Factores asociados a las estancias anormalmente prolongadas en las hospitalizaciones por insuficiencia cardiaca en España / Associated factors with unusually long stays in heart failure hospitalizations in Spain

Fundamento. La insuficiencia cardiaca es un proceso de altaprevalencia que origina repetidos ingresos hospitalarios consobrecarga asistencial e incremento del gasto sanitario. Losobjetivos de este trabajo son describir y caracterizar los casoscon estancias prolongadas por este síndrome, detectandoposibles factores asociados a la misma.Método. Estudio de cohorte histórica de todos los episodiosde personas mayores de 45 años, ingresados por insuficienciacardiaca en el Sistema Sanitario Público Español en el período1997-2007. Fuente: 808.229 episodios clasificados como GruposRelacionados de Diagnóstico 127 y 544, según el Conjunto MínimoBásico de Datos del Instituto de Información Sanitaria. Seevaluaron variables sociodemográficas (edad, género, comunidadautónoma), clínicas (comorbilidades, complicaciones, tipode ingreso y alta) y de gestión (estancia, tipo de hospital, reingresos).Se definió estancia anormalmente prolongada aquellaque superó el percentil 90 (14 y 16 días, respectivamente),construyéndose un modelo de regresión logística para valorarsus posibles factores asociados.Resultados. Presentaron estancias anormalmente prolongadasel 11,4%, mostrando inferior edad media y mayor número dediagnósticos y procedimientos, reingresos y mortalidad que elgrupo sin estancias prolongadas. Padecer anemia, insuficienciarenal, TEP o ictus así como el reingreso y el ingreso programadose asociaron a mayor probabilidad de estancia anormalmenteprolongada.Conclusión. Es posible definir un perfil de comorbilidady sociodemográfico que valore la probabilidad de tener uningreso prolongado, si bien dadas las características de lasbases de datos administrativas la capacidad discriminativadel modelo es discreta(AU)

Background. Heart failure is a process of high prevalencethat causes repeated hospital admissions with increasedhealth care costs. The aim of this article is to describe andcharacterize the cases with long stays due to this syndrome,identifying associated factors wherever possible.Method. An historical cohort of all the episodes of peopleover 45 years with a diagnosis of heart failure admitted inthe Spanish Public Health System in the period 1997-2007.Source: 808,229 episodes classified as Diagnosis RelatedGroups 127 and 544 according to the Minimum Basic Dataprovided by the Institute for Health Information. We assessedsociodemographic variables (age, gender, region),clinical variables (comorbidities, complications, type of admissionand discharge) and management variables (lengthof stay, type of hospital readmissions). An abnormally prolongedstay (APS) was defined as one exceeding the 90thpercentile (14 and 16 days, respectively); we built a logisticregression model to assess their possible associated factors.Results. Eleven point four percent (11.4%) presented abnormallyprolonged stays, showing lower mean age and increasednumber of diagnoses and procedures, readmissions andmortality than the non-abnormally prolonged stay group.Anemia, kidney failure, pulmonary embolism or stroke aswell as readmission and scheduled admission were associatedwith increased likelihood of APS.Conclusion. It is possible to define a comorbidities andsociodemographic profile to assess the likelihood of a prolongedhospital stay, but given the nature of administrativedatabase the model’s discriminative ability is quite discreet(AU)

Optical modulators based on electrocapillarity.

Electrically addressable variable-power optical elements of small (<1-mm) dimensions that can be used as optical modulators are described with experimental results. The devices use the curved interface between two immiscible liquids as an optical element. The electrocapillarity effect is used to change the interfacial tension and hence the curvature and power of the interface. Both transmission and reflection systems are described.