Síntomas depresivos, ansiosos e insomnio, y posibles factores asociados en personal de salud, en un Hospital General en Suramérica, durante la pandemia por COVID-19 en 2020 / Depressive and anxious symptoms and insomnia, and possible associated factors in health workers, in a General Hospital in South America, during the COVID-19 pandemic in 2020

La pandemia por el nuevo coronavirus COVID- 19 ha tenido impacto en la salud mental del personal médico y de enfermería en todo el mundo. Objetivo: identificar la frecuencia de síntomas depresivos, ansiosos e insomnio y los factores posiblemente relacionados con estos desenlaces en el personal sanitario de un hospital de Suramérica durante el primer pico de la pandemia. Materiales y métodos: se aplicaron las escalas PHQ-9 para depresión, GAD- 7 para ansiedad, ISI - 7 para insomnio en 876 trabajadores de la salud del Hospital Pablo Tobón Uribe en la ciudad de Medellín. Resultados: de los 876 participantes (29,2% médicos, 21.2% profesionales de enfermería y 49,5% auxiliares de enfermería), 357 (40.8%) presentaron síntomas depresivos, 300 (34.2%) síntomas ansiosos y 317 (36.2%) insomnio. Se observaron síntomas de depresión, ansiedad e insomnio, con mayor frecuencia en quienes no tenían las necesidades básicas satisfechas y en quienes se sentían estigmatizados por ser personal de salud. Además, la depresión se presentó con más frecuencia en mujeres, la ansiedad en menores de 44 años y el insomnio en personas separadas. Conclusiones: la frecuencia de problemas de salud mental en el personal de salud es considerable. Estos hallazgos demuestran la necesidad de atención en la salud mental de los profesionales médicos y de enfermería durante la pandemia por COVID-19 y la búsqueda de estrategias para mitigar el riesgo en esta población.

Background: pandemic due to novel coronavirus COVID-19 has impacted on the mental health of health care workers all around the world. Material and Methods: this is a cross sectional study in which questionnaires PHQ-9 for depression, GAD-7 for anxiety, ISI-7 for insomnia were virtually and self administered by 876 health care workers laboring in hospital Pablo Tobón Uribe in Medellin city. Results: from 876 participants (29.2% physicians, 21.2% nurses and 49.5% technical nurses), 357 (40.8%) developed depressive symptoms, 300 (34.2%) anxious symptoms and 317 (36.2%) insomnia. Symptoms of depression, anxiety and insomnia were more frequently found in those who did not have basic needs satisfied and in those who felt stigmatized due to being health personal. Besides, depressive symptoms were more frequent in women, anxious symptoms in people younger than 44 years old and insomnia in divorced people. Conclusions: the frequency of mental health problems in health care workers is significant, these findings bring to light the needs for mental health attention in nurses and doctors during COVID-19 pandemic and the research of strategies to mitigate the risk on this population. Feeling stigmatized and not having basic needs satisfied were associated with symptoms of anxiety, depression and insomnia.

Experiencia del proceso de transición de adolescentes con enfermedades crónicas desde la atención pediátrica a la atención de adultos en un hospital general / Experience with the transition process of adolescents with chronic diseases from pediatric to adult care in a general hospital

Introducción. Es clave para la atención óptima de la salud la continuidad del cuidado al pasar de pediatría a la medicina del adulto. Objetivo. Describir la experiencia del proceso de transición de pacientes adolescentes conenfermedades crónicas desde la atención enpediatría a la atención de adultos en un hospital general. Población y métodos. Estudio de cortetransversal de pacientes entre 16 y 24 años con antecedente de trasplante hepático, trasplante renal, enfermedades endocrinas, metabólicas, reumatológicas y mielomeningocele atendidos en un hospital general universitario de tercer nivel entre 2015 y 2019, durante el proceso de transición. Se evaluaron el proceso de atención y el éxito de la transición. Se utilizó el cuestionario de evaluación de preparación para la transición (Transition Readiness Assessment QuestionnaireTRAQ, por su sigla en inglés). Resultados. Se incluyeron 372 pacientes. Las especialidades de atención más frecuentesfueron clínica de mielomeningocele, equipo de trasplante renal y de trasplante hepático. El 37 % participó del proceso de transición. La media de seguimiento por pediatría hasta el inicio de la transición fue de 9 años. La media de edad de comienzo de la transición fue 19 años y la media de edad de finalización, 21 años. La estrategia de transición más frecuente fue clínica conjunta en el 96 %. La mediana del TRAQ ordinal fue de 4; de estos, el 32 % ya había consultado a adultos. El 32,7 % cumplió con una transición exitosa. Conclusiones. La continuidad del cuidadodurante la transición es un proceso que llevó casi dos años y en más de un tercio de los pacientes se realizó en forma exitosa.

Introduction. The continuity of care from pediatrics to adult medicine is key to optimal health care. Objective. To describe the experience of the transition process of adolescent patients with chronic diseases from pediatric to adult care in a general hospital. Population and methods. Cross-sectional study of patients aged 16­24 years with a history of liver transplantation, kidney transplantation, endocrine, metabolic, rheumatic diseases, and myelomeningocele seen at a tertiary care teaching general hospital between 2015 and 2019 during the transition process. The process of health care and transition success were assessed. The Transition Readiness Assessment Questionnaire (TRAQ) was used. Results. A total of 372 patients were included. The myelomeningocele clinic, the kidney transplant and the liver transplant teams were the most common specialties. Thirty-seven percent of participants were involved in the transition process. The mean duration of follow-up by pediatrics until transition initiation was 9 years. The mean age at the beginning of transition was 19 years, and the mean age at the end, 21 years. The joint clinic transition strategy was the most frequent, used in 96% of cases. The median value of the ordinal TRAQ was 4; of these, 32% had already seen adult care physicians. A successful transition was achieved by 32.7%. Conclusions. The continuity of care during transition is a process that took almost 2 years; more than one third of the patients had a successful transition.

Uso de psicofármacos y riesgo de apnea del sueño en pacientes internados en hospital general / Psychotropic drugs and obstructive sleep apnea risk use in hospitalized medical patients

RESUMEN: Se realizó un estudio descriptivo observacional, de corte transversal, con el objetivo de identificar la asociación del consumo de psicofármacos y el aumento del riesgo de padecer apnea obstructiva del sueño (A.O.S.), en pacientes internados y bajo tratamiento con psicofármacos en Hospital General (Hospital Pasteur, Montevideo, Uruguay) durante julio-septiembre de 2019. Se aplicó el cuestionario STOP BANG, hallándose riesgo elevado de A.O.S en el 59,4% de la muestra, del cual 75,6% corresponde al sexo masculino y el 24,4% corresponde al sexo femenino. El riesgo elevado para A.O.S fue: 54,3% para pacientes en tratamiento con un solo psicofármaco y 71,4% con dos. El grupo de antipsicóticos fue el que se asoció con mayor frecuencia al riesgo elevado de A.O.S.

