Perfil del usuario de un servicio de urgencias hospitalarias. Hiperfrecuentación / Characteristics of hospital emergency departments users. Frequent users

Objetivo: Describir la población que acude a Urgencias hospitalarias e identificar las causas de dichas visitas, así como describir el perfil de los que las visitan de forma repetitiva. Método: Estudio descriptivo de visitas y personas que acudieron en 2013. Se han clasificado como infrecuentes si realizaron de una a 3 visitas al año, frecuentes si realizaron de 4 a 9, e hiperfrecuentadores 10 o más. Resultados: En 2013 hubo 86.673 visitas. Se produjeron más visitas en verano y diciembre, y con más visitas en martes, lunes y domingo. El diagnóstico más frecuente fue «lesiones y envenenamientos» (24,3%) y el segundo fue «síntomas, signos y estados mal definidos» (17,1%). En la mayoría de las visitas el destino al alta fue el domicilio (90,6%). En 2013 visitaron urgencias 51.672 personas (50,8% mujeres y 10,2% menores de 15 años). Las personas entre 31 y 50 años y los mayores de 65 años acudieron frecuentemente. Las tasas de frecuentación eran mayores en las personas de zonas cercanas al hospital. Un total de 237 personas (0,5%) realizaron 10 o más visitas en el año. De ellas, 81 acudieron por causas no justificadas. Conclusiones: Las visitas debidas a «estados mal definidos» no son despreciables, sería interesante profundizar en estas causas para establecer medidas. La distancia parece determinante a la hora de acudir al hospital. No se observa relación entre el nivel socioeconómico y frecuentación. La hiperfrecuentación aumentó con la edad y con patología crónica asociada, aunque los hiperfrecuentadores con visitas no justificadas eran más jóvenes

Objective: To present an assessment of the different profiles of patients that visit the emergency department, including a description of the illness leading to such visits, as well to describe the profiles of individuals who visit with high frequency. Method: The study was carried out during 2013. Users were classified as infrequent if they made 1 to 3 visits per year, frequent if they made 4 to 9, and hyper-frequent if they visited at least 10 times. Results: There were 86,673 visits in 2013. There were more visits in July, August and December. Tuesday, followed by Monday and Sunday, were the days that had the highest frequency of visits. The most frequent diagnosis at discharge was "injuries and poisonings" (24.3%), followed by "poorly defined signs, symptoms and status (17.1%) of the visits corresponded to poorly defined states. The discharge to home rate was 90.6%. Out of the 51,672 people who visited the hospital in 2013, 50.8% were female, and 10.2% were under 15 years. Those patients between The ages of 31 and 50, and those over 65 had the highest frequency rate. People living closer to the hospital had higher frequency rate .There were 237 people (0.5%) who made at least 10 visits, and among those, 81 people for no justifiable reason. Conclusions: An in-depth analysis of the visits due to "poorly defined signs, symptoms and status" would be interesting. The distance to the hospital seems to be determining factor for frequent visits. There is no relationship between socioeconomic status and the number of visits. The frequency of visits increases with age and associated chronic disease, although the high-frequency users with unjustified visits were younger

[Characteristics of hospital emergency departments users. Frequent users]. / Perfil del usuario de un servicio de urgencias hospitalarias. Hiperfrecuentación.

OBJECTIVE: To present an assessment of the different profiles of patients that visit the emergency department, including a description of the illness leading to such visits, as well to describe the profiles of individuals who visit with high frequency. METHOD: The study was carried out during 2013. Users were classified as infrequent if they made 1 to 3 visits per year, frequent if they made 4 to 9, and hyper-frequent if they visited at least 10 times. RESULTS: There were 86,673 visits in 2013. There were more visits in July, August and December. Tuesday, followed by Monday and Sunday, were the days that had the highest frequency of visits. The most frequent diagnosis at discharge was "injuries and poisonings" (24.3%), followed by "poorly defined signs, symptoms and status (17.1%) of the visits corresponded to poorly defined states. The discharge to home rate was 90.6%. Out of the 51,672 people who visited the hospital in 2013, 50.8% were female, and 10.2% were under 15 years. Those patients between The ages of 31 and 50, and those over 65 had the highest frequency rate. People living closer to the hospital had higher frequency rate .There were 237 people (0.5%) who made at least 10 visits, and among those, 81 people for no justifiable reason. CONCLUSIONS: An in-depth analysis of the visits due to "poorly defined signs, symptoms and status" would be interesting. The distance to the hospital seems to be determining factor for frequent visits. There is no relationship between socioeconomic status and the number of visits. The frequency of visits increases with age and associated chronic disease, although the high-frequency users with unjustified visits were younger.

Síndrome paraneoplásico en un cáncer de mama / Paraneoplastic syndrome in breast cancer

La dermatomiositis es una miopatía inflamatoria con afectación cutánea que se puede presentar de manera aislada, como un síndrome paraneoplásico (asociada a diferentes tipos de neoplasias) o asociada a conectivopatías. La etiología no está clara y tampoco hay estudios concluyentes en el momento actual de la asociación entre dermatomiositis y cáncer. El síndrome paraneoplásico puede aparecer antes, al mismo tiempo o después de la neoplasia, siendo la relación temporal entre ambas enfermedades difícil de establecer por el pequeño número de casos de los estudios. Presentamos en este artículo un caso de dermatomiositis paraneoplásica. El tumor con el que se relacionaba fue un cáncer de mama cuya presentación coincidió en el tiempo con la dermatomiositis (el diagnóstico se realizó dos meses después de la aparición de la dermatomiositis). El diagnóstico de la neoplasia no se hubiese podido llevar a cabo de no tener un protocolo adecuado para el estudio de la dermatomiositis

Dermatomyositis is an inflammatory myopathy with skin involvement that can occur in an isolated way as a paraneoplastic syndrome (associated to different types of neoplasms) or associated to connective tissue diseases. Its etiology is not clear and there are no conclusive studies at present on the association between dermatomyositis and cancer. The paraneoplastic syndrome may appear before, at the same time, or after the neoplasm, the temporal relationship between both diseases being difficult to establish due to the small number of cases in the studies. In this article, we present a case of paraneoplastic dermatomyositis. The tumor it was related to was a breast cancer whose presentation coincided in time with the dermatomyositis (the diagnosis was made 2 months after the appearance of dermatomyositis). The diagnosis of the neoplasm could not be done as there was no adequate protocol for the study of dermatomyositis