RESUMEN
The aim of this study is to evaluate the association between changes in routinely prescribed laboratory tests and tracheostomy-free survival in amyotrophic lateral sclerosis (ALS). Two hundred seventy-five ALS patients were retrospectively studied. BMI, forced vital capacity, hemoglobin, hematocrit, lymphocytes, cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, proteins, albumin, creatine-phosphokinase, iron, ferritin, transferrin, glucose, urea, uric acid, and creatinine were measured every 6 months from baseline to 24 months, death or study end, together with the probability of death or tracheostomy. Missing data were handled using multiple imputation chained equations. Hemoglobin (OR = 1.71, 95%CI 1.24-2.36 for IQR increase), hematocrit (OR = 1.87, 95%CI 1.34-2.63 for IQR increase), urea (OR = 1.51, 95%CI 1.21-1.89 for IQR increase), and uric acid (OR = 1.98, 95%CI 1.23-3.20 for IQR increase) were directly associated, while triglycerides (OR = 0.69, 0.51 to 0.93 for IQR increase) were inversely associated with the odds of death or tracheostomy. In our cohort, an increase of hemoglobin, hematocrit, urea, and uric acid was directly associated, and an increase of triglycerides was inversely associated with the odds of death or tracheostomy. Should these findings be replicated in an external cohort, they might help to discriminate ALS progression and patients' decisions about procedures and end of life.
Asunto(s)
Esclerosis Amiotrófica Lateral/diagnóstico , Esclerosis Amiotrófica Lateral/mortalidad , Técnicas de Laboratorio Clínico , Anciano , Esclerosis Amiotrófica Lateral/fisiopatología , Esclerosis Amiotrófica Lateral/cirugía , Biomarcadores/sangre , Índice de Masa Corporal , Progresión de la Enfermedad , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Estudios Retrospectivos , Traqueostomía , Capacidad VitalRESUMEN
We have investigated age, sex, nationality, origin, diagnosis and treatment types in ambulatory patients of the External Clinics of the Division Health Mental of the General Hospital for Acute Patients "Dr. Teodoro Alvarez", of 600 Clinical Histories obtained in the years 1980, 1990 and 2000. These data have been extracted with the purpose of studying probable changes in the social and psychopathologic conformation of the patients, in the last two decades.
Asunto(s)
Necesidades y Demandas de Servicios de Salud , Servicios de Salud Mental/estadística & datos numéricos , Argentina , Estudios Epidemiológicos , Hospitales Generales/estadística & datos numéricos , Humanos , Servicios de Salud Mental/normas , Servicios de Salud Mental/tendenciasRESUMEN
Se han investigado los diagnósticos y los distintos tipos de tratamientos de 600 historias clínicas, de pacientes ambulatorios de los consultorios externos de la división salud mental del Hospital general de agudos Dr. Teodoro Alvarez, obtenidas en los años 1980, 1990 y 2000. Se ha comprobado el incremento y la importancia que han adquirido los tratamientos psicoterapéuticos, en las últimas dos décadas, en relación a los distintos abordajes terapéuticos