SUMMARY A cross-sectional study was conducted with the objective of identifying the link between psychotropic medications and an increased risk of suffering from obstructive sleep apnea (OSA) in patients under treatment with psychotropic medication who were hospitalized in General Hospital (Hospital Pasteur, Montevideo, Uruguay) during the July-September 2019 period. The STOP BANG questionnaire was applied, elevated risk of OSA was found in 59.4% of the sample, of which 75.6% were male, while 24.4% were female. The elevated risk of OSA was: 54.4% for patients under treatment with a single psychotropic medication and 71.4% for patients under treatment with two psychotropic medications. Antipsychotics were the most frequently group of psychotropic drugs linked to an elevated OSA risk.

Intervención de enfermería para disminuir la depresión en pacientes con diálisis peritoneal en un hospital de Veracruz / Nursing intervention to reduce depression in patients with peritoneal dialysis in a Veracruz hospital

Introducción: la depresión en personas con enfermedad renal crónica (ERC) tiene efectos en el cumplimiento y aceptación del régimen terapéutico empleado. Objetivo: evaluar la eficacia de una intervención psicoeducativa de enfermería en la disminución de los síntomas de depresión en pacientes adscritos al Programa de Diálisis Peritoneal del Hospital General de Zona No.32 de Minatitlán, Veracruz. Metodología: estudio cuasi experimental; la muestra se integró con 8 pacientes y el muestreo se estableció por conveniencia. Se utilizó el inventario de depresión de Beck II y se aplicó una intervención de enfermería. Resultados: participaron más mujeres (75%), con 50% que utiliza DPA y 50% DPCA. La depresión mínima (37.5%) y la depresión leve (37.5%) predominaron antes de la intervención; luego de la intervención predominó el grado de depresión mínima (87.5%). La media fue de 14.88 en la prueba preliminar y 5.88 en la posterior (p = 0.007). Conclusiones: la intervención de enfermería mostró eficacia al disminuir los grados de depresión en los pacientes con ERC.

Introduction: Depression in a person with chronic kidney disease (CKD), has an impact on the fulfillment and acceptance of the therapeutic regimen used. Objective: To evaluate the efficacy of a psychoeducational nursing intervention to reduce depression symptoms in patients assigned to the peritoneal dialysis program of the General Hospital of Zone No.32 of Minatitlán, Ver. Methods: Quasi-experimental, study. Sample was 8 patients. Sampling was by Convenience. The Beck-II Depression Inventory was used; a nursing psychoeducational intervention was applied. Results: Most of the participants were women (75%); 50% uses DPA and 50% DPCA. Minimum depression (37.5%) and mild depression (37.5%) predominated before the intervention; after intervention, the minimum depression level predominated (87.5%). The average in the Pretest was 14.88 and 5.88 in the Posttest (p = .007). Conclusion: The nursing psychoeducational intervention showed efficacy to decrease depression levels in the group of CKD patients studied.

Perfil clínico y resultados de la pancreatitis aguda en la Unidad de Cuidados Intensivos e Intermedios de un hospital general / Clinical profile and results of acute pancreatitis in the Intensive and Intermediate Care Unit of a general hospital

RESUMEN La pancreatitis aguda (PA) es un proceso inflamatorio agudo del páncreas que, de acuerdo con la clasificación de Atlanta del 2012, puede ser leve, moderada o grave. Objetivo: Describir las características epidemiológicas, clínicas, terapéuticas y los resultados de pacientes con PA ingresados a la unidad de cuidados intensivos e intermedios de un hospital general y compararlos con los descritos en la literatura nacional e internacional. Materiales y métodos: Estudio observacional de pacientes con PA atendidos en un periodo de 3 años. Resultados: Se incluyeron 59 casos; predominó el sexo femenino (54,2%), la edad media fue de 59,3 años, la etiología más frecuente fue biliar (84,7%). Los puntajes de severidad promedio al ingreso fueron APACHE II de 12,4 puntos, SOFA de 4,9 puntos y Marshall modificado de 2,8 puntos; la falla orgánica más frecuente fue la respiratoria (47,5%). La estancia media en cuidados fue 13,9 días y en el hospital fue de 23,3 días. Ningún paciente con PA leve o moderada falleció durante su estancia hospitalaria, 6 pacientes con PA grave fallecieron durante su estancia hospitalaria (20% de los casos de PA grave). Conclusión: Los casos de nuestro hospital tuvieron un perfil clínico y terapéutico semejante al descrito en la literatura mundial y latinoamericano. Se evidenció una estancia hospitalaria mayor a la descrita en trabajos recientes, pero nuestra mortalidad fue menor.

ABSTRACT Acute pancreatitis (AP) is an acute inflammatory process of the pancreas that, according to the 2012 Atlanta classification, can be mild, moderate or severe. Objective: Describe the epidemiological, clinical, therapeutic and outcomes of patients with AP admitted to the intensive care and intermediate care unit of a general hospital and compare them with those described in the national and international literature. Materials and methods: Observational study of patients with AP treated over a period of 3 years. Results: 59 cases were included; the female sex prevailed (54.2%), the average age was 59.3 years, the most frequent etiology was biliary (84.7%). Average entry severity scores were APACHE II of 12.4 points, SOFA of 4.9 points and Marshall modified of 2.8 points; The most frequent organ failure was respiratory (47.5%). The average stay in care was 13.9 days and in the hospital it was 23.3 days. No patients with mild or moderate AP died during their hospital stay, 6 patients with severe AP died during their hospital stay (20% of cases of severe AP). Conclusion: The cases of our hospital had a clinical and therapeutic profile similar to that described in the world and Latin American literature. A hospital staying was greater than that described in recent works, but our mortality was lower.

