OR 8,16; IC 95% 4,13-16,20; p 0,00), COVID-19 (OR 1,96; IC 95% 1,17-3,29; p 0,01) y EPOC (OR 2,44; IC 95% 1,21- 4,89; p 0,01). CONCLUSIONES: No se halla relación entre COVID-19 y riesgo alto de desnutrición. Envejecimiento, COVID-19 y EPOC son factores de riesgo de sarcopenia.

Riesgo de sarcopenia y desnutrición relacionado con COVID-19 en una población institucionalizada de Castilla-La Mancha: determinado por R-MAPP / Risk of sarcopenia and malnutrition related to COVID-19 in an institutionalized population of Castilla-La Mancha (Spain): determined by R-MAPP

FUNDAMENTOS: Conocer el estado de riesgo de desnutrición y sarcopenia de las personas institucionalizadas es clave para entender el contexto actual tras la repercusión que ha tenido la pandemia por coronavirus (COVID-19). MÉTODOS: Se realizó un estudio observacional retrospectivo. Se describen los resultados de la prueba Remote Malnutrition APP (R-MAPP): factores de riesgo de desnutrición (incluyendo la COVID-19), Malnutrition Universal Screening Tool (MUST) y la SARC-F, en una muestra seleccionada de 402 residentes de Castilla-La Mancha (España) durante 2021. Se llevó a cabo un análisis inferencial para determinar qué factores tenían relación con las medidas de respuesta MUST (≥2 puntos) y SARC-F (≥4 puntos). Con los factores que obtuvieron significación estadística se realizó un modelo de regresión multivariante ajustando por cada uno de esos factores. RESULTADOS: La edad media fue de 84,2 años, con un 70,1% de mujeres. El factor de riesgo de desnutrición más frecuente fue el envejecimiento (85,1%). El Índice de Masa Corporal medio fue 26,5 (DE 11,6). Se obtuvo un MUST mayor o igual a 2 puntos en un 16,2%, y un SARC-F igual o mayor de 4 en el 69,9%. Se observó, como factor protector, la EPOC (enfermedad pulmonar obstructiva crónica / OR 0,35; IC 95% 0,13-0,92; p 0,03) contra el riesgo de desnutrición. El riesgo de sarcopenia se relacionó con envejecimiento (OR 8,16; IC 95% 4,13-16,20; p 0,00), COVID-19 (OR 1,96; IC 95% 1,17-3,29; p 0,01) y EPOC (OR 2,44; IC 95% 1,21- 4,89; p 0,01). CONCLUSIONES: No se halla relación entre COVID-19 y riesgo alto de desnutrición. Envejecimiento, COVID-19 y EPOC son factores de riesgo de sarcopenia.(AU)

BACKGROUND: Knowing the risk status of malnutrition and sarcopenia in institutionalized patients is essential to understand the current context after the impact of the coronavirus (COVID-19) pandemic. METHODS: This research used a retrospective, observational study. The results of the Remote Malnutrition APP test (R-MAPP) are described: risk factors for malnutrition (including COVID-19), the Malnutrition Universal Screening Tool (MUST) and the SARC-F, in a selected sample of 402 residents of Castilla-La Mancha (Spain) during 2021. An inferential analysis was performed to determine which factors were related to the MUST (≥2 points) and SARC-F (≥4 points) response measures. With the factors that obtained statistical significance, a multivariate regression model was performed, adjusting for each one. of those factors. RESULTS: Mean age was 84.2 years, 70.1% women. Most frequent risk factor for malnutrition was aging (85.1%). The mean body mass index was 26.5 (SD 11.6). MUST≥2 points was obtained in 16.2%, and a SARC-F≥4 in 69.9%. COPD (Chronic obstructive pulmonary disease / OR 0.35; 95% CI 0.13-0.92; p 0.03) was a protective factor against the risk of maln utrition. The risk of sarcopenia was related to aging (OR 8.16; 95% CI 4.13-16.20; p 0.00), COVID-19 (OR 1.96; 95% CI 1.17-3.29; p 0.01) and COPD (OR 2.44; 95% CI 1.21-4.89; p 0.01). CONCLUSIONS: No relationship is found between COVID-19 and high risk of malnutrition. Aging, COVID-19 and COPD are risk factors for sarcopenia.(AU)

Psychological and Functional Impact of COVID-19 in Long-Term Care Facilities: The COVID-A Study.

