RESUMO
Aplastic anemia (AA) is a rare, life-threatening hematological disease, with a poorly defined incidence. As the data available on AA varies substantially worldwide, a multicenter, ambispective, observational study was carried out between 2010 and 2019 to assess the incidence, clinical management and survival of AA at seven Spanish hospitals. The incidence of AA was 2.83 per million inhabitants per year, consistent with that reported previously in Europe, with a median age at diagnosis of 61 years-old (range 12-86), and a similar number of males and females. The initial diagnosis was severe or very severe AA in 55.8% of cases and 93.7% required transfusion. The most frequent first line therapy was anti-thymocyte globulin (ATG) plus cyclosporin A (CsA, 44.2%), followed by other CsA-based regimes (46.3%), with hematopoietic stem cell transplantation an infrequent 1st line therapy. The 6-month response rate was 68.2%, which then increased over a median follow-up of 3.9 years. The 5-year overall survival (5OS) was 73.6%, similar in severe (78.6%) and very severe AA patients (74.6%) but lower in moderate AA (MAA) patients (68.4%). The 5OS was 100% in 0-25 year-old patients but dropping to 58.3% in patients ≥ 60 years-old. At the last contact, 75.8% of the patients were alive. In conclusion, the incidence, characteristics and management of AA in our study are consistent with that reported previously. In terms of survival, although the global long-term OS rate was good, there is room for improvement, particularly in older patients. Finally, what appears to be a worse long-term survival of MAA patients, as reported previously, reinforces the importance of not underestimating this condition when diagnosed as MAA.
Assuntos
Anemia Aplástica , Transplante de Células-Tronco Hematopoéticas , Masculino , Feminino , Humanos , Idoso , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Recém-Nascido , Lactente , Pré-Escolar , Anemia Aplástica/terapia , Anemia Aplástica/tratamento farmacológico , Espanha/epidemiologia , Incidência , Soro Antilinfocitário/uso terapêutico , Ciclosporina/uso terapêutico , Imunossupressores/uso terapêutico , Resultado do TratamentoRESUMO
Introducción: la población de 60 años y más requiere atención especial dado por la fragilidad que la caracteriza, que compromete su desempeño en las actividades elementales de la vida diaria. Muchos de ellos necesitan atención en instituciones como el hogar de ancianos, donde se les prestan servicios multidisciplinarios. Objetivo: evaluar el nivel de satisfacción de usuarios y prestadores de servicios en relación con la atención recibida en un hogar de ancianos. Material y Métodos: se realizó un estudio descriptivo transversal en el hogar de ancianos General Peraza, municipio 10 de Octubre, durante 2013. La evaluación se realizó mediante la aplicación del "Formulario para satisfacción de usuarios en Hogares de Ancianos" a 40 ancianos internos y del "Formulario para satisfacción de prestadores en Hogares de Ancianos" a 30 trabajadores de la Institución, validados previamente.Resultados: las variables relacionadas con condiciones de vida en usuarios resultaron con menos de 70 por ciento de respuesta buena. La atención recibida por médicos y personal de enfermería fue evaluada de buena en 100 por ciento y 95 por ciento respectivamente. El 87.5 por ciento de los ancianos refirió necesidad de ingresar, y solo 42.5 por ciento se siente a gusto. Las variables relacionadas con la satisfacción de prestadores fueron evaluadas entre regular y mala. Conclusiones: la satisfacción de usuarios y prestadores en el hogar de ancianos de manera general fue baja, hubo un bajo nivel de complacencia por el servicio recibido, insatisfacción con las condiciones de trabajo, privacidad y atención a sus problemas personales(AU)
Introduction: elderly population requires special attention due to the fragility that characterizes these persons, compromising their performance in the most elemental activities of life. Many of them require attention in institutions like the elderly homes, places where are provide a multidisciplinary services to all of those who can´t stay in their own houses.Objective: to assess the satisfaction levels of users and assistants relating to the assistance received at the Elderly home. Material and Methods: a descriptive and transversal study was made at "General Peraza" Elderly Home in 10 de Octubre Municipality, with capacity to 135 persons, during year 2013. Users satisfaction evaluation was done using the "Users satisfaction in Elderly Home Test" previously validated. Results: related variables with users´ life condition had less than 70 percent of correct answers. Attention provided by physicians and nurses was evaluated as "Good" in a 100 percent and 95 percent respectively by the patients. 87, 5 percent of the elderly patients admitted referred the necessity to be admitted at the institution, and only 42, 5 percent feel good there. Related variables with assistants were evaluated between "Regular" and "Bad". Conclusions: satisfaction level among users and assistants at the institution were low, low level of willingness with the received services, working conditions, privacy and attention to their own personal problems were insufficient(AU)