Profile of general hospitals in the Unified Health System / Perfil dos hospitais gerais do Sistema Único de Saúde

ABSTRACT OBJECTIVE To characterize the organization of Brazilian general hospitals that provide services to the Unified Health System using indicators that describe the main dimensions of hospital care. METHODS A 2015 cross-sectional observational study, comprising the range of general hospitals that serve the Unified Health System. We constructed the hospital indicators from two national administrative databases: the National Registry of Health Facilities and the Hospital Information System of the Unified Health System. The indicators include the main dimensions associated with hospital care: public-private mix, production, production factors, performance, quality, case-mix and geographic coverage. Latent class analysis of indicators with bootstrapping was used to identify hospital profiles. RESULTS We identified three profiles, with hospital size being the variable with the highest degree of belonging. Small hospitals show low occupancy rates (21.36%) and high participation of hospitalizations that could have been solved with outpatient care, besides attending only medium complexity cases. They receive few non-residents, indicating that they are mainly dedicated to the local population. Medium-sized hospitals are more similar to small-sized ones: about 100% of the visits are of medium complexity, low occupancy rate (45.81%), high rate of hospitalizations for primary care sensitive conditions (17.10%) and relative importance in the healthcare provision of non-residents (26%). Large hospitals provide high complexity care, have an average occupancy rate of 64.73% and show greater geographical coverage. CONCLUSIONS The indicators point to three hospital profiles, characterized mainly by the production scale. Small hospitals show low performance, suggesting the need to reorganize hospital care provision, especially at the municipal level. The set of proposed indicators includes the main dimensions of hospital care, providing a tool that can help to plan and continuously monitor the hospital network of the Unified Health System.

RESUMO OBJETIVO Caracterizar a organização dos hospitais gerais brasileiros que prestam serviço ao Sistema Único de Saúde por meio de indicadores que descrevem as principais dimensões do cuidado hospitalar. MÉTODOS Estudo observacional transversal para o ano de 2015, compreendendo o universo dos hospitais gerais que atendem o Sistema Único de Saúde. Os indicadores hospitalares foram construídos a partir de duas bases de dados administrativos nacionais: o Cadastro Nacional de Estabelecimento de Saúde e o Sistema de Informações Hospitalares do Sistema Único de Saúde. Os indicadores contemplam as principais dimensões associadas ao cuidado hospitalar: mix público-privado, produção, fatores de produção, desempenho, qualidade, case-mix e abrangência geográfica. A análise de classes latentes dos indicadores com implementação do bootstrapping foi utilizada para a identificação dos perfis hospitalares. RESULTADOS Foram identificados três perfis, sendo porte hospitalar a variável com grau de pertencimento mais elevado. Os hospitais pequenos apresentam baixas taxas de ocupação (21,36%) e elevada participação de internações que poderiam ter sido solucionadas com cuidado ambulatorial, além de atenderem somente a média complexidade. Recebem poucos não residentes, indicando que estão dedicados praticamente à população local. Os hospitais de médio porte se assemelham mais aos de pequeno porte: cerca de 100% dos atendimentos são de média complexidade, baixa taxa de ocupação (45,81%), elevada taxa de internações por condições sensíveis à atenção primária (17,10%) e relativa importância no atendimento de não residentes (26%). Os hospitais grandes realizam os atendimentos de alta complexidade, têm taxa de ocupação média de 64,73% e apresentam maior abrangência geográfica. CONCLUSÕES Os indicadores apontam três perfis de hospitais, caracterizados principalmente pela escala de produção. Os hospitais de pequeno porte apresentam baixa performance, sugerindo a necessidade de reorganização da oferta do cuidado hospitalar, principalmente no nível municipal. O conjunto dos indicadores propostos inclui as principais dimensões do cuidado hospitalar, fornecendo uma ferramenta que pode ser utilizada no planejamento e monitoramento contínuo da rede hospitalar do Sistema Único de Saúde.

Psychiatric hospitalization of alcoholists from rural areas in a general hospital: expectations of families / Hospitalización psiquiátrica en un hospital general de alcoholistas del medio rural: expectativas de los familiares / Internação psiquiátrica no hospital geral de alcoolistas do meio rural: expectativas dos familiares

ABSTRACT Objective: to know the expectations of family members of alcoholics living in rural areas under treatment in a Psychiatric Hospitalization Unit. Method: qualitative research, through interviews with 15 relatives of alcoholics living in rural areas and hospitalized in a Psychiatric Unit. Information was interpreted in the light of Phenomenological Sociology. Results: two concrete categories emerged: Expectations that the family member quits using alcohol and Projects of family members for the alcoholic after discharge. Relatives expected the alcoholic to maintain abstinence and planned post-discharge care, which involved everything from welcoming them to projects with a prospect of control or even fear of not being able to care for the alcoholic. Final considerations: most participants have positive expectations regarding psychiatric hospitalization, but some relatives are not confident about caring for the alcoholic and mentioned alternatives such as hiring a caregiver or nursing homes.

RESUMEN Objetivo: Conocer las expectativas de familiares de alcohólicos residentes en el medio rural con tratamiento en una Unidad de Hospitalización Psiquiátrica. Método: investigación cualitativa, mediante entrevista con 15 familiares de alcohólicos residentes en el medio rural hospitalizados en una Unidad Psiquiátrica. Las informaciones fueron interpretadas bajo la luz de la Sociología Fenomenológica. Resultados: dos categorías concretas han surgido: Expectativas de que el familiar deje de hacer uso de alcohol y Proyectos del familiar del alcohólico después del alta hospitalaria. Los familiares esperaban que el alcohólico mantuviera la abstinencia y planificara los cuidados después del alta, que envolvían desde la acogida en sus hogares hasta proyectos con perspectiva de control o de temor de no tener condiciones de cuidar del alcohólico. Consideraciones finales: la mayoría de los participantes tienen expectativas positivas con relación a la hospitalización psiquiátrica, pero hay familiares que no se sienten seguros en cuidar del alcohólico y mencionaron alternativas como buscar otro cuidador e, incluso, asilos.

RESUMO Objetivo: Conhecer as expectativas de familiares de alcoolistas residentes no meio rural com tratamento em Unidade de Internação Psiquiátrica. Método: pesquisa qualitativa, mediante entrevista com 15 familiares de alcoolistas residentes no meio rural internados em uma Unidade Psiquiátrica. As informações foram interpretadas à luz da Sociologia Fenomenológica. Resultados: emergiram duas categorias concretas: Expectativas de que o familiar pare de fazer uso de álcool e Projetos do familiar do alcoolista após a alta hospitalar. Os familiares esperavam que o alcoolista mantivesse a abstinência e planejavam os cuidados após a alta, envolvendo desde o acolhimento em seus lares a projetos com perspectiva de controle ou de receio de não terem condições de cuidar do alcoolista. Considerações finais: a maioria dos participantes tem expectativas positivas em relação à internação psiquiátrica, mas há familiares que não se sentem seguros em cuidar do alcoolista e mencionaram alternativas como buscar outro cuidador e, até mesmo, asilos.