OBJECTIVE: To analyze the psychological and functional sequelae of the COVID-19 pandemic among older adults living in long term care facilities (LTCFs). DESIGN: Cohort longitudinal study SETTING ANT PARTICIPANTS: A total of 215 residents ≥ 65 years without moderate-to-severe cognitive impairment, living in five LTCFs in Albacete (Spain). MEASUREMENTS: Baseline on-site data were collected between March - June 2020 and three-month follow-up between June to September 2020. Symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and sleep disturbances were measured as psychological variables. Disability in basic activities of daily living (BADL), ambulation and frailty were assessed as functional variables. Differences were analyzed in relation to level of comorbidity and test positivity for COVID-19. RESULTS: At baseline, residents with COVID-19 presented worse functionality, higher frailty levels and malnutrition risk compared to non-COVID-19 residents. At three-month follow-up, higher rates of clinically significant depressive symptoms (57.7%), anxiety symptoms (29.3%), PTSD symptoms (19.1%) and sleep disturbances (93.0%) were found among residents regardless of COVID status. Thus, among 215 residents, 101 (47%) experienced a decline in BADL from baseline to the 3-month follow-up (median functional loss = 5 points in Barthel Index). In multivariate analyses, COVID-19 status did not explain either the functional or the ambulation loss. By contrast, residents with low comorbidity and COVID-19 presented higher PTSD symptoms (effect 2.58; 95% CI 0.93 to 4.23) and anxiety symptoms (effect 2.10; 95% CI 0.48 to 3.73) compared to the low comorbidity/non-COVID19 group. CONCLUSION: COVID-19 pandemic was associated, after three-months, with high psychological impact in older adults in LTCFs., specifically with higher post-traumatic stress and anxiety symptoms. Functional decline did not differ in relation to COVID-19 status but could be related to isolation strategies used for pandemic control.

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn.

BACKGROUND/OBJECTIVES: To analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain. DESIGN: Epidemiological study. SETTING: Six open LTCFs in Albacete (Spain). PARTICIPANTS: 198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents. MEASUREMENTS: Baseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed. RESULTS: The pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals. CONCLUSION: The COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high.

Estado nutricional de ancianos hospitalizados en una unidad geriátrica de agudos / Nutritional status in older adults admitted to an acute geriatric unit

