RESUMO
OBJECTIVES: The aim of this study was to assess prevalence, clinical characteristics, and prognosis in elderly patients with heart failure with preserved ejection fraction (HFPEF) compared to patients with heart failure with reduced ejection fraction (HFREF) who were followed in an internal medicine unit. METHODS: In this retrospective observational study, the sample consisted of 301 patients followed in an internal medicine referral unit between January 2007 and December 2010. All patients were checked to determine their vital status on 31 December 2012. Survival was analyzed using Kaplan-Meier curves, and compared using the log-rank test. RESULTS: Of the 301 patients, 165 (54.8%) were women. In the 263 cases (87.4%) who underwent echocardiographic assessment, 190 (72.2%) had HFPEF and 73 (27.8%) had HFREF. Mean age was similar in the two groups (80.1 and 79.9 years; p=0.905), with a predominance of women in the HFPEF group (60.5% women, 42.5% men; p=0.025). The main etiology was hypertensive heart disease in the HFPEF group. Regarding treatment, more beta-blockers were administered in the HFREF group. No statistically significant differences were observed between the groups in terms of cardiovascular risk factors, comorbidities, NYHA functional class, or mortality. CONCLUSION: Clinical characteristics were similar for both HFPEF and HFREF patients. Women were predominant in the HFPEF group, as was hypertensive etiology. No significant differences in mortality were observed between the groups.
Assuntos
Insuficiência Cardíaca/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Feminino , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Volume SistólicoAssuntos
Abscesso Hepático/complicações , Abscesso Hepático/microbiologia , Veia Porta , Staphylococcaceae , Tromboflebite/etiologia , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Ceftriaxona/administração & dosagem , Ceftriaxona/uso terapêutico , Emergências , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Staphylococcaceae/isolamento & purificação , Tromboflebite/diagnóstico por imagem , Tromboflebite/tratamento farmacológico , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND: Due to the increasing number of intravenous drug users, subjects with immune deficiencies or with prosthetic valves, infective endocarditis (IE) continues to be prevalent and to have a high mortality. AIM: To review all cases of infective endocarditis diagnosed in an Internal Medicine Service. MATERIAL AND METHODS: Retrospective review of medical records of all patients with infective endocarditis, hospitalized in an Internal Medicine ward, between 1989 and 2003. Dukes criteria were used to define definitive, possible and less probable cases of IE. RESULTS: Eighty seven patients with definite IE were identified (66 males, age range 19-84 years), with a mean incidence of 5.3 per 1000 hospitalizations. IE in intravenous drugs users was usually caused by Staphylococcus aureus and presented high risk of embolism (RR: 3,21). Subjects aged over 70 years had a relative risk of mortality of 5.5. Hospital acquired IE was associated with advanced age and IV catheters appeared as the only predisposing factor. Patients with prosthetic valves were also older, their main complication was abscess formation and their mortality was higher. CONCLUSIONS: A closer approach to differential conditions of patients, according to age, intravenous drug use or the presence of prosthetic valves, is necessary.
Assuntos
Endocardite Bacteriana/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estreptocócicas/epidemiologia , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Endocardite Bacteriana/microbiologia , Feminino , Doenças das Valvas Cardíacas/epidemiologia , Doenças das Valvas Cardíacas/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Infecções Relacionadas à Prótese/epidemiologia , Infecções Relacionadas à Prótese/microbiologia , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia , Infecções Estafilocócicas/complicações , Staphylococcus aureus , Infecções Estreptocócicas/complicações , Abuso de Substâncias por Via Intravenosa/epidemiologia , Tromboembolia/epidemiologia , Tromboembolia/microbiologia , Estreptococos ViridansRESUMO
Background: Due to the increasing number of intravenous drug users, subjects with immune deficiencies or with prosthetic valves, infective endocarditis (IE) continues to be prevalent and to have a high mortality. Aim: To review all cases of infective endocarditis diagnosed in an Internal Medicine Service. Material and methods: Retrospective review of medical records of all patients with infective endocarditis, hospitalized in an Internal Medicine ward, between 1989 and 2003. Dukes criteria were used to define definitive, possible and less probable cases of IE. Results: Eighty seven patients with definite IE were identified (66 males, age range 19-84 years), with a mean incidence of 5.3 per 1000 hospitalizations. IE in intravenous drugs users was usually caused by Staphylococcus aureus and presented high risk of embolism (RR: 3,21). Subjects aged over 70 years had a relative risk of mortality of 5.5. Hospital acquired IE was associated with advanced age and IV catheters appeared as the only predisposing factor. Patients with prosthetic valves were also older, their main complication was abscess formation and their mortality was higher. Conclusions: A closer approach to differential conditions of patients, according to age, intravenous drug use or the presence of prosthetic valves, is necessary