Sobrevida post instalación de gastrostomía: experiencia de un centro terciario / Survival post installation of gastrostomy: experience of a tertiary cente

Introduction: Percutaneous Endoscopic Gastrostomy (PEG) is one of the preferred methods for providing enteral feeding to patients whose oral intake nutrition is not feasible. There is limited evidence regarding post- PEG survival. Our primary objective is to evaluate long-term survival and identify main variables in a cohort of patients with PEG. Methodology: A retrospective study of patients who underwent PEG at Sótero del Río Hos- pital between 2013 and 2020 was conducted. Demographic data, indications for PEG, and time from placement to death, in applicable cases, were evaluated. Specific indications were classified into four groups: Neoplasia, Dementia, Stroke (CVA), and Other neurological causes. Kaplan-Meier curves were plotted to represent survival, and log-rank tests were used. Results: 635 patients were included, 53.5% male, with a median age of 69 years (IQR 55-79). Indications included Neoplasia (11.8%), Dementia (9.8%), Stroke (58.4%), and Other neurological causes (20.0%). The overall survival rate was 36%, with rates of 50.23% at one year and 3.94% at five years, and a median survival of 12 months (IQR 4-28). According to the previous diagnosis, the Other neurological causes group had a higher survival rate (p < 0.001), with a median survival of 16 months (IQR 4-35). Conclusions: PEG is an invasive technique where placement is influenced by multiple variables such as previous diagnosis and patient type. Our study demonstrated a survival rate consistent with the literature, where factors such as age and the type of disease that prompted indication are relevant to consider.

Introducción: La gastrostomía endoscópica percutánea (GEP) es uno de los métodos de elección para brindar alimentación enteral a pacientes que ven afectada su capacidad de nutrición por vía oral. Existe escasa evidencia respecto a la sobrevida post GEP, estudios describen un 40% al año, en relación a la gravedad inherente de la enfermedad de base de los pacientes. Nuestro objetivo principal es evaluar la sobrevida a largo plazo y cuáles serían las principales variables que podrían influir, en una cohorte de pacientes con GEP. Metodología: Estudio retrospectivo de pacientes a quienes se les instaló una GEP en el Hospital Sótero del Río, entre los años 2013- 2020. Se evaluaron datos demográficos, indicación de la GEP y tiempo transcurrido desde la instalación hasta el fallecimiento, en los casos correspondientes. Las indicaciones específicas fueron clasificadas en cuatro grandes grupos: Neoplasia, Demencia, Accidente Cerebrovascular (ACV) y Otras causas neurológicas. Se trazaron curvas de Kaplan-Meier para representar la supervivencia y se utilizaron pruebas de log-rank test. En el análisis estadísti- co se utilizó SPSS versión 25. Resultados: Se incluyeron 635 pacientes, 53,5% sexo masculino, con una mediana de edad 69 años (RIQ 55-79). Dentro las indicaciones: Neoplasia (11,8%), Demencia (9,8%), ACV (58,4%) y Otras causas neurológicas (20,0%). La tasa de sobrevida global fue del 36%, siendo al año 50,23 % y a los 5 años 3,94%; con una mediana de sobrevida de 12 meses (RIQ 4-28). Según diagnóstico previo, el grupo Otras causas neurológicos tuvo una mayor sobrevida (p < 0,001), con una mediana de 16 meses (RIQ 4-35). Conclusiones: La GEP es una técnica invasiva donde su instalación responde a múltiples variables como diagnóstico previo y tipo de paciente. Nuestro trabajo demostró una tasa de supervivencia acorde con la literatura, donde los factores como la edad y el tipo de enfermedad que originó indicación son relevantes a considerar.

Experiencia de la pandemia por SARS-CoV-2 en un centro hospitalario de alta complejidad en Chile / Epidemiological profile of patients with COVID-19 admitted to a tertiary care public hospital

BACKGROUND The knowledge about the epidemiological profile of patients admitted to the hospital for severe COVID infection, allows an adequate health care planning and resource allocation. AIM: To describe the epidemiology of patients with COVID-19 admitted to a public hospital between March 2020 and July 2021. Material and Methods: Demographic variables, comorbidities, ventilatory support requirements, and hospital resources were recorded from clinical records and hospital databases of diagnosis related groups. The primary outcomes were overall mortality and need of ventilatory support. RESULTS: In the study period, 4,474 patients (56% males) were hospitalized with a diagnosis of COVID-19. Overall mortality was 25.8% and in-hospital mortality was 18%. Invasive and non-invasive ventilatory support was required in 1349 (30.2%) and 2060 (46%) patients, respectively. The most common comorbidities in admitted patients were diabetes mellitus (29.2%), chronic kidney disease (11.1%), and chronic liver disease (10.4%). The readmission rate was 3.2%. CONCLUSIONS: Mortality associated with COVID-19 in this hospital was similar to the rates reported abroad. Local risk predictors for this infection should be identified.

[Epidemiological profile of patients with COVID-19 admitted to a tertiary care public hospital]. / Experiencia de la pandemia por SARS-CoV-2 en un centro hospitalario de alta complejidad en Chile.

BACKGROUND: The knowledge about the epidemiological profile of patients admitted to the hospital for severe COVID infection, allows an adequate health care planning and resource allocation. AIM: To describe the epidemiology of patients with COVID-19 admitted to a public hospital between March 2020 and July 2021. MATERIAL AND METHODS: Demographic variables, comorbidities, ventilatory support requirements, and hospital resources were recorded from clinical records and hospital databases of diagnosis related groups. The primary outcomes were overall mortality and need of ventilatory support. RESULTS: In the study period, 4,474 patients (56% males) were hospitalized with a diagnosis of COVID-19. Overall mortality was 25.8% and in-hospital mortality was 18%. Invasive and non-invasive ventilatory support was required in 1349 (30.2%) and 2060 (46%) patients, respectively. The most common comorbidities in admitted patients were diabetes mellitus (29.2%), chronic kidney disease (11.1%), and chronic liver disease (10.4%). The readmission rate was 3.2%. CONCLUSIONS: Mortality associated with COVID-19 in this hospital was similar to the rates reported abroad. Local risk predictors for this infection should be identified.