Interconsultas de cuidados paliativos para pacientes con cáncer en un hospital general: Características y oportunidad / Interconsultation on palliative care for patients with cancer in a general hospital. Features and opportunity

Las recomendaciones internacionales apuntan a la integración temprana de cuidados paliativos (CP) en cáncer a través de la atención simultánea y del entrenamiento de los equipos primarios. La Unidad de CP del Hospital General de Agudos E. Tornú realiza interconsultas para pacientes internados en el hospital y brinda capacitación a los equipos tratantes. El perfil de las interconsultas realizadas podría brindar información importante sobre las características de la intervención de CP dentro de la institución. El objetivo de este estudio fue analizar retrospectivamente las interconsultas de primera vez de pacientes con cáncer realizadas a lo largo de 2 años, con foco en la temporalidad, la identificación de problemas por parte del equipo tratante y del equipo de interconsulta de CP, y la prontitud de respuesta y capacidad pronóstica de este último. La población atendida en interconsulta (168 casos) estuvo constituida principalmente por pacientes con enfermedad avanzada, deterioro del estado general, sin posibilidad de tratamiento oncológico y diagnóstico reciente. En aproximadamente 25% de los casos se encontraron indicios de intervención temprana y participación del equipo de CP en la toma de decisiones. Se discute la oportunidad de la intervención de CP y se señalan áreas con necesidad de mejora, como la identificación de síntomas no físicos y el pronóstico, a ser tenidas cuenta en las futuras actividades asistenciales y educativas.

The international recommendations point to the early integration of palliative care (PC) in cancer through simultaneous care and training of primary teams. The PC Unit of the Hospital General de Agudos E. Tornú conducts interconsultations for hospitalized patients in the hospital and provides training to the treatment teams. The profile of the interconsultations carried out could provide important information about the characteristics of the PC intervention within the institution. The objective of this study was to retrospectively analyze the first-time interconsultations of cancer patients carried out over 2 years, focusing on temporality, identification of problems by the treating team and the PC interconsultation team, the promptness of response and the prognostic capacity of the latter. In the period, 168 interconsultations were carried out. Most patients had advanced disease, poor performance status, no possibility of oncological treatment and recent diagnosis. In approximately 25% of the cases, evidence of early intervention and participation of the pc team in decision making was found. The opportunity of PC intervention is discussed and areas needing improvement are indicated, such as the identification of non-physical symptoms and prognosis, to be considered in future care and educational activities.

Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos / Features of patients with trauma admitted to an emergency room of a general hospital

Background: Trauma is the main cause of death among people aged 5 to 44 years. Aim: To describe features, treatment and evolution of trauma patients admitted to an emergency room. Material and Methods: Adult patients admitted in the emergency department of a public hospital due to severe trauma were studied and followed during their hospital stay. Results: We included 114 patients aged 40 ± 17 years (78%men) with an injury severity score of 21 ± 11. Trauma was penetrating in 43%. Traumatic brain injury (TBI) was the most common diagnosis in 46%. In the emergency room, 8% had hypotension, 5% required vasopressors and 23% required mechanical ventilation. The initial lactate was 3.6 ± 2.9 mmol/L. Sixty-five patients (57%) required emergency surgery. The intraoperative lactate was 3 ± 1.7 mmol/L and 20% required vasopressors. Sixty-four patients (56%) were admitted to the ICU, with APACHEII and SOFA scores of 16 ± 8 and 5 ± 3, respectively. ICU lactate was 3.2±1.5 mmol/L. In the ICU 40% required vasopressors and 63% mechanical ventilation. Thirty two percent had coagulopathy, 43% received transfusions and 10% required massive transfusions. The hospital stay was 13 (6-32) days, being significantly longer in patients with TBI. ICU and hospital mortalities were 12.5 and 18.4% respectively. The only predictor for mortality was the APACHEII score (Hazard Ratio 1.18, 95% confidence intervals 1.03-1.36). Conclusions: APACHE score was a predictor of mortality in this group of patients.

Doenças crônicas não transmissíveis e sua relação com o comportamento suicida no âmbito hospitalar / Non-communicable chronic diseases and their relationship with suicidal behavior in hospital context

Objective: This study aimed to learn about what is being produced by scientific publications on the relationship between non-communicable chronic diseases and suicidal behavior in hospital context. Method: A literature integrative review was carried out with articles published between 2006 and 2016 on SciELO Virtual Library and these databases:Portal BVS, Scopus, Web of Science, and Pubmed. Result: The mental health of patients with non-communicable chronic diseases may be heavily affected, putting them in a position of risk for suicidal behavior. Researches in different countries and with different methodologies have evidenced lack of knowledge and preparation from healthcare teams at general hospitals in the face of suicide within the studied population. Conclusion: Professionals working with high-complexity care urgently need training and qualification to identify and properly handle suicidal behavior in hospital context. Moreover, every patient admitted to chronic disease sectors must go through a more comprehensive anamnesis that includes specific questions concerning mental health and risk of suicide.

Objetivo: O estudo visa a conhecer o que vem sendo produzido pelas publicações científicas a respeito da relação entre a doença crônica não transmissívele o comportamento suicida no âmbito hospitalar. Método:Realizou-se uma revisão integrativa de literatura de artigos publicados entre os anos de 2006 e 2016 na Biblioteca Virtual SciELOe também nasseguintes bases de dados:Portal BVS, Scopus, Web of Science ePubmed.Resultado:Os estudos enfatizaram que a saúde mental de pacientes portadores de doenças crônicas não transmissíveis pode serintensamente afetada, colocando-os na posição de risco para o comportamento suicida.Pesquisas de diferentes países e metodologias evidenciaram desconhecimento e despreparo das equipes de saúde dos hospitais gerais diante do risco de suicídio no público estudado.Conclusão:Profissionais de saúde da alta complexidade necessitam urgentemente de treinamento e capacitação para a identificação emanejo adequado do comportamento suicida no contexto hospitalar. Além disso, todo paciente admitido nos setores de doenças crônicas deve passar por uma anamnese ampliada que inclua questões específicas sobre saúde mental e risco de suicídio.

Características das quedas com dano em pacientes hospitalizados / Características de las caídas con daños en pacientes hospitalizados / Characteristics of falls with damage to hospitalized patients

Resumo OBJETIVO Descrever as características das quedas com dano de pacientes, seus fatores de risco e lesões decorrentes. MÉTODOS Estudo longitudinal e retrospectivo de 260 registros de quedas com dano de pacientes adultos em unidades clínicas e cirúrgicas de um hospital geral, de setembro de 2012 a junho de 2017. Os dados foram coletados em maio de 2018 a partir do instrumento de investigação de quedas e prontuário eletrônico, sendo a análise estatística descritiva. RESULTADOS A maioria dos pacientes que sofreram queda com dano eram idosos (78%), do sexo feminino (55%), em tratamento clínico (68%) e desacompanhados (59,4%). As quedas ocorreram da própria altura (63,4%) e no quarto do paciente (67,3%). A gravidade dos danos foi leve em 80,8% dos casos, grave em 11,9% e moderado, 7,3%. CONCLUSÕES Melhorar a compreensão sobre as quedas e suas consequências pode subsidiar os profissionais na avaliação dos riscos e no estabelecimento de medidas preventivas.