OBJETIVO: describir el estado nutricional de los mayores hospitalizados en una unidad geriátrica de agudos (UGA) y su asociación con la mortalidad y la estancia hospitalaria. MATERIAL Y MÉTODOS: estudio retrospectivo de 1084 personas mayores de 65 años en una UGA. Se emplearon el Mini Nutritional Assessment®-Short Form (MNA®-SF) y la valoración global subjetiva (VGS). La asociación entre estado nutricional, mortalidad y estancia hospitalaria prolongada (> 7 días) se analizó mediante un modelo de regresión y el análisis de riesgos de Cox. RESULTADOS: edad media de 86,5 años: 58,7% de mujeres. La puntuación media del MNA®-SF fue de 8,9, estando el 20,0% sin riesgo nutricional, el 48,2% en riesgo nutricional y el 31,7% con malnutrición. Mediante la VGS, el 22,1% estaban bien nutridos, el 54,7% moderadamente desnutridos y el 23,2% gravemente desnutridos. El acuerdo entre VGS y MNA®-SF fue bueno (kappa = 0,654; p < 0,001), clasificando correctamente al 78,5% de los participantes. La malnutrición se asoció a peor estado cognitivo, mayor discapacidad, peor deambulación y niveles menores de proteínas totales, albúmina, colesterol y transferrina. Los pacientes con malnutrición según el MNA®-SF presentaron una mortalidad ajustada mayor que la de los bien nutridos (HR: 1,80; IC 95%: 1,01-3,20), igual que aquellos con VGS de C frente a los de A (HR: 1,66; IC 95%: 0,96-2,86). Los pacientes con VGS de B (OR: 1,42; IC 95%: 1,04-1,96) y C (OR: 1,73; IC 95%: 1,18-2,54) presentaron mayor riesgo ajustado de estancia hospitalaria prolongada frente a los bien nutridos. Los pacientes con malnutrición según el MNA®-SF presentaron mayor riesgo ajustado de estancia hospitalaria prolongada (OR: 1,59; IC 95%: 1,09-2,33) frente a los bien nutridos. CONCLUSIONES: el riesgo nutricional y la malnutrición son muy frecuentes en los mayores hospitalizados en una UGA y se asocian con mayor mortalidad y estancias más prolongadas

OBJECTIVE: to describe the nutritional status of older adults hospitalized in an acute geriatric unit (AGU) and its association with mortality and days of hospitalization. MATERIAL AND METHODS: a retrospective study in 1,084 adults older than 65 years, hospitalized in an AGU. The Mini Nutritional Assessment®-Short Form (MNA®-SF) and subjective global assessment (SGA) were used. The association between nutritional status, mortality, and long hospital stay (> 7 days) was analyzed using regression models and Cox hazard models. RESULTS: mean age was 86.5 years: 58.7 % were women. Mean MNA®-SF score was 8.9 (20.0 %, well nourished; 48.2 %, at nutritional risk, and 31.7 % with malnutrition). Using the SGA, 22.1 % were well nourished, 54.7 % had moderate malnutrition, and 23.2 % had severe malnutrition. Agreement between SGA and MNA®-SF was good (kappa, 0.654; p < 0.001), and correctly classified 78.5 % of participants. Malnutrition was associated with poorer cognitive status, greater disability, worse ambulation, and lower levels of total protein, albumin, cholesterol, and transferrin. Patients with malnutrition in the MNA®-SF assessment had a higher adjusted mortality risk than those who were well nourished (HR, 1.80; 95 % CI, 1.01-3.20), same as those with SGA C versus A (HR, 1.66; 95 % CI, 0.96-2.86). Patients with SGA B and C presented a higher adjusted risk of long hospitalization as compared to well nourished subjects (OR, 1.42; 95 % CI, 1.04-1.96 and OR, 1.73; 95 % CI, 1.18-2.54, respectively. Patients with malnutrition per the MNA-SF® presented a higher adjusted risk of long hospitalization as compared to well nourished subjects (OR, 1.59; 95 % CI, 1.09-2.33). CONCLUSIONS: nutritional risk and malnutrition are very common in older adults in AGUs, and are associated with higher mortality and longer hospital stay

[Nutritional status in older adults admitted to an acute geriatric unit]. / Estado nutricional de ancianos hospitalizados en una unidad geriátrica de agudos.

