Calidad de vida al alta hospitalaria de pacientes con sobrepeso ingresados en servicios de medicina interna / Quality of life at discharge of patients with overweight admitted to internal medicine departments

Objetivo: Evaluar la calidad de vida (CVRS) al alta hospitalaria de pacientes con sobrepeso en los servicios de medicina interna de 4 hospitales españoles. Material y método: Estudio descriptivo transversal con los datos de pacientes con índice de masa corporal ≥25kg/m2, de ≥18 años, no diabéticos, ingresados en cuatro servicios de medicina interna a lo largo de un año. El día del ingreso se les recogió variables sociodemográficas y el Índice de Comorbilidad de Charlson [ICC] el día del alta, la CVRS (cuestionario EQ-5D-5L) y los días de hospitalización. Resultados: muestra final de 168 pacientes. Con la Escala Visual Analógica del EQ-5D-5L, los pacientes del hospital de la ciudad de Granada presentaron una mediana de puntuación de 45, y de 60 en el resto de hospitales (0=peor a 100= mejor estado de salud). En los hospitales de la ciudad de Granada, Baza, Ceuta y Motril se obtuvieron unas medianas de días de estancia de 8, 6, 9 y 8, con unas medianas de edad de 81, 71, 51 y 72 años y unas medianas en el ICC de 5, 3, 0 y 1, respectivamente. No existió correlación entre los días de hospitalización con el Índice de Comorbilidad de Charlson (Coef. -0.57, p=0.48), edad (Coef -0.09, p=0.25), ni escala EVA (Coef. -0.65, p=0.43). Conclusiones: Hay gran heterogeneidad en la CVRS y en casi todas las características estudiadas en los pacientes entre los hospitales incluidos. Los pacientes del hospital de la ciudad de Granada tienen las peores valoraciones en la CVRS, son los de más edad y tienen peor ICC. Los pacientes del hospital de Ceuta son los de menos edad y tienen mejor ICC. Recomendaciones: las intervenciones en atención primaria que tengan en cuenta la CVRS al alta hospitalaria, podría mejorar la gestión clínica y sanitaria. (AU)

Objective: To evaluate the health-related quality of life (HRQoL) at hospital discharge of patients with overweight in internal medicine departments of four Spanish hospitals. Material and Methods: Descriptive cross-sectional study of non-diabetic patients aged ≥18 years with body mass index (BMI) ≥25 Kg/m2 admitted to four internal medicine departments over a one-year period. Data were gathered on sociodemographic variables and Charlson Comorbidity Index (CCI) at admission and on HRQoL (EQ-5D-5L questionnaire) and length of hospital stay at discharge. Results: The final sample included 168 patients. The median EQ-5D-5L visual analog scale score was median of 45 in Granada hospital, and median of 60 in the rest. (0 = worst to 100 = best imaginable). Median lengths of hospital stay were 8, 6, 9, and 8 days in Granada, Baza, Ceuta, and Motril hospitals, respectively, median ages were 81, 71, 51, and 72 years, respectively, and median CCI values were 5, 3, 0, and 1, respectively. No correlation was observed between length of hospital stay and CCI (coefficient -0.57, p=0.48), age (coefficient -0.09, p=0.25), or VAS (coefficient -0.65, p=0.43). Conclusions There is a wide heterogeneity in the HRQoL and almost all studied characteristics among participating centers. Patients in the hospital in Granada city have the worst HRQoL, highest age, and worst CCI value. The patients of the Ceuta hospital have lowest age and the best CCI. Recommendations: primary care interventions that take account of the HRQoL at hospital discharge could improve clinical and health care management. (AU)

Hospital Intervention to Reduce Overweight with Educational Reinforcement after Discharge: A Multicenter Randomized Clinical Trial.

INTRODUCTION: Obesity and overweight affect more than one-third of the world's population and pose a major public health problem. OBJECTIVE: To evaluate the impact of an educational intervention on dietary habits and physical exercise in patients with overweight admitted to departments of internal medicine, comprising a pre-discharge educational session with follow-up and reinforcement by telephone at 3, 6, and, 12 months post-discharge. Outcome variables were weight, systolic (SBP) and diastolic (DBP) blood pressures, health-related quality of life (HRQOL), hospital readmissions, emergency department visits, and death. METHOD: A randomized experimental study with a control group was performed in hospitalized non-diabetic adults aged ≥18 years with body mass index (BMI) ≥25 Kg/m2. RESULTS AND CONCLUSIONS: The final sample included 273 patients. At three months post-discharge, the intervention group had lower SBP and DPB and improved dietary habits (assessed using the Pardo Questionnaire) and VAS-assessed HRQOL in comparison to the control group but a worse EQ-5Q-5L-assessed HRQOL. There were no between-group differences in hospital readmissions, emergency department visits, or mortality at any time point. Both groups evidenced a progressive improvement over the three follow-up periods in weight, SBP, and dietary habits but a worsening of EQ-5D-5L-value-assessed HRQOL. DISCUSSION: The intervention group showed greater improvements over the short term, but between-group differences disappeared at 6 and 12 months. Weight loss and improvements in key outcomes were observed in both groups over the follow-up period. Further research is warranted to determine whether a minimum intervention with an educational leaflet, follow-up phone calls, and questionnaires on overweight-related healthy habits, as in the present control group, may be an equally effective strategy without specific individual educational input.

Differences in Dietary Habits, Physical Exercise, and Quality of Life between Male and Female Patients with Overweight.

Overweight can be an additional problem in patients admitted to hospital. OBJECTIVE: To analyze gender differences in pre-admission dietary habits and physical exercise and in HRQoL at hospital discharge among hospitalized adults with overweight. METHODS: Cross-sectional study in non-diabetic patients enrolled in a clinical trial with body mass index (BMI) ≥ 25 Kg/m2 at admission. Bivariate analyses used Pearson's chi-square test and Fisher's exact test for qualitative variables and the Mann-Whitney test for numerical variables. RESULTS: The study included 148 males and 127 females. At admission, women had higher BMI (p = 0.016) than men and a larger percentage consumed drugs for depression (p = 0.030) and anxiety (p = 0.049), and followed a religion-based diet (p = 0.022). Pre-admission, women had healthier habits related to dietary caloric intake (p = 0.009) and greater adherence to recommendations for a healthy diet (p = 0.001). At discharge, women described worse self-perceived health (p = 0.044) and greater pain/discomfort (p = 0.004) in comparison to men. CONCLUSIONS: Pre-admission, women had better habits related to a healthy diet and did not differ from men in habits related to physical exercise but had a higher BMI. At discharge, women reported worse self-perceived health and greater pain/discomfort. These differences should be considered for the adequate clinical management of patients with overweight.