Resumen OBJETIVO Describir las características de las caídas de pacientes con daño, sus factores de riesgo y las lesiones derivadas. MÉTODO Estudio longitudinal y retrospectivo de 260 registros de caídas con daño de pacientes adultos en unidades clínicas y quirúrgicas de un hospital general, de septiembre de 2012 a junio de 2017. Se recolectaron los datos en mayo de 2018 a partir del instrumento de investigación de caídas e informes electrónicos, siendo el análisis estadístico descrito. RESULTADOS Se registraron 260 caídas con daño, en su mayoría en ancianos (78%), del sexo femenino (55%), en tratamiento clínico (68%,) y desatendidos (59,4%). Las caídas ocurrieron por la propia altura (63,4%) y en la habitación del paciente (67,3%). La gravedad de los daños fue leve en el 80,8% de los casos, grave en 11,9%, y moderado en 7,3%. CONCLUSIÓN Mejorar la comprensión sobre las caídas y sus consecuencias puede subsidiar a los profesionales para identificar y evaluar los riesgos y establecer medidas preventivas.

Abstract OBJECTIVE Describe the characteristics of falls in patients with damage, their risk factors and injuries. METHOD Retrospective and longitudinal study of 260 records of falls with damage of adult patients in clinical and surgical units of a general hospital, from September 2012 to June 2017. Data were collected in May 2018 from the electronic fall and electronic record research instrument, and the statistical analysis was described. RESULTS There were 260 falls with damage, mostly in the elderly (78%), female (55%), in clinical treatment (68%) and unaccompanied (59.4%). The falls occurred at the same height (63.4%) and in the patient's room (67.3%). The severity of the damage was mild in 80.8% of cases, severe in 11.9% and moderate in 7.3%. CONCLUSION Improving understanding of falls and their consequences can assist professionals in identifying and assessing risks and in establishing preventive measures.

Prevalence of Methicillin-resistant Staphylococcus aureus in the Surgical Wards of the Port-of-Spain General Hospital, Trinidad and Tobago / Prevalencia del estafilococo dorado resistente a la meticilina en las salas quirúrgicas del Hospital General de Puerto España, Trinidad y Tobago

ABSTRACT Objective: Methicillin-resistant Staphylococcus aureus (MRSA) is associated with soft tissue infections in surgical patients. In severe cases, it may result in pneumonia, septicaemia and osteomyelitis. Limited data are available with regard to its prevalence and associations in the Caribbean. This study aimed to assess the prevalence of MRSA in patients hospitalized in the surgical wards of the Port-of-Spain General Hospital (POSGH), Trinidad and Tobago, and determine associated risk factors. Methods: Over the period of April 1 to August 1, 2013, all patients from the surgical wards of the POSGH who had had wound swabs taken were identified. Demographic data included duration of hospital stay, surgical and medical history, antibiotic use and type of wound swab. Microbiological reports were then retrieved and analyses done. Results: A total of 153 patients had wound swabs taken. There were 38 patients (24%) infected with Staphylococcus aureus, with 15 (39.5%) growing MRSA. Increased susceptibility to MRSA was associated with age, gender, ethnicity, duration of hospital stay, co-morbidities, previous antibiotic use, previous surgery and the type of wound (p < 0.05). Conclusion: The prevalence of MRSA in the surgical wards of the POSGH was 39.5% of Staphylococcus aureus isolates. Risk factors included the age range of 60-69 years, patients with co-morbidities, hospital stays of longer than one week, previous surgery and prior use of antibiotics. We recommend more awareness of this problem in the practice of Caribbean medicine to improve infection rates.

RESUMEN Objetivo: El estafilococo dorado resistente a la meticilina (EDRM) se asocia con infecciones de tejidos blandos en pacientes quirúrgicos. En casos severos, puede dar lugar a pulmonía, septicemia y osteomielitis. Los datos disponibles con respecto a su prevalencia y asociaciones en el Caribe son limitados. Este estudio persigue evaluar la prevalencia de EDRM en pacientes hospitalizados en las salas quirúrgicas del Hospital General de Puerto de España (POSGH, siglas en inglés) en Trinidad y Tobago, y determinar los factores de riesgo asociados. Métodos: Durante el período del 1 de abril al 1 de agosto de 2013, fueron identificados todos los pacientes de las salas quirúrgicas del Hospital POSGH a quienes se les había practicado frotis de las heridas. Los datos demográficos incluyeron la duración de la estadía hospitalaria, las historias clínicas y quirúrgicas, el uso de antibióticos, y el tipo de frotis de la herida. Luego se obtuvieron los informes microbiológicos y se realizaron los análisis. Resultados: A un total de 153 pacientes se le tomaron frotis de heridas. Hubo 38 pacientes (24%) infectados con estafilococos dorados, de los cuales 15 (3.5%) presentaban EDRM creciente. El aumento de la susceptibilidad a EDRM se asoció con la edad, el género, la etnicidad, la duración de la estadía hospitalaria, las co-morbilidades, el uso previo de antibióticos, las cirugías previas, y el tipo de herida (p < 0.05). Conclusión: La prevalencia de EDRM en las salas quirúrgicas del Hospital POSGH fue 39.5% de aislados de estafilococos dorados. Los factores de riesgo incluyeron un rango de edad de 60-69 años, pacientes con co-morbilidades, estancia hospitalaria de más de una semana, cirugía previa, y uso previo de antibióticos. Recomendamos tomar más conciencia de este problema en la práctica médica en el Caribe a fin de mejorar las tasas de infección.

