RESUMEN
INTRODUCTION: The presence of iron deficiency (ID) in patients with acute heart failure (AHF) is high. There are few studies on the characteristics of these patients and the safety of ferric carboxymaltose administration (FCM). OBJECTIVE: Study the differences among patients with AHF based on the presence and type of ID as well as the safety of FCM administration in these patients. METHOD: The AHF-ID study is a multicentre, analytical, prospective follow-up cohort including patients admitted to six Spanish hospitals for AHF. ID was defined as serum ferritin <100 µg/L (group A) or ferritin 100-299 µg/L with a TSAT <20% (group B). In cases receiving FCM the appearance of adverse events was analysed. Adjusted Cox regression was used to determine the association with 30-days reattendance for AHF after discharge. RESULTS: A total of 221 patients were recruited; 191 (86.4%) presented ID, 121 (63.4%) group A and 70 (36.6%) group B. There were scarce differences between the groups analysed. No differences were found in 30-days reattendance for AHF. FCM was administered to 158 (71.5%) patients, with 8 (5.1%) presenting adverse events, the most frequent being digestive alterations. Treatment was not discontinued in any case. CONCLUSIONS: There are scarce differences between the presence and the type of ID in patients with AHF. The administration of FCM in patients with ID and AHF is safe.
Asunto(s)
Anemia Ferropénica/sangre , Anemia Ferropénica/tratamiento farmacológico , Compuestos Férricos/uso terapéutico , Ferritinas/sangre , Insuficiencia Cardíaca/tratamiento farmacológico , Maltosa/análogos & derivados , Anemia Ferropénica/complicaciones , Femenino , Compuestos Férricos/efectos adversos , Insuficiencia Cardíaca/complicaciones , Humanos , Masculino , Maltosa/efectos adversos , Maltosa/uso terapéutico , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Fundamento y objetivo: La consulta telefónica urgente integrada dentro del funcionamiento de cada centro podría ser una herramienta útil en la gestión de las urgencias. El objetivo de este trabajo ha sido analizar la implementación de una central de llamadas(ICO24horas) para la atención de urgencias onco-hematológicas. Método: Estudio descriptivo y prospectivo de las consultas atendidas por ICO24horasdesde el 1 de octubre al 31 de diciembre del 2007. Para todas las llamadas se registraron variables socio-demográficas, clínicas y relacionadas con la consulta telefónica, y alas 24-72 horas se realizó una auditoría de calidad y satisfacción. Resultados: Se atendieron 656 llamadas, las cuales correspondieron a 498 casos médicos. Entre los motivos de consulta destacan: fiebre (12%), dolor (8%) y dudas terapéuticas(8%). El 60% fueron dados de alta telefónicamente, sin intervención de ningún otro nivel asistencial. En el control, el 100% de los pacientes afirmaron haberse sentido bien atendidos, y el 79% consideró que les habían resuelto el problema por el cual habían llamado. Conclusiones: ICO24horas es una herramienta eficaz y eficiente en la atención inicial de las urgencias oncológicas, que facilita el acceso a la consulta inmediata, evita desplazamientos innecesarios y contribuye a mejorar el uso de los servicios de urgencias hospitalarios (AU)
Background and objective: Urgent telephone consultation integrated into a hospitals patient care routines can be a useful tool in the management of urgent cases. The objective of this study was to analyze the setting up of a 24-hour callcenter (ICO24horas) to attend urgent hematologic and oncologic consultations. Patients and methods: Prospective, descriptive study including all consultations to ICO24horas between October 1 and December 31, 2007. Social, demographic, and clinical variables were recorded; call details were also registered. All calls underwent a quality and satisfaction audit within 24 to 72 hours. Results: There were 656 calls concerning 498 patients. The main reasons for consultation were fever (12%), pain (8%),and doubts about treatment (8%). At the end of the call, 60% were considered resolved, with no need for the intervention of other care services. In the survey, all patients stated they felt well attended by the ICO24horas staff and79% considered that the problem about which they had rung had been resolved. Conclusions: ICO24horas is an effective and efficient tool in the initial response to urgent oncologic problems, providing access to immediate consultation, avoiding unnecessary journeys, and contributing to improving the use of hospital emergency services (AU)