INTRODUCTION: Objective: to describe the nutritional status of older adults hospitalized in an acute geriatric unit (AGU) and its association with mortality and days of hospitalization. Material and methods: a retrospective study in 1,084 adults older than 65 years, hospitalized in an AGU. The Mini Nutritional Assessment®-Short Form (MNA®-SF) and subjective global assessment (SGA) were used. The association between nutritional status, mortality, and long hospital stay (> 7 days) was analyzed using regression models and Cox hazard models. Results: mean age was 86.5 years: 58.7% were women. Mean MNA®-SF score was 8.9 (20.0%, well nourished; 48.2%, at nutritional risk, and 31.7% with malnutrition). Using the SGA, 22.1% were well nourished, 54.7% had moderate malnutrition, and 23.2% had severe malnutrition. Agreement between SGA and MNA®-SF was good (kappa, 0.654; p < 0.001), and correctly classified 78.5% of participants. Malnutrition was associated with poorer cognitive status, greater disability, worse ambulation, and lower levels of total protein, albumin, cholesterol, and transferrin. Patients with malnutrition in the MNA®-SF assessment had a higher adjusted mortality risk than those who were well nourished (HR, 1.80; 95% CI, 1.01-3.20), same as those with SGA C versus A (HR, 1.66; 95% CI, 0.96-2.86). Patients with SGA B and C presented a higher adjusted risk of long hospitalization as compared to well nourished subjects (OR, 1.42; 95% CI, 1.04-1.96 and OR, 1.73; 95% CI, 1.18-2.54, respectively. Patients with malnutrition per the MNA-SF® presented a higher adjusted risk of long hospitalization as compared to well nourished subjects (OR, 1.59; 95% CI, 1.09-2.33). Conclusions: nutritional risk and malnutrition are very common in older adults in AGUs, and are associated with higher mortality and longer hospital stay.

INTRODUCCIÓN: Objetivo: describir el estado nutricional de los mayores hospitalizados en una unidad geriátrica de agudos (UGA) y su asociación con la mortalidad y la estancia hospitalaria. Material y métodos: estudio retrospectivo de 1084 personas mayores de 65 años en una UGA. Se emplearon el Mini Nutritional Assessment®-Short Form (MNA®-SF) y la valoración global subjetiva (VGS). La asociación entre estado nutricional, mortalidad y estancia hospitalaria prolongada (> 7 días) se analizó mediante un modelo de regresión y el análisis de riesgos de Cox. Resultados: edad media de 86,5 años: 58,7% de mujeres. La puntuación media del MNA®-SF fue de 8,9, estando el 20,0% sin riesgo nutricional, el 48,2% en riesgo nutricional y el 31,7% con malnutrición. Mediante la VGS, el 22,1% estaban bien nutridos, el 54,7% moderadamente desnutridos y el 23,2% gravemente desnutridos. El acuerdo entre VGS y MNA®-SF fue bueno (kappa = 0,654; p < 0,001), clasificando correctamente al 78,5% de los participantes. La malnutrición se asoció a peor estado cognitivo, mayor discapacidad, peor deambulación y niveles menores de proteínas totales, albúmina, colesterol y transferrina. Los pacientes con malnutrición según el MNA®-SF presentaron una mortalidad ajustada mayor que la de los bien nutridos (HR: 1,80; IC 95%: 1,01-3,20), igual que aquellos con VGS de C frente a los de A (HR: 1,66; IC 95%: 0,96-2,86). Los pacientes con VGS de B (OR: 1,42; IC 95%: 1,04-1,96) y C (OR: 1,73; IC 95%: 1,18-2,54) presentaron mayor riesgo ajustado de estancia hospitalaria prolongada frente a los bien nutridos. Los pacientes con malnutrición según el MNA®-SF presentaron mayor riesgo ajustado de estancia hospitalaria prolongada (OR: 1,59; IC 95%: 1,09-2,33) frente a los bien nutridos. Conclusiones: el riesgo nutricional y la malnutrición son muy frecuentes en los mayores hospitalizados en una UGA y se asocian con mayor mortalidad y estancias más prolongadas.

[Comprehensive Care Home Unit: reduction of hospital resources during influenza outbreaks]. / Unidad domiciliaria de atención integral: Reducción de recursos hospitalarios durante brotes de gripe.