Tiempo de referencia asociado a la causa de mortalidad materna en el Hospital Regional Docente Materno Infantil "El Carmen", 2009-2015 / Reference time associated with the cause of maternal mortality in the Regional Maternal and Child Teaching Hospital "El Carmen", 2009- 2015

RESUMEN Objetivo: Identificar la asociación entre el tiempo de referencia y la causa mortalidad materna en el Hospital Regional Docente Materno Infantil '"El Carmen". Métodos: Estudio analítico, retrospectivo, transversal, en base a datos de todos los casos de muerte materna ocurridas en el Hospital Regional Docente Materno Infantil El Carmen. Estudio censal que cubrió la totalidad de las madres fallecidas atendidas en dicho hospital durante el periodo 2009-2015 y que sus datos se encontraron en base del establecimiento; se excluyó las historias clínicas con falta de información, incompletas, o de periodos anteriores. Resultados. De las 29 pacientes que fallecieron desde el 2009, la mediana de edades fue 28,5 años (rango intercuartílico: 27-35 años de edad); la mayoría murió en el puerperio (76,5%). La tendencia tuvo una elevación durante el transcurso del 2009 al 2015. Hubo diferencias estadísticamente significativas en el tiempo de traslado (p<0,001), el tipo de complicación (p=0,019) y en la causa final de la muerte (p<0,001). Se encontró que las causas indirectas de muerte tuvieron un mayor tiempo de referencia (67,5 minutos de la causa indirecta versus 15 minutos de la causa directa), siendo esto estadísticamente significativo (p=0,0387). Conclusiones: Existe una tendencia creciente a las muertes maternas, además, se encontró diferencias del tipo de complicación y la causa final de muerte según el lugar de procedencia de las gestantes.

ABSTRACT Objective: To identify the association between the reference time and the maternal mortality cause in the Regional Hospital Materno Infantil 'El Carmen'. Methods: Analytical, retrospective, cross - sectional study, based on data from all cases of maternal death at the Hospital Regional Materno Infantil 'El Carmen'. Census study that covered all the deceased mothers attended at that hospital during the period 2009-2015 and that their data were found on the basis of the establishment; Clinical Histories were excluded with incomplete information, or from previous periods. Results: Of the 29 patients who died since 2009, the median age was 28.5 years (interquartile range: 27-35 years of age); There were statistically significant differences in the time of transfer (p <0.001), the type of complication (p = 0.019) and in the final cause of death (p <0.001). It was found that the indirect causes of death had a longer reference time (67.5 minutes of the indirect cause versus 15 minutes of the direct cause), being this statistically significant (p = 0.0387). Conclusion: There is an increasing tendency to maternal deaths, in addition, differences were found in the type of complication and the final cause of death according to the place of origin of the pregnant women.

Predictors of length of stay in an acute psychiatric inpatient facility in a general hospital: a prospective study

Objective: There have been significant reductions in numbers of psychiatric beds and length of stay (LOS) worldwide, making LOS in psychiatric beds an interesting outcome. The objective of this study was to find factors measurable on admission that would predict LOS in the acute psychiatric setting. Methods: This was a prospective, observational study. Results: Overall, 385 subjects were included. The median LOS was 25 days. In the final model, six variables explained 14.6% of the variation in LOS: not having own income, psychiatric admissions in the preceding 2 years, high Clinical Global Impression and Brief Psychiatric Rating Scale scores, diagnosis of schizophrenia, and history of attempted suicide. All variables were associated with longer LOS, apart from history of attempted suicide. Conclusions: Identifying patients who will need to stay longer in psychiatric beds remains a challenge. Improving knowledge about determinants of LOS could lead to improvements in the quality of care in hospital psychiatry.

Percepção dos familiares acerca do grupo de apoio realizado em uma unidade de internação psiquiátrica / Percepción de los familiares acerca del grupo de apoyo realizado en una unidad de internación psiquiátrica / Perception of family members regarding the support group conducted in a psychiatric intervention ward

Resumo OBJETIVO Objetiva analisar a percepção de familiares de pacientes com sofrimento psíquico acerca do grupo de apoio em uma internação psiquiátrica. MÉTODO Pesquisa com abordagem qualitativa, exploratória, descritiva, realizada em hospital geral do Rio Grande do Sul com dez familiares que participavam de grupo de apoio semanal. A coleta de dados ocorreu no mês de outubro de 2016 através de entrevistas semiestruturadas. Empregou-se a análise de conteúdo temática para tratamento dos dados, na qual emergiu a categoria: Percepção dos familiares sobre o grupo de apoio. RESULTADOS Os familiares percebiam o grupo como um espaço de apoio e fortalecimento, de escuta e trocas entre os integrantes, de informação sobre a doença e tratamento e de segurança e inserção da família no tratamento. CONSIDERAÇÕES FINAIS Portanto, o grupo de apoio pode ser entendido como uma ação estratégica de cuidado ao familiar, repercutindo na sua vida e no tratamento de quem está internado.

Resumen OBJETIVO Analizar la percepción de familiares de pacientes con trastorno mental acerca del grupo de apoyo en una internación psiquiátrica. MÉTODO Investigación con abordaje cualitativo, exploratorio y descriptivo, realizada en el hospital General de Rio Grande do Sul, con diez familiares que participaban en un grupo de apoyo semanal. La recolección de datos ocurrió en el mes de octubre de 2016 por medio de entrevistas semiestructuradas. Se empleó al análisis temático de contenido para tratar a los datos, y emergió la categoría: Percepción de los familiares sobre el grupo de apoyo. RESULTADOS Los familiares perciben al grupo como un espacio de apoyo y fortalecimiento, de escucha e intercambios entre los integrantes, de información sobre la enfermedad y tratamiento, y de seguridad e inserción de la familia en el tratamiento. CONSIDERACIONES Finales El grupo de apoyo puede ser entendido como una acción estratégica de cuidado al familiar, repercutiendo en su vida y en el tratamiento de quien está internado.

Abstract OBJECTIVE To analyze the perception of relatives of patients with mental disorders about the support group in a psychiatric hospitalization ward. METHOD This is a research with a qualitative, exploratory an descriptive approach, performed at a General Hospital in Rio Grande do Sul with ten relatives of patients who had been participating in a weekly support group. Data collection took place in October 2016, through semi-structured interviews. A thematic content analysis was used for the treatment of data, whence emerged the category: Perception of family members about the support group. RESULTS The relatives perceive the group as a space that gives them strength and support, allowing for listening and experience exchange among its members, giving information on the disease and treatment, safety, and inserting the family in the treatment. FINAL CONSIDERATIONS The support group can be understood as a strategic action of caring for the family, affecting their lives and the treatment of those who are hospitalized.

Características de la población y las atenciones de rehabilitación que recibe en un hospital general / Referral to rehabilitation services of patients discharged from a general hospital with a potentially disabling condition

Background Patients discharged from general hospitals with a potentially disabling condition can benefit in their recovery with the aid of physical medicine and rehabilitation services. Aim To determine the proportion of patients discharged from a general hospital with a potentially disabling condition, who were derived to physiatry for rehabilitation. Material and Methods Review of the discharge database of a general hospital, identifying all discharges with a potentially disabling condition, and those who were effectively derived for rehabilitation. Results Only 7% of patients with a potentially disabling condition were effectively evaluated by Physiatry. Among these patients, 20% had neurological diseases and 19% had an amputation. Those attended by physiatry had a higher proportion of multidisciplinary care by the rehabilitation team. Conclusions A low proportion of patients discharged with a potentially disabling conditions are referred for an adequate rehabilitation therapy.

