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RESUMEN Objetivo: Valorar si en nuestra población los factores de riesgo cardiovascular (FRCV) se correlacionan con la severidad de la COVID-19 en pacientes hospitalizados. Material y Métodos: Estudio de cohortes retrospectivo de pacientes con COVID-19 ingresados entre los meses de abril y diciembre del 2020 en un centro terciario en el sur de España. Se valoró la asociación entre los FRCV y la severidad del SARS-COV2. Se consideró como COVID severo aquel que ingresó en la Unidad de Cuidados Intensivos (UCI) o que falleció. Resultados: Se analizaron 608 pacientes ingresados con diagnóstico de neumonía por COVID-19, la mediana de edad fue de 73 años (RIC: 64-81) años. Los pacientes fueron predominantemente varones (55,8%). La hipertensión arterial fue el FRCV más común (83,7%), seguido de la dislipemia (50,2%), diabetes (43,1%), obesidad (32,9%) y tabaquismo (15,6%). Durante la estancia un total del 25,8% de los pacientes tuvieron un pronóstico desfavorable: un 7,9% precisó ingreso en UCI y un 22,9% fallecieron. En el análisis multivariante resultaron variables independientes para padecer un COVID severo el género masculino (OR: 1,697; IC 95%: 1,138-2,532), la edad avanzada (OR: 1,697; IC 95%: 1,138-2,532), y la obesidad (OR: 1,634; IC95%: 1,370-1,947). Conclusión. Existe una gran prevalencia de FRCV en los pacientes ingresados por COVID 19 de nuestra población. La obesidad, junto con la edad avanzada y el género masculino se asocian con una mayor gravedad y mortalidad hospitalaria en los pacientes ingresados con SARS-CoV 2. ABSTRACT Objective: To assess whether cardiovascular risk factors (CVRF) are correlated with the severity of COVID-19 in hospitalized patients in our population. Material and Methods: Retrospective cohort study of patients with COVID-19 admitted between the months of April and December 2020 in a tertiary center in southern Spain. The association between CVRF and the severity of SARS-COV2 was assessed. Severe COVID was considered to be one who was admitted to the Intensive Care Unit (ICU) or who died. Results: 608 patients admitted with a diagnosis of COVID-19 pneumonia were analyzed, the median age was 73 years (IQR: 64-81) years. The patients were predominantly male (55.8%). Hypertension was the most common CVRF (83.7%), followed by dyslipidemia (50.2%), diabetes mellitus (43.1%), obesity (32.9%), and smoking (15.6%). During the stay, a total of 25.8% of the patients had an unfavorable prognosis: 22.9% died and 7.9% required admission in the ICU. In the multivariate analysis, significant independent variables were found for suffering from severe COVID: male sex (OR: 1,697; IC 95%: 1,138-2,532), age (OR: 1.697; CI 95%: 1,138-2,532), and obesity (OR: 1,634; 95% CI: 1,370-1,947). Conclusions: There is a high prevalence of CVRF in patients hospitalized for COVID 19 in our population. Obesity, along with older age and male gender, are associated with greater severity and hospital mortality in patients admitted with SARS-CoV-2

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OBJECTIVE: To validate an artificial intelligence model that can predict the mortality prognosis of hospitalized patients with sepsis. MATERIALS AND METHODS: An ambispective observational cohort study, which included electronic records of adult patients from the Central Hospital of the State of Chihuahua, Mexico, from July 2018 to March 2020 and January 2021 to January 2022. Three models were analyzed: neural networks, support vector machine and random forests. For model validation, the sample was divided into 80% for training and 20% for testing. For the last group (20%), a 10-fold cross-validation was implemented to calculate sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: A total of 353 files were analyzed, of which only 218 were chosen. The best model was the neural networks; however, its area under the curve (AUC) score barely reached 0.80, the random forests algorithm (AUC 0.667) and the support vec- tor machine algorithm (AUC 0.641) were below this value. Of the 3 models, only the cross-validation with the neural networks was done, of 20% of the test data, 10 validations were implemented. The AUC scores obtained in each fold ranged from 0.771 to 0.830. CONCLUSIONS: The model is good, even working with few data. It is intended to collect a larger sample to retrain and validate the model with more data and improve learning and performance and finally be applicable to patients. [ABSTRACT FROM AUTHOR]

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Background: There is a continuing increase in the prevalence of people affected with progressive chronic diseases. Palliative care is another form of care and organization of health problems that improve quality. Objective: To determine the incidence of patients with advanced chronic illness and need of palliative care (NPC) and intrahospital mortality in a reference hospital. Methods: Prospective observational study in hospitalized patients over 18 years of age in the internal medicine department who met at least one criterion of the NECPAL CCOMS-ICO tool. They were followed until death or discharge to determine intrahospital mortality. We used descriptive and inferential statistics. Results: We studied 370 admissions from April to August 2021, including 110 patients, 59 women (55.3%) and 51 men (44.7%), age 65.5 ± 15.85 years. The incidence of NPC was 29.7%. The most frequent comorbidity was oncologic in 39 patients (35.5%), followed by chronic heart disease in 17 patients (15.5%); 38 patients were classified as NECPAL grade I (34.5%), 44 NECPAL II (40%) and 28 NECPAL III (25.5%). Twenty-five patients died during their in-hospital stay, with a mortality of 22.7%. Conclusions: The incidence of hospitalized patients in need of palliative care is considerable, more than half of them for non-oncologic pathology. More effective care strategies are required for external referral and multidisciplinary in-hospital care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the prevalence of these symptoms in the Mexican population treated at the General Hospital no. 46 and to examine whether anosmia is related to a mild form of the disease. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out, extracting information from patients treated at the General Hospital no. 46 with a positive test for SARS-CoV-2, from June 2020 to September 2021. RESULTS: The sample included 8694 patients with a mean age of 49 years; 52.8% were men; 28.4% were classified as severe patients, with a predominance of males (p = 0.008). A prevalence of 10.6% of anosmia and 10.8% of dysgeusia was found. The relationship between the absence of anosmia and death as the cause of discharge was analyzed, considering sex a covariate. The results indicated that, in the case of men, the absence of anosmia was associated with a higher probability of death as a cause of hospital discharge. CONCLUSIONS: This inverse association between anosmia and mortality could have important implications in the classification and management of patients. Therefore, it is essential to continue investigating this relationship through more multicenter studies. [ABSTRACT FROM AUTHOR]

