High mortality among hospitalized adult patients with COVID-19 pneumonia in Peru: A single centre retrospective cohort study.

BACKGROUND: Peru is the country with the world's highest COVID-19 death rate per capita. Characteristics associated with increased mortality among adult patients with COVID-19 pneumonia in this setting are not well described. METHODS: Retrospective, single-center cohort study including 1537 adult patients hospitalized with a diagnosis of SARS-CoV-2 pneumonia between May 2020 and August 2020 at a national hospital in Lima, Peru. The primary outcome measure was in-hospital mortality. RESULTS: In-hospital mortality was 49.71%. The mean age was 60 ± 14.25 years, and 68.38% were males. We found an association between mortality and inflammatory markers, mainly leukocytes, D-dimer, lactate dehydrogenase, C-reactive protein and ferritin. A multivariate model adjusted for age, hypertension, diabetes mellitus, and corticosteroid use demonstrated that in-hospital mortality was associated with greater age (RR: 2.01, 95%CI: 1.59-2.52) and a higher level of oxygen requirement (RR: 2.77, 95%CI: 2.13-3.62). Conclusions: In-hospital mortality among COVID-19 patients in Peru is high and is associated with greater age and higher oxygen requirements.

Hospitalizaciones inapropiadas en el servicio de emergencia de un hospital general / Inappropriate hospitalization in a general hospital's emergency service

Objetivo. Determinar la frecuencia de hospitalizaciones inapropiadas y los factores relacionados en el servicio de emergencia de un hospital general. Material y métodos. Estudio transversal, descriptivo de corte retrospectivo. Se reviso una muestra de 154 admisiones desde el servicio de emergencia a salas de hospitalización de medicina interna entre enero a junio del 2012. Se recolectan variables como edad, sexo, procedencia y grado de instrucción, diagnósticoo de ingreso, turno de hospitalización, entre otras. Se utilizó el Appropriateness Evaluation Protocol para determinar la adecuación de ingreso. Los resultados se expresaron en frecuencia, y medias. Para variables cuantitativas se usó la prueba t de Student y la prueba no paramétrica de Mann-Withney; y, para la comparación de proporciones se utilizó la prueba de ji cuadrado. Resultdos. Del total de hospitalizaciones por emergencia, 7,79% fueron inapropiadas; 58% de las admisiones inadecuadas tuvieron como diagnóstico de ingreso síntomas y signos generales. Se encontró asociación entre el diagnóstico de ingreso y la hospitalización inapropiada. Conclusión. El porcentaje de hospitalizaciones inapropiadas desde el servicio de emergencia concuerda con los valores reportados por la literatura internacional. En diagnósticos de ingreso no definidos, la probabilidad de una hospitalización inapropiada es alta.

Objective. To determine the frequency of inappropriate hospitalizations and the related factors in a general hospital's emergency service. Materials and methods. A descriptive, retrospective and cross-sectional study was done. It was reviewed a sample of 154 admissions from emergency service to the internal medicine wards from January to June 2012. Variables such as age, sex, origin, educational level, entry diagnosis, hospitalization turn among others were collected. Appropriateness Evaluation Protocol was used to determine the adequacy of hospitalization. The data was expressed in frequencies and averages. It was used the t-Student and non-parametric Mann-Withney test for quantitative variables; test the Chi-square test was used for comparison of proportions. Conclusion. In hypertensive persons, stage I, red wine consumption increased the antioxidant status. Results. The proportion of inappropriate hospitalizations from the emergency service is consistent with those reported in the international literature. A no definite diagnosis at entry increased the likelihood of inappropriate hospitalization.