Internações e reinternações psiquiátricas em um hospital geral de Porto Alegre: características sociodemográficas, clínicas e do uso da Rede de Atenção Psicossocial / Psychiatric admission and readmission in a general hospital of Porto Alegre: sociodemographic, clinic, and use of Network for Psychosocial Care characteristics

RESUMO: Introdução: O fenômeno da porta giratória é caracterizado por repetidas e frequentes reinternações psiquiátricas. Objetivo: Investigar as características sociodemográficas, clínicas e de acompanhamento em serviços da Rede de Atenção Psicossocial (RAPS) associadas às internações e às reinternações psiquiátricas de usuários de um hospital geral de Porto Alegre. Métodos: Estudo transversal realizado com uma amostra de 96 participantes. Resultados: Mais da metade da amostra (53,1%) era do sexo feminino, 51% eram solteiros e a idade média foi de 44,33 anos. Dos dados clínicos, 36,5% (n = 35) dos usuários estavam em sua primeira internação e 36,5% (n = 35) preencheram o critério para reinternação frequente. Os resultados mostraram que usuários com reinternações frequentes referiam um número significativamente menor de pessoas com as quais consideravam que poderiam contar. Já os usuários de primeira internação viviam com um número significativamente maior de pessoas que o restante da amostra e possuíam, com menor frequência, vínculo com serviço de saúde, utilizando o hospital como porta de entrada para o cuidado em saúde mental. Em relação ao acompanhamento na rede, 34,4% da amostra não frequentava nenhum serviço da RAPS antes da internação à época do estudo e somente 4,1% fazia uso de serviços de reabilitação psicossocial. Conclusão: Destacamos a importância do hospital como ponto articulador da rede e estratégico para realizar a ponte com os serviços da RAPS. Apesar de a literatura internacional investigar e registrar o fenômeno da porta giratória, percebe-se que esse é um campo que necessita de maiores investigações no território brasileiro.

ABSTRACT: Introduction: The revolving door phenomenon is characterized by repeated and frequent psychiatric readmissions. Objective: We aim to investigate sociodemographic, clinic, and follow-up characteristics in health services associated to psychiatric admissions and readmissions of inpatients in a general hospital of Porto Alegre. Methods: It is a cross-sectional study with a sample of 96 participants. Results: More than half of the sample (53.1%) were female, 51% were single, and the average age was 44.3 years old. From clinic data, 36% (n = 35) of the users were in their first admission, and 36% (n = 35) met the criteria for frequent readmission. The results show that users with frequent readmissions significantly mentioned fewer people on whom they could rely. Alternatively, users in first admission lived with a significant larger number of people than the rest of the sample and had, with less frequency, bond with health services other than hospitals, using hospitals as an entrance door to mental health care. Regarding follow-up in the network, 34.4% of the sample did not visit often NPC services before admission, and only 4.1% used psychosocial rehabilitation services. Conclusion: We highlight the importance of hospitals as an articulation point in the network, and as strategic to connect with NPC services. In spite of international literature investigation and registration of the frequent psychiatric readmission phenomenon, we notice it is a field that needs greater investigation in Brazil.

Intervenção prevencionista para acidentes de trabalho com agentes biológicos em enfermagem / Preventive intervention for occupational accidents with biological agents in nursing

O estudo teve como objeto os acidentes de trabalho com agentes biológicos entre profissionais de enfermagem em um hospital geral público. Objetivos: descrever o conhecimento, atitude e prática dos profissionais de enfermagem sobre os riscos ocupacionais biológicos; discutir com os trabalhadores de enfermagem uma proposta de práticas prevencionistas para acidentes de trabalho com agentes biológicos; implementar práticas prevencionistas para acidentes com agentes biológicos na perspectiva de uma cultura de prevenção de acidentes no trabalho. O percurso metodológico fez uso da pesquisa descritiva, exploratória e de intervenção, de natureza quantitativa e qualitativa, com abordagem do conhecimento, atitude e práticas em saúde e do método da pesquisa convergente assistencial. O espaço físico foi um hospital geral público, localizado em uma cidade do interior do estado de Minas Gerais. Os participantes foram 36 trabalhadores de enfermagem que notificaram acidentes de trabalho com agentes biológicos no período entre 2013 e 2015. Os instrumentos para coleta de dados utilizados foram: questionário sociodemográfico e laboral dos participantes, descrição dos acidentes de trabalho e dos riscos ocupacionais biológicos; questionário de conhecimento, atitude e práticas em saúde diante dos riscos ocupacionais biológicos; roteiro para discussões individuais e em grupo; e, observação participante. Os dados quantitativos foram tratados através de análise estatística descritiva com utilização do programa SPSS, enquanto os dados qualitativos foram submetidos a análise temática. Posteriormente, as propostas de intervenção preventivas sugeridas pelos participantes foram aplicadas nos ambientes de trabalho. O projeto foi aprovado em Comitê de Ética em Pesquisa e seguiu as exigências da Resolução 466/2012. Os resultados evidenciaram que os acidentes de trabalho com agentes biológicos caracterizam-se, predominantemente, por lesões percutâneas causadas por instrumentos perfurocortantes que atingiram os dedos das mãos de técnicos de enfermagem do sexo feminino. O modelo de análise identificou divergências entre o conhecimento, atitude e práticas em saúde, tais como, deficiência no conhecimento acerca de normas de prevenção, atitudes inadequadas sobre higienização das mãos e comportamentos inseguros, como baixa adesão a práticas de precaução padrão, ao uso de EPI e a aplicação da NR 32. Da análise de conteúdo emergiram as seguintes categorias temáticas que posteriormente balizaram as intervenções: situações e causas dos acidentes de trabalho com agentes biológicos; fatores intervenientes na prevenção de acidentes de trabalho com agentes biológicos; EPI como forma de proteção dos trabalhadores de enfermagem; e, responsabilidades das instituições hospitalares para promoção da saúde e segurança dos trabalhadores de enfermagem. Posteriormente, as ações preventivas para acidentes de trabalho com agentes biológicos incluíram a realização de diálogos de segurança, sinalização para precaução padrão, folder, pôster, criação do jornal "Cultura de Segurança", campanha prevencionista pela Intranet, vigilância do trabalho seguro e participação em seminário.(AU)