En los tumores sólidos la hipereosinofilia es un fenómeno raro y se asocia principalmente con carcinomas secretores de mucina. Los tumores tiroideos asociados a neutrofilia y/o eosinofilia se han descrito exclusivamente en pacientes con cáncer anaplásico de tiroides. La eosinofilia asociada con cáncer papilar de tiroides es extremadamente rara y se encuentran muy pocos casos descriptos actualmente. Se ha sugerido que tres citocinas, a saber, la interleucina-3 (IL-3), la interleucina-5 (IL-5) y el factor estimulante de colonias de granulocitos y macrófagos (GM-CSF), pueden actuar como un péptido eosinofílico potencial. Hasta el momento solo se han reportado tres pacientes con cáncer diferenciado de tiroides asociados a eosinofilia, dos de tipo papilar y uno de tipo medular. Paciente de 48 años consultó en el año 2022 por adenopatías cervicales bilaterales de 3 años de evolución asociado a síndrome consuntivo e hipereosinofilia. Se solicitó PET CT que evidenció foco hipermetabólico en lóbulo tiroideo derecho y metástasis ganglionares, pulmonares, óseas y hepáticas; ecografía tiroidea que evidencia en lóbulo derecho nódulo de alta sospecha de malignidad y conglomerado de adenopatías con lavado de aguja positivo para tiroglobulina. Evaluada la hipereosinofilia con valores iniciales de leucocitosis de GB 30310/mm3 (10608/mm3 de eosinófilos) hasta valores máximos de GB 77090/mm3 (eosinófilos 20814/mm3) se interpretó como síndrome paraneoplásico y se inició corticoterapia en dosis inmunosupresoras sin respuesta. Nuestras observaciones presentadas en este artículo están en línea con la mayoría de los estudios que reflejan que la hipereosinofilia paraneoplásica se caracteriza por una enfermedad más avanzada y un mal pronóstico.

Background and Objective: From the onset of COVID-19 pandemic, the presence of previous cardiopathy was thought to be related with a worse prognosis of the disease. We aimed to analyse that theoretical adverse impact in a large cohort of patients. Method: We selected 1065 patients admitted for SARS-CoV-2 pneumonia between March and June 2020, divided in three groups according to (1) absence of cardiopathy, (2) presence of valvular heart disease or ischemic heart disease, or (3) presence of heart failure. We analysed the differences between groups regarding the need for admission in intensive care unit for mechanical ventilation or mortality during admission, or mortality during admission or in the next 6 months. Results: The factors that were associated with a worse prognosis both in acute phase and in the next 6 months were age, male gender, obesity and oncologic disease. The presence of previous cardiopathy did not have an adverse prognostic impact neither initially nor in the short term, in our study. Conclusions: We did not obtain significative association of the presence of cardiopathy with a worse medical evolution, neither in acute phase nor in the short term, of patients admitted for SARS-CoV-2 pneumonia. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the prevalence of these symptoms in the Mexican population treated at the General Hospital no. 46 and to examine whether anosmia is related to a mild form of the disease. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out, extracting information from patients treated at the General Hospital no. 46 with a positive test for SARS-CoV-2, from June 2020 to September 2021. RESULTS: The sample included 8694 patients with a mean age of 49 years; 52.8% were men; 28.4% were classified as severe patients, with a predominance of males (p = 0.008). A prevalence of 10.6% of anosmia and 10.8% of dysgeusia was found. The relationship between the absence of anosmia and death as the cause of discharge was analyzed, considering sex a covariate. The results indicated that, in the case of men, the absence of anosmia was associated with a higher probability of death as a cause of hospital discharge. CONCLUSIONS: This inverse association between anosmia and mortality could have important implications in the classification and management of patients. Therefore, it is essential to continue investigating this relationship through more multicenter studies. [ABSTRACT FROM AUTHOR]

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Introducción: la criptococosis meníngea es una infección oportunista universal que presenta factores pronósticos variables, especialmente en pacientes inmunosuprimidos. Objetivo: identificar variables clínicas y paraclínicas asociadas con el desenlace, al final de la hospitalización, en pacientes con criptococosis meníngea atendidos en un hospital de tercer nivel en Bogotá, Colombia. Materiales y métodos: estudio observacional descriptivo. La información se obtuvo por medio de registros de historias clínicas de pacientes con diagnóstico confirmado de criptococosis meníngea durante el periodo 2016-2021. Resultados: se analizaron 54 casos, el 85,2?% de ellos de sexo masculino, con una mediana de edad de 38 años. El síntoma principal fue cefalea (74,1?%), con un promedio de duración de 30 días antes del ingreso. El 83,3?% tenía diagnóstico de VIH, con niveles de CD4 por debajo de 50 células/mm3 y recuentos elevados de carga viral. El líquido cefalorraquídeo mostró en más del 50?% hipertensión intracraneal, pleocitosis de predominio linfocitario, hiperproteinorraquia e hipoglucorraquia. El tipo de patógeno aislado más frecuente fue C. neoformans var neoformans. Las variables más prevalentes en el grupo de pacientes que fallecieron fueron la presencia de pleocitosis en LCR (p?=?0,025), cultivo para hongo positivo (p?=?0,02) y aislamiento C. neoformans var neoformans (p?=?0,03). Discusión: la criptococosis meníngea es una patología frecuente en hombres en la cuarta década de la vida y con infección por VIH, sin embargo, los factores relacionados con la mortalidad parecen variar dependiendo de la localización geográfica. Conclusión: en nuestro estudio los factores más prevalentes fueron la presencia de pleocitosis en LCR, cultivo positivo, aislamiento de C. neoformans var neoformans.

