Satisfacción y utilidad del tratamiento rehabilitador a través de material educativo en pacientes con COVID-19 / Satisfaction and utility of rehabilitative treatment through educational material in patients with COVID-19

Objetivo: En Madrid, durante la pandemia por COVID-19, debido a la saturación hospitalaria se precisó la medicalización de hoteles para traslado de pacientes infectados por SARS-CoV-2 con evolución favorable. Su situación clínica tipo era de fatiga y desacondicionamiento físico, precisando y beneficiándose de un abordaje rehabilitador. El Servicio de Rehabilitación desarrolló material educativo en formato de papel sobre ejercicio terapéutico adaptado a las diferentes situaciones funcionales detectadas. El objetivo es describir el perfil de pacientes ingresados en un hotel medicalizado y analizar el grado de satisfacción y adherencia al ejercicio pautado durante el ingreso y en domicilio y los factores relacionados. Material y método: Estudio descriptivo de pacientes ingresados en el Hotel Colón durante dos meses de 2020, con análisis de variables socio demográficas, y de cuestionarios con respecto al grado de adherencia y satisfacción del tratamiento rehabilitador durante ingreso y al alta. Resultado: Participaron 100 pacientes con una edad media de 52 años±14.5, donde el 61% (n=61) fueron mujeres. El 99% (n=99) refirió comprender los ejercicios, los realizaron durante el ingreso el 90% (n=90), mientras un 58% (n=58) los continuó al alta. El 92% (n=92) se mostró «muy satisfecho» con el material educativo, considerándolo fácil de realizar en el 100% (n=100) de los casos. Conclusión: Los pacientes se mostraron satisfechos con el material educativo, fueron ejercicios comprensibles y tuvieron adherencia durante el ingreso y en domicilio. El material educativo en formato papel podría considerarse una herramienta útil para el manejo de pacientes con infección por SARS-CoV-2.(AU)

Objective: In Madrid, during the pandemic, due to hospital saturation, medicalisation of hotels was required for the transfer of patients infected by SARS-CoV-2 with favourable evolution. Their typical clinical situation was one of fatigue and physical deconditioning, requiring and benefiting from a rehabilitative approach. The Rehabilitation Department developed educational material in paper format on therapeutic exercise adapted to the different functional situations detected. To describe the profile of patients admitted to a medicalised hotel and to analyse the degree of satisfaction, utility and adherence to the exercise prescribed during hospitalisation and at home and the related factors. Material and method: We conducted a descriptive study of patients admitted to the Hotel Colon during April and May 2020. We analysed the socio-demographic and clinical variables, as well as the responses to the adherence and satisfaction questionnaires about rehabilitation management during admission and at discharge. Results: 100 patients participated in the study with a mean age of 52±14.5 years, where 61% (n=61) were women. 99% (n=99) reported they understood the material with a 90% (n=90) adherence to exercise during admission and 58% (n=58) at discharge. 92% (n=92) were “very satisfied” with the educational material and considered it easy to perform in 100% (n=100) of cases. Conclusion: The use of paper-based educational material of therapeutic exercise appears to be an effective resource in the management of patients with SARS-CoV-2 infection during admission, thus minimising the exposure of healthcare staff.(AU)

[Satisfaction and utility of rehabilitative treatment through educational material in patients with COVID-19]. / Satisfacción y utilidad del tratamiento rehabilitador a través de material educativo en pacientes con COVID-19.

OBJECTIVE: In Madrid, during the pandemic, due to hospital saturation, medicalisation of hotels was required for the transfer of patients infected by SARS-CoV-2 with favourable evolution. Their typical clinical situation was one of fatigue and physical deconditioning, requiring and benefiting from a rehabilitative approach. The Rehabilitation Department developed educational material in paper format on therapeutic exercise adapted to the different functional situations detected. To describe the profile of patients admitted to a medicalised hotel and to analyse the degree of satisfaction, utility and adherence to the exercise prescribed during hospitalisation and at home and the related factors. MATERIAL AND METHOD: We conducted a descriptive study of patients admitted to the Hotel Colon during April and May 2020. We analysed the socio-demographic and clinical variables, as well as the responses to the adherence and satisfaction questionnaires about rehabilitation management during admission and at discharge. RESULTS: 100 patients participated in the study with a mean age of 52±14.5 years, where 61% (n=61) were women. 99% (n=99) reported they understood the material with a 90% (n=90) adherence to exercise during admission and 58% (n=58) at discharge. 92% (n=92) were "very satisfied" with the educational material and considered it easy to perform in 100% (n=100) of cases. CONCLUSION: The use of paper-based educational material of therapeutic exercise appears to be an effective resource in the management of patients with SARS-CoV-2 infection during admission, thus minimising the exposure of healthcare staff.