OBJECTIVE: The Comprehensive Care Home Unit of the General Hospital of Villarrobledo is a unit formed by a geriatrician who sees people in nursing homes to improve their quality of care. The activity of the Unit has been analyzed, mainly with the objective of avoiding referral to the emergency room, avoiding hospital admissions, avoiding hospital readmissions and reducing the number of hospital admission days. METHODS: We retrospectively described the clinical activity of the Unit during the influenza outbreak of 2017 and 2018. We selected sociodemographical variables, functional assessment scales (Katz index, Barthel index and the Functional Ambulation Classification), and the Global Deterioration Scale. We registered mortality, type of treatment, oncological patients and patients with supplementary tests. The population was divided into four subgroups: hospital admission avoided, hospital re-admission avoided, referral to the emergency department avoided and reduction of admission days. The demographic characteristics were described, including the mode or mean of the variables. An economic report was made, and an analysis of cost per process according to the subgroups, means of Related Groups for the Diagnosis and degree of dependency measured by the Barthel index. RESULTS: We selected 112 patients, they had a mean age of 82.2 years, Katz G (34.8%), IB 28.8 (DE 34.9), FAC 0 (63.4%) and GDS 7 (22.3%). The most frequent disease seen was respiratory infection (63.2%), 71.4% received active treatment, 10.7% complementary tests were performed, 17.9% oncological and 17% mortality. Cost analysis: hospital readmission avoided (€ 4,128 per patient) and patients with total disability (BI 0-20, € 3,623 per patient) presented more economic saving. The economic savings were more than € 230,000. CONCLUSIONS: The contribution of the Unit during periods of influenza outbreak is cost saving because of reduced numbers of admissions, numbers of readmissions, days of admission and emergency room visits.

OBJETIVO: La Unidad Domiciliaria de Atención Integral (UDAI) del Hospital General de Villarrobledo está formada por un geriatra que atiende a las personas institucionalizadas para mejorar su calidad asistencial. Se analizó la actividad de la UDAI, principalmente en el objetivo de evitar ingresos y reingresos hospitalarios, evitar visitas a urgencias y facilitar el alta hospitalaria prematura. METODOS: Describimos de forma retrospectiva la actividad de la UDAI durante los brotes de gripe del 2017 y 2018. Aportamos variables sociodemográficas, escalas de valoración funcional (índice de Katz, índice de Barthel y la Escala de Valoración Funcional de la Marcha), y la Escala de Deterioro Global. Registramos mortalidad, tipo de tratamiento, pacientes oncológicos y pruebas complementarias. Se dividió la población en cuatro subgrupos: ingreso hospitalario evitado, reingreso hospitalario evitado, derivación a urgencias evitada y reducción días de ingreso. Se describieron las características demográficas, incluido la moda o media de las variables. Se realizó una memoria económica, y un análisis de coste por proceso según los subgrupos, medias de Grupos Relacionados por el Diagnóstico y grado de dependencia medido por el Índice de Barthel. RESULTADOS: Se seleccionaron 112 pacientes, presentaban una edad media de 82,2 años, Katz G (34,8%), IB 28,8 (DE 34,9), FAC 0 (63,4%) y GDS 7 (22,3%). La enfermedad más frecuente fue la infección respiratoria (63,4%), recibieron tratamiento activo un 71,4%, se realizaron pruebas complementarias en un 10,7%, oncológico 17,9% y exitus 17%. Análisis de costes: el reingreso hospitalario evitado (4.128 € por paciente) y los pacientes con discapacidad total (IB 0 ­ 20, 3.623 € por paciente) presentaron un mayor ahorro de costes. El ahorro económico fue de más de 230.000€. CONCLUSIONES: La contribución de la UDAI durante los periodos de brote de gripe supone un ahorro de costes basado en disminuciones de hospitalizaciones, disminución de reingresos, acortamiento de estancias hospitalarias y reducción de derivaciones a urgencias.

