ABSTRACT
Objetivos. Describir los factores predictivos de mortalidad hospitalaria en pacientes nonagenarios. Pacientes y método. Se estudió retrospectivamente a 421 pacientes ≥ 90 años ingresados en un servicio de Medicina Interna. Se analizó mediante regresión logística la asociación de parámetros demográficos, clínicos y funcionales con la mortalidad intrahospitalaria. Resultados. La edad media (DE) fue de 92,5 años (2,5), con 265 (62,9%) mujeres. Los principales diagnósticos fueron enfermedades infecciosas (257 pacientes, 61%) e insuficiencia cardiaca (183, 43,5%), y la estancia media fue de 11,9 días (8,6). Durante el ingreso fallecieron 96 pacientes (22,8%). Los factores predictivos de mortalidad fueron la edad (p = 0,002), el estado funcional (p = 0,006), la comorbilidad (p = 0,018) y los diagnósticos de neumonía (p = 0,001), sepsis (p = 0,012) e insuficiencia respiratoria (p < 0,001). Conclusión. La mortalidad hospitalaria de pacientes nonagenarios atendidos en Medicina Interna supera el 20% y se asocia a neumonía, carga de comorbilidad y deterioro funcional (AU)
Objectives. To describe the predictors of hospital mortality in nonagenarian patients. Patients and method. We retrospectively studied 421 patients aged 90 years or older hospitalised in a department of internal medicine. Using logistic regression, we analysed the association between demographic, clinical and functional parameters and hospital mortality. Results. The mean age was 92.5 years (SD±2.5), and 265 (62.9%) of the patients were women. The main diagnoses were infectious diseases (257 patients, 61%) and heart failure (183, 43.5%), and the mean stay was 11.9 days (SD±8.6). During the hospitalisation, 96 patients died (22.8%). The predictors of mortality were age (P=.002), functional state (P=.006), comorbidity (P=.018) and diagnoses of pneumonia (P=.001), sepsis (P=.012) and respiratory failure (P<.001). Conclusion. The hospital mortality of nonagenarian patients treated in internal medicine exceeds 20% and is associated with pneumonia, comorbidity burden and functional impairment (AU)
Subject(s)
Humans , Aged, 80 and over , Hospital Mortality/trends , Internal Medicine/statistics & numerical data , Cause of Death/trends , Indicators of Morbidity and Mortality , Retrospective Studies , Aged, 80 and over/statistics & numerical data , Forecasting/methods , Inpatient Care UnitsABSTRACT
OBJECTIVES: To describe the predictors of hospital mortality in nonagenarian patients. PATIENTS AND METHOD: We retrospectively studied 421 patients aged 90 years or older hospitalised in a department of internal medicine. Using logistic regression, we analysed the association between demographic, clinical and functional parameters and hospital mortality. RESULTS: The mean age was 92.5 years (SD±2.5), and 265 (62.9%) of the patients were women. The main diagnoses were infectious diseases (257 patients, 61%) and heart failure (183, 43.5%), and the mean stay was 11.9 days (SD±8.6). During the hospitalisation, 96 patients died (22.8%). The predictors of mortality were age (P=.002), functional state (P=.006), comorbidity (P=.018) and diagnoses of pneumonia (P=.001), sepsis (P=.012) and respiratory failure (P<.001). CONCLUSION: The hospital mortality of nonagenarian patients treated in internal medicine exceeds 20% and is associated with pneumonia, comorbidity burden and functional impairment.
ABSTRACT
Un varón de 51 años fue evaluado por hipertensión arterial en nuestro hospital en 1996, objetivándose en el seguimiento alteraciones dentales, hipercalciuria, hiperuricosuria, litiasis renal, osteopenia y una aceptable respuesta al tratamiento antihipertensivo con verapamilo, tiazidas y alopurinol. Se comenta la elevada prevalencia de esta situación en los hipertensos estudiados en nuestro hospital, de perfil familiar en algunas ocasiones, y la aceptable respuesta de la hipertensión arterial al tratamiento cuando se incluyen tiazidas, combinándolo con alopurinol, si existen alteraciones del metabolismo del ácido úrico
A 51 year-old-man was evaluated for hypertension in our hospital in 1996. Follow up observations included dental alteration, hypercalciuria, hyperuricosuria, renal lithiasis and osteopeny. The patient was also observed to acceptably respond to antihypertensive treatment with verapamil, thiazides and allopurinol. Discussed are the facts that this situation is quite prevalent among hypertensive patients in our hospital, some having a family history of such, and that the hypertension responds favourably to treatment when thiazides are included in combination with allopurinol if alterations in uric acid metabolism are present
