RESUMO
OBJECTIVE: This article aims to assess the utility of CURB-65 in predicting 30-day mortality in adult patients hospitalized with COVID-19. METHODS: This work is a cohort study conducted between March 1 and April 30, 2020 in Ecuador. RESULTS: A total of 247 patients were included (mean age 60 ± 14 years, 70% men, overall mortality 41.3%). Patients with CURB-65 ≥ 2 had a higher mortality rate (57 vs. 17%, p < .001) that was associated with other markers of risk: advanced age, hypertension, overweight/obesity, kidney failure, hypoxemia, requirement for mechanical ventilation, or onset of respiratory distress. CONCLUSIONS: CURB-65 ≥ 2 was associated with higher 30-day mortality on the univariate (Kaplan-Meier estimator) and multivariate (Cox regression) analysis.
Assuntos
COVID-19 , Adulto , Idoso , Estudos de Coortes , Equador/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2RESUMO
Objetivo: Valorar la utilidad del CURB-65 para predecir la mortalidad a 30 días en pacientes adultos hospitalizados con COVID-19. Métodos: Cohorte realizada entre el 1 de marzo y el 30 de abril de 2020 en Ecuador. Resultados: Se incluyeron 247 pacientes (edad media 60±14 años, 70% varones, mortalidad global 41,3%). Los pacientes con CURB-65≥2 presentaron mayor mortalidad (57 vs. 17%, p<0,001), en asociación con otros marcadores de riesgo: edad avanzada, hipertensión arterial, sobrepeso/obesidad, fracaso renal, hipoxemia, requerimiento de ventilación mecánica o desarrollo de distrés respiratorio.Conclusiones: En el análisis univariado (Kaplan-Meier) y multivariado (regresión de Cox) el CURB-65≥2 se relacionó con una mayor mortalidad a 30 días (AU)
Objective: This article aims to assess the utility of CURB-65 in predicting 30-day mortality in adult patients hospitalized with COVID-19. Methods: This work is a cohort study conducted between March 1 and April 30, 2020 in Ecuador. Results: A total of 247 patients were included (mean age 60±14 years, 70% men, overall mortality 41.3%). Patients with CURB-65≥2 had a higher mortality rate (57 vs. 17%, p<.001) that was associated with other markers of risk: advanced age, hypertension, overweight/obesity, kidney failure, hypoxemia, requirement for mechanical ventilation, or onset of respiratory distress. Conclusions: CURB-65≥2 was associated with higher 30-day mortality on the univariate (Kaplan-Meier estimator) and multivariate (Cox regression) analysis (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Pandemias , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Estimativa de Kaplan-Meier , Estudos de Coortes , Prognóstico , EquadorRESUMO
OBJECTIVE: This article aims to assess the utility of CURB-65 in predicting 30-day mortality in adult patients hospitalized with COVID-19. METHODS: This work is a cohort study conducted between March 1 and April 30, 2020 in Ecuador. RESULTS: A total of 247 patients were included (mean age 60 ± 14 years, 70% men, overall mortality 41.3%). Patients with CURB-65 ≥ 2 had a higher mortality rate (57 vs. 17%, p < .001) that was associated with other markers of risk: advanced age, hypertension, overweight/obesity, kidney failure, hypoxemia, requirement for mechanical ventilation, or onset of respiratory distress. CONCLUSIONS: CURB-65 ≥ 2 was associated with higher 30-day mortality on the univariate (Kaplan-Meier estimator) and multivariate (Cox regression) analysis.
RESUMO
En el presente artículo se revisa la utilidad del uso de la ecografía pulmonar (EP) en el diagnóstico, la estratificación pronóstica y el tratamiento de los pacientes con insuficiencia cardiaca (IC). Se abordan aspectos técnicos a la hora de realizar una ecografía pulmonar, así como la importancia de la presencia de las líneas B en el diagnóstico y el valor pronóstico de la congestión pulmonar. Por otra parte, se revisan las evidencias más recientes publicadas hasta la fecha en el empleo de la EP en la IC. Por último, se hace referencia a los nuevos ensayos clínicos en marcha, como el estudio EPICC, realizado de forma conjunta por los Grupos de Trabajo de Insuficiencia Cardiaca y Ecografía Clínica de la Sociedad Española de Medicina Interna
The present article reviews the usefulness of lung ultrasound in the diagnosis, prognostic stratification and treatment of patients with heart failure. The article addresses the technical aspects when performing lung ultrasonography, as well as the importance of the presence of B-lines in the diagnosis and the prognostic value of pulmonary congestion. Moreover, the article reviews the most recently published evidence on the use of lung ultrasound in heart failure. Lastly, the article references the new clinical trials currently underway, including the EPICC study conducted jointly by the Heart Failure and Clinical Ultrasonography Workgroups of the Spanish Society of Internal Medicine
Assuntos
Humanos , Ultrassonografia , Insuficiência Cardíaca/diagnóstico por imagem , Edema Pulmonar/diagnóstico por imagem , Insuficiência Cardíaca/tratamento farmacológico , Diuréticos/uso terapêutico , Edema Pulmonar/etiologia , Insuficiência Cardíaca/complicações , Tórax/diagnóstico por imagemRESUMO
The present article reviews the usefulness of lung ultrasound in the diagnosis, prognostic stratification and treatment of patients with heart failure. The article addresses the technical aspects when performing lung ultrasonography, as well as the importance of the presence of B-lines in the diagnosis and the prognostic value of pulmonary congestion. Moreover, the article reviews the most recently published evidence on the use of lung ultrasound in heart failure. Lastly, the article references the new clinical trials currently underway, including the EPICC study conducted jointly by the Heart Failure and Clinical Ultrasonography Workgroups of the Spanish Society of Internal Medicine.