Unidad domiciliaria de atención integral: Reducción de recursos hospitalarios durante brotes de gripe / Comprehensive Care Home Unit: reduction of hospital resources during influenza outbreaks

Fundamentos: La Unidad Domiciliaria de Atención Integral (UDAI) del Hospital General de Villarrobledo está formada por un geriatra que atiende a las personas institucionalizadas para mejorar su calidad asistencial. Se analizó la actividad de la UDAI, principalmente en el objetivo de evitar ingresos y reingresos hospitalarios, evitar visitas a urgencias y facilitar el alta hospitalaria prematura. Métodos: Describimos de forma retrospectiva la actividad de la UDAI durante los brotes de gripe del 2017 y 2018. Aportamos variables sociodemográficas, escalas de valoración funcional (índice de Katz, índice de Barthel y la Escala de Valoración Funcional de la Marcha), y la Escala de Deterioro Global. Registramos mortalidad, tipo de tratamiento, pacientes oncológicos y pruebas complementarias. Se dividió la población en cuatro subgrupos: ingreso hospitalario evitado, reingreso hospitalario evitado, derivación a urgencias evitada y reducción días de ingreso. Se describieron las características demográficas, incluido la moda o media de las variables. Se realizó una memoria económica, y un análisis de coste por proceso según los subgrupos, medias de Grupos Relacionados por el Diagnóstico y grado de dependencia medido por el Índice de Barthel. Resultados: Se seleccionaron 112 pacientes, presentaban una edad media de 82,2 años, Katz G (34,8%), IB 28,8 (DE 34,9), FAC 0 (63,4%) y GDS 7 (22,3%). La enfermedad más frecuente fue la infección respiratoria (63,4%), recibieron tratamiento activo un 71,4%, se realizaron pruebas complementarias en un 10,7%, oncológico 17,9% y exitus 17%. Análisis de costes: el reingreso hospitalario evitado (4.128 Euros por paciente) y los pacientes con discapacidad total (IB 0 - 20, 3.623 Euros por paciente) presentaron un mayor ahorro de costes. El ahorro económico fue de más de 230.000 Euros. Conclusiones: La contribución de la UDAI durante los periodos de brote de gripe supone un ahorro de costes basado en disminuciones de hospitalizaciones, disminución de reingresos, acortamiento de estancias hospitalarias y reducción de derivaciones a urgencias

Background: The Comprehensive Care Home Unit of the General Hospital of Villarrobledo is a unit formed by a geriatrician who sees people in nursing homes to improve their quality of care. The activity of the Unit has been analyzed, mainly with the objective of avoiding referral to the emergency room, avoiding hospital admissions, avoiding hospital readmissions and reducing the number of hospital admission days. Methods: We retrospectively described the clinical activity of the Unit during the influenza outbreak of 2017 and 2018. We selected sociodemographical variables, functional assessment scales (Katz index, Barthel index and the Functional Ambulation Classification), and the Global Deterioration Scale. We registered mortality, type of treatment, oncological patients and patients with supplementary tests. The population was divided into four subgroups: hospital admission avoided, hospital re-admission avoided, referral to the emergency department avoided and reduction of admission days. The demographic characteristics were described, including the mode or mean of the variables. An economic report was made, and an analysis of cost per process according to the subgroups, means of Related Groups for the Diagnosis and degree of dependency measured by the Barthel index. Results: We selected 112 patients, they had a mean age of 82.2 years, Katz G (34.8%), IB 28.8 (DE 34.9), FAC 0 (63.4%) and GDS 7 (22.3%). The most frequent disease seen was respiratory infection (63.2%), 71.4% received active treatment, 10.7% complementary tests were performed, 17.9% oncological and 17% mortality. Cost analysis: hospital readmission avoided (Euros 4,128 per patient) and patients with total disability (BI 0-20, Euros 3,623 per patient) presented more economic saving. The economic savings were more than Euros 230,000. Conclusions: The contribution of the Unit during periods of influenza outbreak is cost saving because of reduced numbers of admissions, numbers of readmissions, days of admission and emergency room visits