Oncological patients admitted to an intensive care unit. Analysis of predictors of in-hospital mortality. / Pacientes oncológicos ingresados en Unidad de Cuidados Intensivos. Análisis de factores predictivos de mortalidad.

OBJECTIVE: To analyze the factors influencing in-hospital mortality among cancer patients admitted to an Intensive Care Unit (ICU). DESIGN: A retrospective observational study was carried out. SETTING: The ICU of a community hospital. PATIENTS: Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h. INTERVENTIONS: Review of clinical data. VARIABLES OF INTEREST: Referring ward and length of stay prior to admission to the ICU, type of tumor, extent, Eastern Cooperative Oncology Group (ECOG) score, reason for ICU admission, severity (SOFA, APACHE-II, SAPS-II), type of therapy received in the ICU, and in-hospital mortality. RESULTS: A total of 167 patients (mean age 71.1 years, 62.9% males; 79% solid tumors) were included, of which 61 (36%) died during their hospital stay (35 in the ICU). The factors associated to increased in-hospital mortality were ECOG scores 3-4 (OR 7.23, 95%CI: 1.95-26.87), metastatic disease (OR 3.77, 95%CI: 1.70-8.36), acute kidney injury (OR 3.66, 95%CI: 1.49-8.95) and SOFA score at ICU admission (OR 1.26, 95%CI: 1.10-1.43). A total of 60.3% of the survivors were independent at hospital discharge. CONCLUSIONS: In our series, only one-third of the critically ill cancer patients admitted to the ICU died during hospital admission, and more than 50% showed good performance status at hospital discharge. The clinical prognostic factors associated to in-hospital mortality were poor performance status, metastatic disease, SOFA score at ICU admission and acute kidney injury.

[Anemia in elderly patients admitted to an acute geriatric ward]. / Prevalencia y valor pronóstico al año de la anemia en pacientes ingresados en una unidad geriátrica de agudos.

OBJECTIVE: To describe the characteristics, prevalence and prognostic of anemia in older patients admitted to an acute geriatric unit. MATERIAL AND METHODS: A prospective descriptive study was conducted on patients admitted to a geriatric unit. Anemia was defined using the World Health Organization criteria. A comprehensive geriatric assessment was performed on all patients. When possible, a telephone follow-up re-evaluation (mortality, functional status) was performed one year after discharge. RESULTS: A total of 145 patients were studied. The mean age was 81 years, and 93 (64.13%) were anemic. Chronic diseases and iron deficiency anemia were the most frequent. Anemic patients had lower scores in the Barthel Index (P<.05). The mortality one year after discharge was 47.9%, with no differences between anemic or non-anemic patients (OR 2.07, [0.98-4.4]). All the geriatric indexes (Barthel index; Charlson comorbidity index, Mini-mental state examination and Mini Nutritional Assessment) showed worse scores in patients who died one year after discharge. CONCLUSIONS: The prevalence of anemia in the elderly admitted to a geriatric unit is elevated, and associated with a poorer functional status.

Functional outcome of stroke and the cumulative experience of a stroke unit.

OBJECTIVE: Patients with acute stroke are more likely to survive and achieve independence if they are treated in a stroke unit. Available information in our setting is scarce. We analyse the outcomes of our patients on the basis of cumulative experience in a stroke unit. PATIENTS AND METHODS: A retrospective cohort study of patients admitted to a stroke unit. We differentiate between two groups according to the year of admission: group A (July 2007-December 2009) and group B (January 2010-December 2011), analysing early outcome based on the score on the National Institute of Health stroke scale and mortality at discharge, and medium-term outcome in terms of mortality and functional status according to the modified Rankin scale at three months. RESULTS: A total 1070 patients were included. There were no differences between groups with respect to favourable outcome (68.3% vs 63.9), hospital mortality (5.1% vs 6.6%), or 90-day mortality (12.8% vs 13.1%). The percentage of patients who were independent at 90 days was greater in group B (56.3% vs 65.5%, P=.03). In the multivariate analysis adjusted for stroke subtype and fibrinolytic therapy, the association between patient independence and admission period remained present. CONCLUSIONS: The probability of functional independence in our patients increased alongside accumulated experience in our stroke unit with no differences in mortality.