RESUMO
OBJETIVO: Valorar la utilidad del CURB-65 para predecir la mortalidad a 30 días en pacientes adultos hospitalizados con COVID-19. MÉTODOS: Cohorte realizada entre el 1 de marzo y el 30 de abril de 2020 en Ecuador. RESULTADOS: Se incluyeron 247 pacientes (edad media 60 ± 14 años, 70% varones, mortalidad global 41,3%). Los pacientes con CURB-65 ≥ 2 presentaron mayor mortalidad (57 vs. 17%, p < 0,001), en asociación con otros marcadores de riesgo: edad avanzada, hipertensión arterial, sobrepeso/obesidad, fracaso renal, hipoxemia, requerimiento de ventilación mecánica o desarrollo de distrés respiratorio. CONCLUSIONES: En el análisis univariado (Kaplan-Meier) y multivariado (regresión de Cox) el CURB-65 ≥ 2 se relacionó con una mayor mortalidad a 30 días
OBJECTIVE: This article aims to assess the utility of CURB-65 in predicting 30-day mortality in adult patients hospitalized with COVID-19. METHODS: This work is a cohort study conducted between March 1 and April 30, 2020 in Ecuador. RESULTS: A total of 247 patients were included (mean age 60±14 years, 70% men, overall mortality 41.3%). Patients with CURB-65 ≥ 2 had a higher mortality rate (57 vs. 17%, p <.001) that was associated with other markers of risk: advanced age, hypertension, overweight/obesity, kidney failure, hypoxemia, requirement for mechanical ventilation, or onset of respiratory distress. CONCLUSIONS: CURB-65 ≥ 2 was associated with higher 30-day mortality on the univariate (Kaplan-Meier estimator) and multivariate (Cox regression) analysis
Assuntos
Humanos , Infecções por Coronavirus/mortalidade , Índice de Gravidade de Doença , Previsões/métodos , Síndrome Respiratória Aguda Grave/mortalidade , Equador/epidemiologia , Valor Preditivo dos Testes , Risco Ajustado/métodos , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave/patogenicidade , Pandemias/estatística & dados numéricos , Estudos de CoortesRESUMO
RESUMEN Antecedentes: La comunidad ecuatoriana es la tercera comunidad extranjera más numerosa en España. Sin embargo, es poco lo que se conoce acerca de su estado de salud cardiovascular (CV) y si los efectos de la migración han causado un detrimento en dicho estado. Métodos: Con el objetivo de conocer la salud CV en una población ecuatoriana de migrantes en Madrid, se realizó un estudio transversal no aleatorizado en el que se incluyeron personas de nacionalidad ecuatoriana, mayores de 25 años, residentes en Madrid desde hace un año o más. Se realizaron encuestas, mediante el uso de cuestionarios previamente validados, para determinar el estado de salud CV de la población, así como el grado de distress psicológico. Resultados: Se incluyeron 165 participantes (68,5% mujeres), con edad promedio de 49 años. El 86,1% de la población estudiada presentó salud cardiovascular pobre y 13,9% intermedia, sin diferencias significativas según el sexo. No hubo individuos que cumplan las 7 variables con valores ideales. Las mujeres presentaron puntuaciones más altas en el cuestionario DASS-21 en comparación a los hombres (p<0,05). Conclusión: En la población migrante ecuatoriana residente en Madrid, más del 85% presentó una salud CV pobre, y ninguno presentó una salud CV ideal. Los factores de riesgo más prevalentes en dicha población fueron pobre actividad física, sobrepeso/obesidad y malos hábitos dietéticos. Se requieren más estudios para identificar la situación real de riesgo CV de la población migrante ecuatoriana. Probablemente, a medio-largo plazo, será necesario implementar políticas de salud especialmente dirigidas a los migrantes.
ABSTRACT Background: The Ecuadorian community is the third largest foreign community in Spain. However, little is known about their cardiovascular (CV) health status and whether the effects of migration have caused a detriment in that state. Methods: With the aim of knowing the CV health in an Ecuadorian population of migrants in Madrid, a non-randomized, cross-sectional study was carried out, which included people of Ecuadorian nationality, older than 25 years, living in Madrid for a year or more. Surveys were conducted through the use of previously validated questionnaires, to determine the health status of the population, as well as the degree of neuro-physiological distress. Results: We included 165 participants (68.5% women), with an average age of 49 years. Of these, 86.1% presented poor cardiovascular health and 13.9% intermediate, without significant differences according to sex. There were no individuals that met the 7 variables consistent with and ideal CV status. Women had higher scores on the DASS-21 questionnaire compared to men (p <0.05). Conclusion: In the Ecuadorian migrant population living in Madrid, more than 85% had poor CV health, and none had an ideal CV health. Most prevalent risk factors in this population were poor physical activity, overweight/obesity and poor dietary habits. More studies are required to identify the real situation of CV risk in the Ecuadorian migrant population. Probably, in the medium-long term, it will be necessary to implement health policies especially addressed to migrants.
