[Factor analysis of health related quality of life in patients admitted to a short stay medical unit]. / Análisis factorial de la calidad de vida relacionada con la salud de pacientes que ingresan en una unidad de corta estancia médica.

BACKGROUND: Disease and hospital admission have a great impact on the quality of life of an individual. AIM: To identify the factors associated with health related quality of life (HRQL) in patients admitted to a Short Stay Medical Unit (SSMU). PATIENTS AND METHODS: Prospective cohort study of 335 patients aged 15 to 99 years (196 males) consecutively admitted to the SSMU. In all we recorded sociodemographic data, number of previous hospital admissions, admission type, main diagnosis, lenght of stay, comorbidities, the Goldberg Depression and Anxiety Scale, the Karnofsky Perfomance Scale, the Barthel Index and quality of life with the EuroQol-5D instrument. After studying the associations between variables, we carried out a factor analysis of those that were significantly related to HRQL. RESULTS: Mean body mass index was 27.7 Kg/m(2) and 83% were emergency admissions. Heart failure, chronic obstructive pulmonary disease exacerbation, acute coronary syndromes and cardiac arrhythmias, constituted 56% of all admissions. HRQL was statistically related to age, gender, educational status, caregiving situation, number of previous admissions, main diagnosis, length of stay, Goldberg scale and Karnofsky, Barthel and Charlson indexes. Factor analysis reduced the original variables to five, which explained 67.8% of the variance, as follows: Factor 1- Karnofsky and Barthel indexes (27.8%); Factor 2- age, educational status, caregiving situation (12.3%); Factor 3- the Goldberg scale (10.4%); Factor 4- admission type (8.8%); Factor 5- main diagnosis (8.4%). CONCLUSIONS: HRQL in patients admitted to Short Stay Medical Unit is partially related to perfomance status, age, social and psychological status, admission type an the main diagnosis.

Peak expiratory flow rate as predictor of inpatient death in patients with chronic obstructive pulmonary disease.

OBJECTIVES: Few studies analyze hospital deaths and related factors in patients with acute exacerbation of chronic obstructive pulmonary disease who require hospitalization. METHODS: A cross-sectional study was done with 284 patients who had been admitted consecutively to the Short Stay Medical Unit at the Juan Canalejo Hospital in A Coruña. RESULTS: Eleven patients (3.9%) died. The independent variables for predicting death were the peak expiratory flow (OR, 0.96; 95% CI, 0.94 to 0.98), long-term oxygen therapy (OR, 12.46; 95% CI, 2.1 to 72.4), and body mass index (OR, 0.73; 95% CI, 0.59 to 0.90). A peak expiratory flow < 150 L/min showed the best specificity and positive predictive value with maximum sensitivity for predicting death. The results of the arterial blood gasses and the functional tests did not predict hospital death. CONCLUSIONS: Peak expiratory flow was the most important predictive value for determining the risk of death in patients who required hospitalization for acute exacerbation of chronic obstructive pulmonary disease. Additional studies are required to validate these findings.

Análisis factorial de la calidad de vida relacionada con la salud de pacientes que ingresan en una unidad de corta estancia médica / Factor analysis of health related quality of life in patients admitted to a short stay medical unit

Background: Disease and hospital admission have a great impact on the quality of life of an individual: Aim: To identify the factors associated with health related quality of life (HRQL) in patients admitted to a Short Stay Medical Unit (SSMU). Patients and methods: Prospective cohort study of 335 patients aged 15 to 99 years (196 males) consecutively admitted to the SSMU. In all we recorded sociodemographic data, number of previous hospital admissions, admission type, main diagnosis, ¡enght of stay, comorbidities, the Goldberg Depression and Anxiety Scale, the Karnofsky Perfomance Scale, the Barthel Index and quality of life with the EuroQol-5D instrument. After studying the associations between variables, we carried out a factor analysis of those that were significantly related to HRQL. Results: Mean body mass index was 27.7 Kg/m² and 83 percent were emergency admissions. Heart failure, chronic obstructive pulmonary disease exacerbation, acute coronary syndromes and cardiac arrhythmias, constituted 56 percent of all admissions. HRQL was statistically related to age, gender, educational status, caregiving situation, number of previous admissions, main diagnosis, length of stay, Goldberg scale and Karnofsky, Barthel and Charlson indexes. Factor analysis reduced the original variables to five, which explained 67.8 percent of the variance, as follows: Factor 1- Karnofsky and Barthel indexes (27.8 percent); Factor 2- age, educational status, caregiving situation (12.3 percent); Factor 3- the Goldberg scale (10.4 percent); Factor 4- admission type (8.8 percent); Factor 5- main diagnosis (8.4 percent). Conclusions: HRQL in patients admitted to Short Stay Medical Unit is partially related to perfomance status, age, social and psychological status, admission type an the main diagnosis (RevMéd Chile 2009; 137:1163-72).