Background: mortality in patients with acute kidney injury is high and sometimes low- and medium-income health systems lack tools capable of predicting the prognosis of these patients. Objective: to estimate the prognostic value of short-term mortality of the neutrophil/lymphocyte ratio in patients with acute kidney injury in an intensive unit care. Methods: a retrospective cohort analytical study was conducted in 124 patients with acute kidney injury from January 1, 2022 to December 31, 2022. A k-means cluster analysis was performed, requesting the creation of three clusters according to values of the neutrophil/lymphocyte ratio. Survival curves were constructed using the Kaplan-Meier method and the survival means were compared using the Log-Rank test. The optimal cut-off point of the neutrophil/lymphocyte ratio was established for the prediction of mortality and the discriminatory capacity was evaluated through the area under the curve of the C statistic. Results: mortality was higher in the third tercil (76.74 %). The deceased patients had a significantly higher median index than the survivors (6.73 vs. 4.55; p

Introduction: Heart failure is a common, progressive, and life-threatening condition whose risk is often overestimated. Effective tools are required to discriminate the risk and therefore a system based on the assembly of neural networks was trained for this purpose. Objective: To present the results of the training and internal validation of a system based on a set of artificial neural networks for the prognosis of one-month mortality in patients hospitalized for acute heart failure, and to compare the results of each of the individual networks developed and four set systems simple voting and AdaBoost. Materials and method: From a cohort of 462 patients diagnosed with decompensated heart failure, 11 networks were trained and then assembled using four systems: simple voting, two systems weighted by operating characteristics (predictive values and likelihood ratios) and Boosting. Operating characteristics for the 30-day prognosis of death were calculated and compared with two clinical rules and logistic regression applied to the same population. Results: The various ensemble methods had a better prognostic performance than each of the networks that composed them. Voting weighted by predictive values performed best, with an accuracy of 89.0% (95% CI: 82.6-93.2%) although the results’ confidence intervals overlapped. Conclusions: The ensemble of neural networks through voting weighted by predictive values showed an adequate performance for predicting 30-day mortality in acute heart failure. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: hyperchloremia and hypernatremia are common complications in critically ill children and have been associated with the development of acute kidney injury (AKI) and mortality. Objective: to estimate the incidence of hyperchloremia and hypernatremia during the first 72 hours of admission to a pediatric intensive care unit (PICU), and to evaluate their association with AKI and mortality. Material and methods: prospective cohort study, conducted over a period of 15 months. Patients with disorders in plasma levels of chloride (Cl-) or sodium (Na+), as well as with AKI at the time of admission, were excluded. Values > 110 mEq/L Cl- and > 145 mEq/L Na+ were considered as hyperchloremia and hypernatremia, respectively. A sample size of 255 patients was calculated. Statistical analysis. Odds Ratio (OR) and 95% confidence intervals (95% CI) were calculated for bivariate and multivariate analyses. Results: among 241 patients, the incidence of hyperchloremia was 12.4% (n = 30), and of hypernatremia 18.6% (n = 45). The frequency of AKI was 35.6%, and mortality was 14.1%. In logistic regression analysis, hypernatremia was associated with AKI (OR 2.7, 95% CI 1.3-5.7, p < 0.006), but not with mortality. While hyperchloremia was not identified as a risk for AKI or death. Conclusions: hyperchloremia and hypernatremia are common in critically ill pediatric patients, but only hypernatremia seems to confer a higher risk of complications. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic represented a challenge in medical care. A tool would be very useful to establish the prognosis of in-hospital death that is reliable and can be applied to the Mexican population entitled to the IMSS. Objective: To propose a prognostic scale to stratify patients with viral pneumonia COVID-19 in the emergency services. Material and methods: A nested case-control study was conducted in a cohort of patients who were consecutively admitted to the emergency department with viral pneumonia COVID-19. The cases were those patients who died, and the controls were those who were discharged due to health improvement. An association analysis was performed between the variables with significant differences between groups. Subsequently, the association was adjusted using a multivariate logistic regression model, from which the prognostic scale was developed. Results: A total of 70 subjects with COVID-19 were included, 34 cases and 36 controls. Chronic diseases, smoking, severe pulmonary involvement diagnosed by tomography, leukocytosis, and pulse oximetry less than 80% with were associated with in-hospital mortality; Odds Ratio (OR) of >1.1. Vaccination was a protective factor (OR = 0.04, CI95%: 0.01-0.16). A score greater than 3 points on the prognostic scale predicts in-hospital mortality with a specificity of 0.86 and a sensitivity of 0.73. Conclusions: The proposed prognostic scale can be a useful tool in the classification of patients with COVID-19 viral pneumonia in the emergency room services of secondary care level Hospitals. [ABSTRACT FROM AUTHOR]

Introduction: A nosocomial outbreak of coronavirus disease (COVID-19) occurred in the Toda Chuo General Hospital in Toda City, Saitama Prefecture, Japan in December 2020. The purpose of this study was to compare the accuracy of three prognostic indices for predicting the outcome of COVID-19 in patents with COVID-19 pneumonia. Patients and methods: Patients in the Department of Urology and Transplant Surgery at Toda Chuo General Hospital with nosocomially acquired COVID-19 confirmed by a positive polymerase chain reaction test were included in the study. We used the COVID-GRAM, International Severe Acute Respiratory and Emerging Infections Consortium’s World Health Organization 4C Mortality Score, and COVID-19 Registry Japan to independently predict the prognoses of 10 patients and identify common prognostic factors. All three indices include age, dyspnea, and comorbidities as prognostic factors. Results: Ten patients were included in the study, of which two patients died. According to the COVID-GRAM both patients were “high risk,” whereas the 4C Mortality Score predicted “high risk” and “very high risk.” Conclusion: The prognostic scores of all three indices were useful for predicting illness severity. Resumen: Objetivos: En diciembre de 2020 se produjo un brote nosocomial de enfermedad por coronavirus (COVID-19) en el Hospital General Toda Chuo de la ciudad de Toda, prefectura de Saitama, Japón. El propósito de este estudio fue comparar la exactitud de tres índices pronósticos para predecir el resultado de COVID-19 en pacientes con neumonía por COVID-19. Métodos: Se incluyeron en el estudio pacientes del Departamento de Urología y Cirugía de Trasplantes del Hospital General Toda Chuo con COVID-19 adquirida por vía nosocomial confirmada por una prueba de reacción en cadena de la polimerasa positiva. Se utilizaron los índices COVID-GRAM, International Severe Acute Respiratory and Emerging Infections Consortium's World Health Organization 4C Mortality Score y COVID-19 Registry Japan para predecir de forma independiente el pronóstico de 10 pacientes e identificar factores pronósticos comunes. Los tres índices incluyen la edad, la disnea y las comorbilidades como factores pronósticos. Resultados: Se incluyeron en el estudio 10 pacientes. Dos pacientes fallecieron. Según el COVID-GRAM ambos pacientes eran de ''alto riesgo'', mientras que el 4C Mortality Score predijo ''alto riesgo'' y ''muy alto riesgo''. Conclusión: Las puntuaciones pronósticas de los tres índices fueron útiles para predecir la gravedad de la enfermedad.