Atención paliativa en personas con enfermedades crónicas avanzadas / Palliative care needs in advanced chronic illness

Alrededor del 75% de las personas morirá a causa de una o varias enfermedades crónicas progresivas. A partir de esta proyección, la OMS instó a los países a diseñar estrategias para el fortalecimiento de los cuidados paliativos como parte del tratamiento integral. En Cataluña, España, la medición de la prevalencia de estos pacientes según el debe decir NECPAL CCOMS-ICO© fue de 1.5% de la población. Es una evaluación cuali-cuantitativa, multifactorial indicativa y no dicotómica que completa el médico tratante. En Argentina no conocemos información sobre estos enfermos. Nuestro objetivo fue explorar y caracterizar en una población accesible de la Ciudad Autónoma de Buenos Aires la proporción de pacientes crónicos con necesidades de atención paliativa, mediante el NECPAL CCOMS-ICO©. Se relevaron los hospitales generales de la Región Sanitaria 2: (Piñero, Álvarez y Santojanni) y sus áreas programáticas. En la Región Sanitaria 1 se incorporó al hospital Udaondo de gastroenterología. Se entrevistaron 53 médicos (704 pacientes). Se identificó que 29.5% presentaba enfermedades crónicas avanzadas; el 72.1% de esos pacientes eran NECPAL positivos, más jóvenes que en otros estudios (mediana 64) y más del 98% tenían alto índice de comorbilidad. Se registró la demanda (31.4%) y necesidad (52.7%) de atención paliativa. Se describieron indicadores específicos de fragilidad, progresión y gravedad según enfermedad crónica. El principal hallazgo fue identificar, con un instrumento no basado en la mortalidad, que, en la ciudad de Buenos Aires, 1 de cada 3 pacientes con enfermedades crónicas podría morir en el próximo año y tenía necesidades de atención paliativa.

About 75% of population will die from one or more chronic progressive diseases. From this projection WHO urged countries to devise strategies for strengthening palliative treatment as part of comprehensive care. In Catalonia, Spain, direct measurement of the prevalence of these patients with NECPAL CCOMS-ICO© tool was 1.5% of the population. This tool is an indicative, not dichotomous, quali-quantitative multifactorial evaluation to be completed by the treating physician. In Argentina there is no information on these patients. Our goal was to explore and characterize the proportion of chronically ill patients in palliative care needs, by NECPAL CCOMS-ICO© tool, in an accessible population of the City of Buenos Aires. General hospitals of the Health Region 2 (Piñero, Álvarez and Santojanni) and its program areas were surveyed. In Health Region 1, we surveyed the Udaondo gastroenterology hospital. A total of 53 physicians (704 patients) were interviewed. It was identified that 29.5% of these patients were affected by advanced chronic diseases; 72.1% of them were NECPAL positive, younger (median 64) than in others studies, and more than 98% presented high levels of comorbidity. Palliative care demand (31.4%) and needs (52.7%) were recorded. Specific indicators of fragility, progression, severity and kind of chronic disease were described. The main finding was to identify, with an instrument not based on mortality that, in Buenos Aires City, 1 in 3 patients with chronic diseases could die in the next year and had palliative care needs.

Espondilodiscitis: experiencia clínica en un hospital general de Chile / Spondylodiscitis: clinical experience in a Chilean general hospital

Introducción: La espondilodiscitis (ED) implica prolongados períodos de hospitalización, de latencia diagnóstica y riesgo de complicaciones a largo plazo. No existen publicaciones recientes en Chile al respecto. Objetivos: Caracterizar un grupo de pacientes con ED. Pacientes y Métodos: Serie clínica, que incluyó pacientes en un período de ocho años. Resultados: 37 pacientes, 37,8% mujeres y 62,2% hombres, con promedio etario 66,8 años; 64,9% adultos mayores, 35,1% diabéticos y 21,6% con co-morbilidad urológica. Los principales síntomas fueron dolor y fiebre. 89,2% tuvo elevación de VHS. 86,5% contó con resonancia magnética, que siempre fue confirmatoria, siendo la columna lumbar la localización más frecuente (43,2%). Se identificó etiología en 28/37 pacientes: en 71,4% cocáceas grampositivas (Staphylococcus aureus predominantemente), sólo en 10,7% M. tuberculosis. Staphylococcus aureus estuvo asociado a co-morbilidades médicas en forma significativa (p < 0,05) y el grupo de bacilos gramnegativos a historia hepatobiliar y/o intestinal (p < 0,05). El método de mayor rendimiento fue el cultivo obtenido por punción quirúrgica. El tratamiento antimicrobiano fue indicado en promedio por 63,8 días (IQR 53-72), con reacciones adversas en 18,9%. La estadía hospitalaria fue 38,9 días promedio, no existiendo fallecidos durante este período. 18,9% presentó secuelas motoras. Discusión: La mayoría de pacientes con ED correspondió a adultos mayores, siendo S. aureus la principal etiología. Hubo una baja frecuencia de M. tuberculosis. Resultó considerable la magnitud de efectos adversos asociados a la terapia antimicrobiana y las complicaciones neurológicas.

Background: Spondylodiscitis (SD) involves long periods of hospitalization, diagnostic latency and risk of long-term complications. No updated series are available in Chile and a change in demographic features and etiology is suspected. Aim: To characterize a group of patients with SD. Patients and Methods: Clinical series including patients over an 8 year period. Results: We identified 37 patients; 37.8% women and 62.2% men (mean age 66.8 years); 64.9% were elderly; 35.1% had diabetes and 21.6% urological comorbidity. Main symptoms were pain and fever. Erythrocyte sedimentation rate was elevated in 89.2%, and 86.5% patients had MRI, which was always confirmatory. Lumbar spine was the most common site of infection (43.2%). Etiology was identified in 28/37 patients: 71.4% yielded grampositive cocci (Staphylococcus aureus predominantly), Mycobacterium tuberculosis was identified in only 10.7%. Staphylococcus aureus was associated to medical comorbidities (p < 0,05) and gramnegative bacilli to hepatobiliar or intestinal symptoms (p < 0,05). Culture obtained by a surgical procedure had the highest yield. The average duration of antibiotic therapy was 63.8 days (IQR 53-72). Treatment-related side effects were detected in 18.9% of patients. The average hospital stay was 38.9 days. No deaths occurred during hospitalization. Motor sequelae were present in 18.9% of this series. Discussion: Most patients with SD were older adults. Staphylococcus aureus was predominant and M. tuberculosis was uncommon. Antibiotic side effects were relevant as well as the neurological complications.