Functional status and mortality at month and year in nonagenarians hospitalized due to acute medical illness.

OBJECTIVES: To analyze risk factors associated with short and long-term mortality in nonagenarians hospitalized due to acute medical conditions. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of all patients aged 90 years or older admitted in a geriatric unit during 2009 due to medical acute illness. Baseline variables were collected at admission (sex, cause of admission, Charlson index, serum albumin, functional, and mental status), functional loss at admission (as the difference between Barthel index(BI) 2 weeks before admission and BI at admission), and functional loss at discharge(as the difference between BI 2 weeks before admission and BI at discharge). The association of these variables with mortality at 1 month and 1 year after admission was analyzed by multivariate Cox regression analysis. RESULTS: Out of all patients admitted, 434 (33%) were 90 years old or older and 76.3% were female. Mortality at 1 month and 1 year after admission was 19% and 57%, respectively. In the month mortality multivariate analysis, being older (HR, 1.11; 95% CI=1.02 to 1.20), a previous Barthel index less than 40 points (HR, 5.87; 95% CI=1.16 to 29.67), and functional loss at admission (HR; 1.13; 95% CI=1.03 to 1.25) were independent risk factors. When patients that died 1 month after admission were excluded, the presence of hypoalbuminemia <3g/dl (HR, 2.70; 95% CI=1.69 to 4.32) and functional loss at discharge (HR-1.08, 95% CI=1.03 to 1.14) were the factors associated with 1 year mortality. CONCLUSIONS: In nonagenarians, functional impairment is the most important risk factor associated with short and long-term mortality after hospitalization due to acute medical illness.

Anticoagulante lúpico: manifestaciones clínicas / Lupic anticoagulant: clinical presentations

Se analizan las manifestaciones clínicas de 17 pacientes en los cuales por un episodio trombótico o excepcionalmente hemorrágico, se diagnosticó la presencia de un anticoagulante lúpico. Se destaca la predominancia del sexo femenino, la edad joven (mediana 23 años), la trombosis a localización predominantemente venosa y en zonas atípicas, pudiendo verse también trombosis arteriales e infartos placentarios. El Lupus Eritematoso Sistémico, solo estuvo presente en tres pacientes, no demostrándose en el resto de la población otra causa etiológica