Introducción. El tratamiento oncológico perioperatorio en pacientes con cáncer gástrico localmente avanzado está indicado; aun así, no siempre es posible. El objetivo de este estudio fue evaluar la supervivencia de los pacientes según la administración de quimioterapia perioperatoria. Métodos. Estudio observacional, tipo cohorte ambispectivo, incluyendo pacientes con cáncer gástrico localmente avanzado quienes recibieron o no quimioterapia perioperatoria. Resultados. Se incluyeron 33 pacientes, 90,9 % pertenecían al régimen subsidiado de salud y el 78,8 % en estadio T4. El grupo que recibió quimioterapia perioperatoria, que solo tuvo 5 pacientes (15,1 %), presentó mayor supervivencia global a 2 años (100 %), seguido del grupo de quimioterapia postoperatoria (58,8 %) y del grupo sin quimioterapia, que alcanzó una supervivencia global a 2 años de 54,5 %. Discusión. La supervivencia global fue mayor en el grupo de quimioterapia perioperatoria, consonante a lo descrito a nivel internacional, aunque los pacientes se encontraban en un estadío localmente más avanzado, la mayoría con T4 y N+ según AJCC VIII edición. Conclusiones. El estadío clínico es un factor pronóstico importante y, en nuestro medio, la mayoría de los pacientes consultan en estadíos localmente más avanzados. A eso se suman las dificultades en el acceso a la atención en salud. Aun así, la quimioterapia perioperatoria mostró una supervivencia mayor en pacientes con cáncer gástrico localmente avanzado.

Introducción. El cáncer gástrico es la cuarta causa de muerte por cáncer a nivel mundial, con más de un millón de casos diagnosticados cada año. La cirugía con intención curativa sigue siendo el pilar del manejo para los pacientes resecables. La identificación de pacientes con mayor riesgo de morbimortalidad es importante para el proceso de toma de decisiones, sin existir hasta el momento una herramienta ideal. La revisión y el análisis de la experiencia de un centro oncológico de referencia pueden generar información útil. Métodos. Estudio observacional de cohorte histórica, en el que se incluyeron los pacientes llevados a gastrectomía por adenocarcinoma gástrico en el Instituto Nacional de Cancerología, Bogotá, D.C., Colombia, entre el 1° de enero del 2010 y el 31 de diciembre del 2017. Resultados. Se evaluaron 332 pacientes, de los cuales el 57,2 % eran hombres con edad promedio de 61 años. La mortalidad en esta serie fue del 4,5 % y la morbilidad de 34,9 %. El factor asociado con mayor riesgo de muerte fue la edad, con un HR de 1,05 (p=0,021). Se encontró un mayor riesgo en el grupo de pacientes con ASA mayor a II (p=0,009). El 17,4 % presentaron complicaciones mayores a IIIA de la clasificación de Clavien-Dindo. Conclusiones. En el presente trabajo las cifras de morbilidad y mortalidad son similares a las reportadas en la literatura. Solo la edad y la clasificación de ASA mostraron asociación con valor estadístico significativo para complicaciones postoperatorias.

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Objetivo: Determinar la frecuencia de pluripatología en una Unidad de Insuficiencia Cardíaca, definir las características de los pacientes pluripatológicos y su pronóstico vital según dos modelos: el índice PROFUND y el Seattle Heart Failure Model. Material y métodos: Se han analizado de forma consecutiva los pacientes observados en la consulta de insuficiencia cardíaca de un hospital de tercer nivel durante dos meses. Se han registrado comorbilidades, categorías de pluripatología y los índices de Charlson, Barthel, Seattle Heart Failure Model y PROFUND. Resultados: Se incluyeron 246 pacientes, de los que 118 (48%) fueron pluripatológicos, con índice de Charlson 7,9±3,8 y PROFUND 3,5±7,1. La categoría de pluripatología más prevalente fue la A, seguida de la B y C. Los pluripatológicos fueron mayores (77 vs. 73 años, p=0,001), más frágiles, con mayor limitación funcional (Barthel: 84,7 vs. 96,1, p

El síndrome de vasoconstricción cerebral reversible se produce por la constricción variable, segmentaria y multifocal, de las arterias cerebrales y, generalmente, es de curso benigno. Se describe el caso de una mujer de 49 años que consultó por cefalea, síntomas visuales y convulsiones; tres días después, presentaba áreas de vasoconstricción en, por lo menos, dos territorios vasculares y dos segmentos de las mismas arterias. Fue internada en la unidad de cuidados intensivos para controlarle la presión arterial y recibir tratamiento médico. Tuvo una evolución tórpida y, en el séptimo día de hospitalización, desarrolló edema cerebral maligno, tras lo cual ocurrió la muerte cerebral. Se inició entonces el plan de donación de órganos y, posteriormente, se practicó una autopsia guiada del cerebro. El estudio de patología descartó vasculitis y reveló áreas de hemorragia en la convexidad cerebral. Se discuten los aspectos más relevantes de los casos con evolución fulminante informados en la literatura científica. El síndrome de vasoconstricción cerebral reversible se asocia con resultados fatales cuando los pacientes tienen una deficiencia neurológica focal, la neuroimagen inicial muestra alteraciones y hay un deterioro clínico rápido. Es importante conocer los factores asociados con un mal pronóstico, y establecer estrategias tempranas de intervención y prevención.

Objetivo: Determinar predictores de mortalidad intrahospitalaria y mal pronóstico funcional en pacientes sometidos a cirugía por hemorragia intracerebral. Materiales y métodos: Se analizaron las historias clínicas, reportes operatorios y tomografías cerebrales de pacientes con hemorragia intracerebral desde marzo 2018 hasta marzo de 2020. Se realizó un análisis de regresión logística univariado y multivariado para determinar predictores independientes de mortalidad intrahospitalaria y mal pronóstico funcional al alta. Resultados: La mortalidad intrahospitalaria fue de 33.7% (n = 31 pacientes). Predictores independientes de mortalidad fueron el sexo femenino (OR = 3.01; p = 0.031) y un Glasgow < 8 puntos al ingreso (OR = 3.19; p = 0.031). Un mal pronóstico funcional luego de la intervención se encontró en 77 pacientes (83.7%). Predictores independientes de mal pronóstico funcional fueron una Escala de Rankin modificada > 3 (OR = 15.5; p = 0.01) y déficit motor pre-operatorio (OR = 8.95; p = 0.042). Conclusiones: En pacientes con diagnóstico de hemorragia intracerebral tratados con cirugía se encontró una alta mortalidad y morbilidad. El sexo femenino y factores clínicos como el estado de conciencia y el estado funcional al ingreso fueron predictores independientes de mortalidad intrahospitalaria y mal pronóstico funcional.

