EsVida scale development and validation to assess the requirement of emergency management in cases of infectious gastroenteritis. / Construcción y validación de la escala EsVida para la valoración del requerimiento de manejo en urgencias de una gastroenteritis infecciosa.

INTRODUCTION: Infectious gastroenteritis can result in unnecessary emergency room consultations. Instruments are needed to detect the risks for unfavorable progression. AIM: To develop and validate a comprehensive severity scale for acute gastroenteritis in children. MATERIALS AND METHODS: Data associated with complications (probable items) were determined through a MeSH search. The EsVida scale was developed with 4 theoretic domains: personal history (3 items), social problems (2 items), risks for severe gastroenteritis (4 items), and signs of fluid and electrolyte imbalance (4 items). The items were evaluated as present (one point) or absent (zero points) on a 0 to 13-point scale. To validate the instrument, an observational study was conducted at the emergency service on children from one to 13 years of age with acute gastroenteritis. The scale was re-developed utilizing the risks calculated by logistic regression analysis. RESULTS: Ninety-seven pediatric patients were evaluated using the EsVida scale (theoretic development). Its initial version showed an area under the ROC curve of 0.69 (95% CI of 0.6 to 0.79). After risk adjustment, it was simplified to a total of 5 items, with a score of 0 to 42.5. The new scale produced an area under the ROC curve of 0.85 (95% CI of 0.75 to 0.90). At a cutoff value of 12 points, the scale had 69.8% sensitivity and 70.5% specificity. A score below 6 indicated that patients could be managed at home at no risk. CONCLUSIONS: The modified EsVida scale could be used as an aid in deciding on at-home management in cases of acute infectious gastroenteritis.

[Features information of the surgical process and patients' satisfaction]. / Características de la información en el proceso quirúrgico y satisfacción de los pacientes.

AIM: To explore the relationship between the perceived characteristics of the information that patients receive on the surgical procedure and their satisfaction. METHOD: Observational cross-sectional study, conducted by the use of surveys at the Virgen Macarena University Hospital (VMUH) of Seville, in July 2009. It involved 75 patients selected by convenience sampling. The ANOVA test was performed according to the assessed characteristics of the information in order to determine the differences in satisfaction. RESULTS: The value obtained in the satisfaction with the information of physicians and nurses are high. Nevertheless, 42, 5% had the impression of not being able to ask questions and 71, 4% were not asked for authorized relatives to be informed. When applying the ANOVA test, statistically significant differences were obtained for the satisfaction with the information received by the physicians, depending on having received it prior to surgery, and the privacy while receiving this information. On the other hand, the satisfaction with the information provided by nursing professionals is related to the supplying of information on discharge and further home care instructions.