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Introduction: Evacuation of spontaneous intracerebral hematoma is part of its treatment. Postoperative mortality is high in deep hematomas and sometimes higher than when conservative treatment is performed. Objective: To compare the hospital mortality of patients with deep spontaneous intracerebral hematoma without hydrocephalus, in relation to surgical or conservative treatment. Methods: This is an analytical study carried out at General Calixto García University Hospital, from January 2016 to December 2019, in patients diagnosed with deep spontaneous intracerebral hematoma without hydrocephalus, 32 operated by craniotomy and evacuation of the hematoma and 30 treated conservatively that resulted from random age matching, data were obtained from medical records. The t-student test, Fisher's exact statistic and odd ratio were used. Results: Mortality was related to older age in both groups (p= 0.032 in the surgical group and p= 0.021 in the conservative group), as well as the Glasgow Coma Scale ≤ 8 points (p= 0.001 in the surgical group and p= 0.008 in the conservative group); mortality was 84.4% in the surgical procedure and 63.3% in the conservative procedure. This difference was significant (p= 0.045). Conclusions: In patients with deep spontaneous intracerebral hematoma without hydrocephalus, higher mortality is associated with older age and values on the Glasgow scale for coma ≤ 8 points, both factors of poor prognosis. In turn, in those treated by craniotomy and evacuation of the hematoma, there are more deaths than in those treated conservatively. [ABSTRACT FROM AUTHOR]

Introduction: There are different prognostic scores to determine the probability of death in burned patients. The Garces Index (GI) used in Chile is not accepted worldwide. Aim: We decided to evaluate the correlation between IG and Abbreviated Burn Severity Index (ABSI), which is widely used. Materials and Method: Cross-sectional analytical and descriptive study of burned patients uploaded to the online platform "National Burns Registry" and then admitted to our center between July 2017 and July 2018. Pearson's correlation coefficient between IG and ABSI was calculated. Both variables were normalized to be able to make them comparable and the agreement between them was calculated with Lin's correlation coefficient. With logistic regression analysis, the associated probability of death was calculated for both variables and areas of the ROC curves of both scores were compared. Results: Of 141 patients, 15 died during hospitalization, with a mean GI 104 ± 49 and ABSI 7 ± 2. Pearson's correlation coefficient between GI and ABSI showed a very high correlation with a value of 0.928. Lin's correlation coefficient gave moderate agreement with a value of 0.93. When checking which of the two scores best predicts the probability of death through sensitivity and specificity analysis, the ROC curve covers more area in IG (0.82 vs 0.83) without being statistically significant. Conclusions: Both scores, IG and ABSI, are very similar when it comes to predicting the probability of death, which is why they are comparable at the time of sharing the results in scientific studies. [ABSTRACT FROM AUTHOR]

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Introducción. La infección por el nuevo coronavirus SARS-Cov-2 es una emergencia de salud pública en todo el mundo; su diagnóstico se basa en pruebas moleculares, en tanto que su pronóstico depende de los antecedentes del paciente y de algunos exámenes paraclínicos. En Colombia aún no se cuenta con datos de pronóstico en una población local. Objetivo. Evaluar los factores asociados con el desarrollo de la enfermedad grave en pacientes hospitalizados con diagnóstico de infección por SARS-CoV-2, así como los factores pronósticos de la mortalidad. Materiales y métodos. Se hizo un estudio de cohorte ambispectivo en pacientes hospitalizados en la Fundación Cardioinfantil entre marzo y junio de 2020. Resultados. De los 104 pacientes analizados, en el 31,7 % (n=33) la infección fue grave y en el 9,6 % (n=10) se produjo la muerte. El factor pronóstico más importante de la mortalidad fue el desarrollo de la enfermedad grave, seguido de una edad de más de 60 años y la desnutrición. Para el desarrollo de la enfermedad grave los factores pronósticos fueron los antecedentes de hemodiálisis (hazard ratio, HR=135), diabetes (HR=4,4) y el aumento en el nivel de la lactato deshidrogenasa (LDH) (HR=1,004), en tanto que un conteo de linfocitos superior a 1.064 fue un factor protector (HR=0,9). El puntaje del National Early Warning Score (NEWS2) correspondiente a las categorías de alto y bajo riesgo fue el que mejor rendimiento tuvo. No hubo diferencia entre los tratamientos administrados. Conclusiones. Los factores pronósticos más importantes para la mortalidad fueron tener más de 60 años, hipertensión, diabetes y cirrosis, en tanto que para el desarrollo de la enfermedad grave fueron la enfermedad renal crónica con hemodiálisis, un puntaje de NEWS2 de alto riesgo al ingreso, y aumento en los niveles de LDH y proteína C reactiva, y leucocitosis.

Background: AKI is frequent in critically ill patients, in whom the leading cause of AKI is sepsis. The role of intrarenal and systemic inflammation appears to be significant in the pathophysiology of septic-AKI. The neutrophils to lymphocytes and platelets (N/LP) ratio is an indirect marker of inflammation. The aim of this study was to evaluate the prognostic ability of N/LP ratio at admission in septic-AKI patients admitted to an intensive care unit (ICU). Methods: This is a retrospective analysis of 399 septic-AKI patients admitted to the Division of Intensive Medicine of the Centro Hospitalar Universitário Lisboa Norte between January 2008 and December 2014. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to define AKI. N/LP ratio was calculated as: (Neutrophil count × 100)/(Lymphocyte count × Platelet count). Results: Fifty-two percent of patients were KDIGO stage 3, 25.8% KDIGO stage 2 and 22.3% KDIGO stage 1. A higher N/LP ratio was an independent predictor of increased risk of in-hospital mortality in septic-AKI patients regardless of KDIGO stage (31.59 ± 126.8 vs 13.66 ± 22.64, p = 0.028; unadjusted OR 1.01 (95% CI 1.00–1.02), p = 0.027; adjusted OR 1.01 (95% CI 1.00–1.02), p = 0.015). The AUC for mortality prediction in septic-AKI was of 0.565 (95% CI (0.515–0.615), p = 0.034). Conclusions: The N/LP ratio at ICU admission was independently associated with in-hospital mortality in septic-AKI patients. Resumen: Antecedentes: La LRA es frecuente en pacientes críticos, en quienes la causa principal de LRA es la sepsis. El papel de la inflamación intrarrenal y sistémica parece ser significativo en la fisiopatología de la LRA por sepsis. La relación entre neutrófilos y linfocitos y plaquetas (N/LP) es un marcador indirecto de inflamación. El objetivo de este estudio fue evaluar la capacidad pronóstica de N/LP en el momento del ingreso en pacientes con LRA por sepsis ingresados en una unidad de cuidados intensivos. Métodos: Se trata de un análisis retrospectivo de 399 pacientes con LRA por sepsis ingresados en la Unidad de Medicina Intensiva del Centro Hospitalario Universitario Lisboa Norte, entre enero de 2008 y diciembre de 2014. Se usó la clasificación del Kidney Disease Improving Global Outcomes (KDIGO) para definir la LRA. La relación N/LP se calculó como: (recuento de neutrófilos × 100)/(recuento de linfocitos × recuento de plaquetas). Resultados: El 52% de los pacientes presentaba KDIGO estadio 3, el 25,8% KDIGO estadio 2 y el 22,3% KDIGO estadio 1. Un valor más elevado de N/LP fue un factor pronóstico independiente de mayor riesgo de mortalidad intrahospitalaria en pacientes con LRA por sepsis, independientemente del estadio KDIGO (31,59 ± 126,8 frente a 13,66 ± 22,64, p = 0,028); OR sin ajustar 1,01 (IC del 95%: 1,00-1,02, p = 0,027), OR ajustada 1,01 (IC del 95%: 1,00-1,02, p = 0,015). El AUC para la predicción de mortalidad en la LRA por sepsis fue de 0,565 (IC del 95%: 0,515-0,615, p = 0,034). Conclusiones: La relación N/LP en el momento del ingreso en la unidad de cuidados intensivos se asoció de forma independiente con la mortalidad intrahospitalaria en pacientes con LRA por sepsis.

RESUMEN Introducción y objetivos: Las guías clínicas recomiendan la realización de una coronariografía en los pacientes con infarto agudo de miocardio sin elevación del segmento ST (IAMSEST). Sin embargo, no está claramente establecido el mejor momento para hacerla. Por ello, el objetivo del presente trabajo fue analizar si practicar un cateterismo precoz (durante las primeras 24 h) se relaciona con un mejor pronóstico, en comparación con hacerlo de manera diferida (más allá de las 24 h). Métodos: De enero de 2014 a junio de 2016 ingresaron en la unidad de cuidados agudos cardiológicos de un hospital terciario 447 pa­cientes consecutivos con diagnóstico de IAMSEST a los que se hizo una coronariografía. Se clasificó de forma retrospectiva a los pacientes en 3 grupos en función del momento de realización del cateterismo: durante las primeras 24 h, entre las 24 y 72 h tras el diagnóstico, y después de las primeras 72 h. Resultados: El cateterismo se llevó a cabo en las primeras 24 h en 285 pacientes (63,8%). No se identificaron diferencias entre los grupos en cuanto a sexo, prevalencia de factores de riesgo cardiovascular ni presencia de comorbilidad. Tampoco se encontraron diferencias en las variables pronósticas analizadas ni en la mortalidad. En el seguimiento a los 12 meses, la incidencia de eventos cardiovasculares y la mortalidad fueron similares entre los grupos. Conclusiones: En el presente estudio, la realización de una coronariografía precoz (en las primeras 24 h) a los pacientes ingresados por IAMSEST no mostró beneficio clínico en términos de supervivencia o reducción de eventos cardiovasculares.

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Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: Estudiar en pacientes pluripatológicos (PP) si el índice PROFUND, una puntuación pronostica multidimensional objetiva, es superior a la intuición del médico clínico para predecir la muerte durante el primer año de seguimiento luego de la internación en clínica médica Métodos: Estudio prospectivo y observacional. Se incluyó pacientes adultos pluripatológicos. Variables: índice PROFUND, Pronostico subjetivo de muerte (PSM) ¿Cree usted que este paciente va a fallecer en los próximos 12 meses?: “si” PSM(+) “no” PSM(-). Mortalidad a 12 meses del alta. Resultados: Se analizaron 92 pacientes. La edad promedio fue 75,3 (± 9,5) años y el 51,1% varones. Fallecieron 47 pacientes (51,6%). El índice PROFUND promedio fue 6,9(± 4,5) puntos y el PSM fue (+) en el 46,7%. Fallecieron el 65,9% (29 de 44) y el 38,3% (18 de 47) de los pacientes con índice PROFUND >6 y ≤6 puntos, respectivamente (p=0,0021). De los 43 pacientes con PSM(+) fallecieron el 58,1% y de los 48 con PSM(-) el 45,8% (p=0,1003). A partir del modelo de Cox, el riesgo de morir es 2 veces mayor en los pacientes con índice PROFUND>6 puntos (HR: 2,269 IC95%:1,231-4,184) El AUC para predecir mortalidad a 12 meses del índice PROFUND y PS fueron: 0,712 (IC95%: 0,607-0,817) y 0,561 (IC95%: 0, 458-0,664) respectivamente (p 0.0212). Conclusión: En pacientes pluripatológicos internados, el índice PROFUND, supera la capacidad pronostica de mortalidad a 12 meses del médico clínico tratante.

Objective: To investigate possible early prognostic factors among middle-aged and older adult and explore prognostic rules stratifying risk of patients. Design: Community-based retrospective cohort. Setting: Primary Health Care Tarragona region. Participants: 282 community-dwelling symptomatic patients ≥50 years with laboratory-confirmed COVID-19 (hospitalised and/or outpatient) during March-June 2020 in Tarragona (Southern Catalonia, Spain). Main outcome measurements: Relationship between demographics, pre-existing comorbidities and early symptomatology (first 5-days) and risk of suffering critical outcome (ICU-admission/death) across clinical course was evaluated by logistic regression analyses, and simple predictive models were developed. Results: Of the 282 cases (mean age: 65.9 years; 140 men), 154 (54.6%) were hospitalised (30 ICU-admitted) and 45 (16%) deceased. Median time follow-up in clinical course was 31 days (range: 30–150) for survivors and 14 days (range: 1–81) for deceased patients. In crude analyses, increasing age, male sex, some comorbidities (renal, respiratory or cardiac disease, diabetes and hypertension) and symptoms (confusion, dyspnoea) were associated with an increased risk to suffer critical outcome, whereas other symptoms (rinorrhea, myalgias, headache, anosmia/disgeusia) were related with reduced risk. After multivariable-adjustment only age/years (OR: 1.04; 95% CI: 1.01–1.07; p = 0.004), confusion (OR: 5.33; 95% CI: 1.54–18.48; p = 0.008), dyspnoea (OR: 5.41; 95% CI: 2.74–10.69; p

Introducción. El cáncer gástrico es el quinto cáncer diagnosticado con mayor frecuencia y la tercera causa de muerte por cáncer en el mundo. En el tratamiento quirúrgico, la evidencia actual apoya las medidas preoperatorias e índices pronósticos para mejorar la supervivencia. El índice nutricional pronóstico, que une los valores de los linfocitos circulantes en sangre periférica con los de la albúmina sérica, ha presentado características de ser un marcador nutricional e inmunológico con valor predictivo sobre complicaciones y mortalidad. El objetivo de este estudio fue determinar la relación entre el índice nutricional pronóstico con las complicaciones y mortalidad en pacientes con cáncer gástrico sometidos a gastrectomía. Métodos. Se llevó a cabo un estudio observacional descriptivo, de corte transversal, con componente analítico, mediante la revisión retrospectiva de las historias clínicas. Resultados. Se analizaron 113 pacientes sometidos a gastrectomía total o subtotal. Se encontró asociación entre el índice nutricional pronóstico y la mortalidad; todos los pacientes que murieron tenían un índice menor o igual a 46. También se encontró asociación inversa entre el valor del índice y la presentación de complicaciones posoperatorias, como sepsis, peritonitis, fuga de la anastomosis y sangrado. Discusión. Similar a nuestro análisis, varios estudios plantean que un índice nutricional pronóstico bajo podría tener un valor predictivo sobre la frecuencia de complicaciones y supervivencia global en pacientes con cáncer gástrico llevados a cirugía. Conclusión. El índice nutricional pronóstico se asocia con la mortalidad y complicaciones posoperatorias en pacientes sometidos a gastrectomía por cáncer gástrico.

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Introduction. Hyponatremia is the most common electrolyte disorder in patients with chronic heart failure affecting up to 28% of patients at admission. It has been shown to be an independent predictor of mortality, extended length of hospital stay and rehospitalization. The objective is to evaluate the presence of hyponatremia in patients with decompensated heart failure and describe its relationship with length of hospital stay and mortality. Methodology. A prospective cohort study in patients hospitalized at internal medicine service at a high level of complexity hospital in Bogotá, Colombia diagnosed with decompensated heart failure between April 2011 and March 2012. Sodium was measured on admission, 72 hours and at the seventh day of hospitalization. We evaluated the association between hyponatremia at hospital admission, mortality at 30 days and length of hospital stay. Results. 162 patients were included with an average age of 72 years, 52.5% male. Forty-one (25.3%) had hyponatremia at admission. Among the patients with normal sodium at admission, 6 had hyponatremia at 72 hours and 2 at the seventh day. Inhospital mortality in the total population was 9.2%, in the hyponatremia group 12.2%, and 8.2% in those who did not have it (p = 0.45). The average length of hospital stay was higher in patients with hyponatremia, 6.6 vs 8.4 days (p = 0.12). Discussion. The incidence of hyponatremia at admission in this group of patients was similar to that reported in the literature. Conclusions. The results showed a trend towards higher mortality and hospital stay in patients with hyponatremia, even though it was not statistically significant. Cómo citar. Diaztagle-Fernández JJ, Chaves-Saltiago WG, Sprockel-Díaz JJ, Acevedo-Velasco AD, Rodríguez-Benítez FH, Benavides-Solarte MF, et al. Asociación entre hiponatremia, mortalidad y estancia hospitalaria en pacientes con falla cardíaca descompensada. MedUNAB. 2019;22(3), 294-303. doi: 10.29375/01237047.3497 Introducción. La hiponatremia es la alteración electrolítica más frecuente en pacientes con falla cardíaca crónica, que afecta hasta el 28% de pacientes en el ingreso hospilatario. Se ha demostrado que es un predictor independiente de mortalidad, estancia prolongada y rehospitalización. El objetivo es describir la frecuencia de hiponatremia en pacientes con falla cardíaca descompensada y su relación con la estancia hospitalaria y mortalidad. Metodología. Cohorte prospectiva en pacientes hospitalizados por el servicio de Medicina Interna en un hospital de cuarto nivel de Bogotá, Colombia, con diagnóstico de falla cardíaca descompensada entre abril de 2011 y marzo de 2012. Se midió el sodio al ingreso, a las 72 horas y al día séptimo de hospitalización. Se evaluó la relación de la hiponatremia al ingreso con la estancia hospitalaria y la mortalidad intrahospitalaria a 30 días. Resultados. Se incluyeron 162 pacientes, con promedio de edad de 72 años, 52.5% hombres. Cuarenta y uno (25.3%) presentaron hiponatremia al ingreso. Entre los pacientes que presentaron sodio normal al ingreso, 6 presentaron hiponatremia a las 72 horas y 2 a los 7 días. La mortalidad intrahospitalaria en la población total fue 9.2%, en el grupo de hiponatremia 12.2%, y 8.2% en los que no la tuvieron (p= 0.45). El promedio de estancia hospitalaria fue superior en los pacientes con hiponatremia, 6.6 vs. 8.4 días (p= 0.12). Discusión. La incidencia de hiponatremia al ingreso en este grupo de pacientes fue semejante a la reportada en la literatura. Conclusiones. Existe una tendencia hacia una mayor mortalidad y estancia hospitalaria en pacientes con hiponatremia, aun cuando no fue estadísticamente significativa. Cómo citar. Diaztagle-Fernández JJ, Chaves-Saltiago WG, Sprockel-Díaz JJ, Acevedo-Velasco AD, Rodríguez-Benítez FH, Benavides-Solarte MF, et al. Asociación entre hiponatremia, mortalidad y estancia hospitalaria en pacientes con falla cardíaca descompensada. MedUNAB. 2019;22(3), 294-303. doi: 10.29375/01237047.3497 Introdução. A hiponatremia é o desequilíbrio hidroeletrolítico mais frequente em pacientes com insuficiência cardíaca crônica, que afeta até 28% dos pacientes internados. Demonstrou ser um preditor independente de mortalidade, permanencia prolongada e re-internação. O objetivo é descrever a frequência de hiponatremia em pacientes com insuficiência cardíaca descompensada e sua relação com internação hospitalar e mortalidade. Metodologia. Coorte prospectiva em pacientes internados pelo serviço de Medicina Interna em um hospital de quarto nível em Bogotá, Colômbia, com diagnóstico de insuficiência cardíaca descompensada, entre abril de 2011 e março de 2012. Foi medido o sódio na admissão, às 72 horas e no sétimo dia de internação. Foi avaliada a relação de hiponatremia na admissão com internação e a mortalidade hospitalar aos 30 dias. Resultados. Foram incluídos 162 pacientes, com idade média de 72 anos, 52,5% homens. Quarenta e um (25,3%) apresentaram hiponatremia na admissão. Entre os pacientes que apresentaram sódio normal na admissão, seis apresentaram hiponatremia às 72 horas, e dois aos sete dias. A mortalidade hospitalar na população total foi de 9,2%, no grupo de hiponatremia 12,2% e 8,2% naqueles que não apresentaram (p = 0,45). O tempo médio de internação foi maior nos pacientes com hiponatremia, 6,6 vs. 8,4 dias (p = 0,12). Discussão. A incidência de hiponatremia na admissão nesse grupo de pacientes foi semelhante à relatada na literatura. Conclusões. Existe uma tendência de maior mortalidade e permanência hospitalar em pacientes com hiponatremia, mesmo que não tenha sido estatisticamente significante. Cómo citar. Diaztagle-Fernández JJ, Chaves-Saltiago WG, Sprockel-Díaz JJ, Acevedo-Velasco AD, Rodríguez-Benítez FH, Benavides-Solarte MF, et al. Asociación entre hiponatremia, mortalidad y estancia hospitalaria en pacientes con falla cardíaca descompensada. MedUNAB. 2019;22(3), 294-303. doi: 10.29375/01237047.3497

The reversible cerebral vasoconstriction syndrome is a variable, segmental, and multifocal constriction of brain arteries, usually with a benign course. We describe the case of a 49-year-old woman who presented with headaches, visual symptoms, and seizures. Three days after admission, vasoconstriction areas were found in at least two vascular territories in two segments of the same arteries. The patient was admitted to the intensive care unit where her blood pressure was monitored and she received medical treatment. Surprisingly, the patient presented an unpredicted evolution in developing malignant cerebral edema on the seventh day after admission. She then suffered brain death and was taken to organ donation. A guided nervous system necropsy was later performed. The pathology discarded vasculitis and exhibited hemorrhage areas in the cerebral convexity. Herein, we discuss the most relevant aspects of cases with fulminant evolution reported in the literature. The reversible cerebral vasoconstriction syndrome is usually associated with fatal outcomes when patients exhibit focalization, their first neuroimaging typically shows disturbances, and a rapid clinical deterioration occurs. It is crucial to identify factors linked to poor prognosis and set intervention strategies and early prevention. [ABSTRACT FROM AUTHOR]

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Objetivo: Describir las características de los pacientes hospitalizados en la Unidad de Cuidados Intermedios del Hospital Uldarico Rocca Fernández y determinar los factores asociados a mortalidad. Materiales y métodos: Estudio observacional, descriptivo y retrospectivo realizado en la Unidad de Cuidados Intermedios del Hospital Uldarico Rocca Fernández Lima-Perú, que incluye los pacientes hospitalizados por SARS-CoV-2 durante el periodo comprendido entre el 1 de julio al 30 de setiembre del 2020. Se revisó la historia clínica y registros hospitalarios para buscar características epidemiológicas, características clínicas, resultados de exámenes auxiliares al ingreso y el desenlace de la hospitalización. Resultados: Se estudiaron 71 historias clínicas, las características epidemiológicas predominantes fueron sexo masculino (80,28 %) y edad promedio de 64,72 años ± 13,64. La mayoría de los pacientes (61,97 %) presentaba al menos una comorbilidad, las más frecuentes fueron obesidad (35,21 %) e hipertensión arterial (32,39 %). La media de estancia hospitalaria fue de 13 días (± 12 días) y la tasa de mortalidad encontrada fue de 71,83 %. Conclusiones: A partir de los resultados encontrados, esta investigación respalda lo siguiente: la población masculina presenta mayor riesgo de enfermar. Además, existen factores asociados a un peor pronóstico de mortalidad, como ser mayor de 60 años, ingresar por el servicio de emergencia con una saturación menor de 80 % y una estancia hospitalaria prolongada

Objective: To describe the characteristics of patients hospitalized in the Intermediate Care Unit of the Hospital Uldarico Rocca Fernández and determine the factors associated with mortality. Materials and methods: An observational, descriptive and retrospective study carried out in the Intermediate Care Unit of the Hospital Uldarico Rocca Fernández in Lima, Peru, which included patients hospitalized for SARS-CoV-2 from July 1 to September 30, 2020. Clinical records and hospital records were reviewed looking for epidemiological characteristics, clinical characteristics, results of additional tests on admission and the final outcome of hospitalization. Results: Seventy-one (71) clinical records were studied. The predominant epidemiological characteristics were males (80.28 %) and mean age (64.72 years ± 13.64). Most of the patients (61.97 %) had at least one comorbidity, out of which the most common ones were obesity (35.21 %) and hypertension (32.39 %). The mean hospital stay was 13 days (± 12 days) and the mortality rate was 71.83 %. Conclusions: Based on the results, this research supports the following: the male population has a greater risk of becoming ill. In addition, there are factors associated with a worse mortality prognosis, such as age over 60, admission at the emergency room with an oxygen saturation lower than 80 %, and prolonged hospital stay. [ABSTRACT FROM AUTHOR]

Introduction: Acute liver failure (ALF) is a rapidly progressive and multisystem syndrome with high mortality. Objective: To determine prognostic factors of poor outcome in children with ALF. Material and methods: This is a retrospective cohort study with children under 14 years of age. In order to compare clinical and laboratory factors, patients were grouped according to their prognosis, favorable (recovery) and unfavorable (death or need for liver transplantation [LT]). Cox proportional risk analysis was used to determine the association of factors associated with prognosis. Results: 44 patients were included. In the majority, the etiology of ALF could not be identified (56.8%). Fifteen patients (34.1%) had a favorable evolution, and 29 (65.9%) had a poor evolution: 15 died and 14 met LT criteria. In the multivariate model, the poor prognostic factors were: INR (international normalized ratio) > 3.5 (HR = 2.235; 95% CI: 1.722-6.914; p = 0.043) and a higher LIU score (Liver Injury Unit scoring system) (HR = 2.0; 95% CI: 1.996-2.005; p = 0.049). Conclusions: Mortality in children with ALF is high. Factors associated with an unfavorable evolution were INR > 3.5 or high LIU scores. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)