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1. Anxiety, Depression, and Asthma Control: Changes After Standardized Treatment

Author

L. Fernandez Pellon, E. Macias Fernandez, Manuel J Rial, E. Morchon Miguel, V. Vilella Tomás, P. Marin Martinez, V. De Luque Piñana, V. García Paz, M. Morales Villarejo, J. Ruiz Hornillos, J. Herrero Jarque, J. Florido Lopez, J. Beitia Mazuecos, M. Rojas Vilchez, J. Medina Gallardo, J. Valldeperas Combas, A. Pallarés Sanmartín, I. García Núñez, J. Castro Landin, R. Diaz Campos, G. Gala Ortiz, M. Mena Rodriguez, O. Villarreal Balza De Vallejo, Vicente Plaza, E. Pinto Nogues, A. Suárez Rodríguez, P. Sánchez López, S. Díaz Angulo, F. Sola Martinez, M. Moscardó Orenes, M. Alvariño Martin, R. Tejedor Romera, J. Orta Cuevas, Z. Vasquez Gambasica, B. García Figueroa, A. Letran Camacho, M. Modesto Alapont, M. Cervera Del Pino, P. Benito Martinez, S. Varela Losada, F. Carballada Gonzalez, Irina Bobolea, M. Díaz Palacios, Y. Anta Mejias, D. González De Olano, J. Martos Velasco, P. Prieto Montaño, A. Sanchez Alonso, M. Martínez Ceres, J. Donado Uña, Ò. Sotorra Elias, B. Alcázar Navarrete, A. Arnedillo Muñoz, J. Alcazar Ramirez, J. Jiménez López, M. Alvarez Puebla, M. Antón Girones, J. Compaired Villa, P. Mata Calderon, M. Escribano Rodriguez, C. Morales García, I. Molero Sancho, M. De Las Marinas Alvarez, T. Bazus Gonzalez, M. Soria Esojo, A. Vega Castro, A. Moreno Fernandez, G. Jorro Martínez, E. Ortega Sáenz De Tejada, A. Regueiro Moreira, M. Garcimartin Galicia, A. Alonso Gomez, R. Rodriguez Martinez, J. Liñana Santafé, I. Ansotegui Zubeldia, R. Lama Martinez, A. Saura Vinuesa, N. Segura Arazuri, M. Torrecillas Toro, M. Climent Gregori, M. Herrerias Peña, T. Peña Miguel, C. Vila Albelda, C. Diaz Donado, M. Hernandez, A. Losada Peña, M. Gandolfo Cano, J. Montoro Lacomba, J. Quiralte Enriquez, R. Rodríguez Pacheco, M. Arroyo Cozar, P. Rubinstein Aguñin, M. Blanco Aparicio, F. Alvarez Gutierrez, C. Merinas Lopez, R. Mayorgas Costoya, M. Franco Campos, J. Garcia De Pedro, V. Moreno Garcia, J. De Frutos Arribas, J. Alvarez Fernandez, A. Robles Iniesta, M. Do Muíño Joga, A. Bueso Fernandez, P. Serrano Dominguez, M. Jimenez Lara, P. Losada Llorente, C. Colás Sanz, I. Raducan, B. Requejo Mañana, M. Mota Godoy, M. Martos Calahorro, F. Ortiz Portal, J. Zapata Yébenes, F. Nicolau Pastrie, C. Rabade Castedo, M. Salvador Segarra, F. Callejas González, M. Chacon Patiño, G. González Álvarez, J. Olaguibel Rivera, P. Gonzalez Delgado, B. Orosa Bertol, E. De Santiago Delgado, J. Cumplido Bonny, R. Nuñez Orjales, Antonio Fernandez-Sanchez, B. Añíbarro Bausela, D. Ferrer Pargada, S. Niño Bernal, A. Cobas Paz, B. Huertas Barbudo, J. Ciruelos Ayuso, M. Lara Jiménez, D. Gutierrez Fernandez, G. Castaño De Las Pozas, Y. García Villamuza, F. Sánchez-Toril López, E. Naval Sendra, C. Andreu Balaguer, M. Rico Diaz, L. Navarro Seisdedos, D. El-Qutob López, J. Ruiz Cubillan, Miguel Ibáñez Rodríguez, L. Fontan Garcia-Boente, M. Rivera Ortun, A. Padilla Galo, M. Muñoz Pamplona, I. Perez Sampedro, F. Garcia Gonzalez, E. Gómez Nieves, S. Aparicio Español, Astrid Crespo, A. Lloris Bayo, R. Lleonart Bellfill, E. Burches Baixauli, R. Andujar Espinosa, I. Picans, F. Linde De Luna, A. Tabar Purroy, L. Valverde Vazquez, R. Blanco Gonzalez, M. Ballester Canelles, P. Barranco Sanz, F. Ruano Perez, A. Romero Ortiz, S. Jimenez Timon, G. De Luiz Martínez, C. Baeza Martinez, G. Bernaola Hortigüela, J. Chamorro Mohedad, M. Garcés Sotillos, R. Moreno Borque, M. Moro, I. Ali García, S. Lizarza Mendizabal, J. Almagro Lopez, C. Perez Carral, J. Cegoñino De Sus, M. Reche Frutos, R. González Perez, M. Domínguez Fuentes, L. Cassini Gomez De Cadiz, A. Feliu Vila, M. Dordal Culla, M. Corbacho Abelaira, Y. Puente Crespo, D. Romero Ribate, J. Rozadilla Sacanell, J. Lopez Caballero, A. Velez Ruiz De Lobera, A. Montoro De Francisco, M. Ramirez Prieto, N. Marina Malanda, J. Juanola Pla, M. Millan Gonzalez, N. Subira Farre, P. Cordero Rodriguez, F. Gonzalez Barcala, S. Herrera Lara, M. Peña Arellano, J. Igea Aznar, R. Alvarez Sintes, E. Martinez Moragon, J. Greses Giner, M. Martínez Riaza, G. Mediero Carrasco, P. Catalán Serra, M. Rodriguez Hernandez, S. Porcel Carreño, Joaquín Sastre, A. Ruiz San Francisco, R. Bernabeu Mora, M. Alwakil Olbah, H. Izaguirre Flores, J. Subiza Garrido-Lestache, B. Labeguerie Arenaza, B. Presedo Garazo, S. Cimbollek, A. Fuster Gomila, G. Minguez Martin, M. Martín Pérez, S. Garrido Fernández, F. Iglesias Rio, A. Veres Racamonde, B. Rodriguez Jimenez, F. Muñoz Bellido, A. Moral De Gregorio, A. López Viña, J. Marin Torrado, I. Flores Martín, M. Avilés Inglés, A. Lahuerta Castro, and P. Galindo Bonilla

Subjects
Adult, Male, Spirometry, medicine.medical_specialty, Vital capacity, Anxiety, Hospital Anxiety and Depression Scale, Severity of Illness Index, 03 medical and health sciences, FEV1/FVC ratio, 0302 clinical medicine, Forced Expiratory Volume, Internal medicine, Health care, Humans, Immunology and Allergy, Medicine, 030212 general & internal medicine, Depression (differential diagnoses), Asthma, medicine.diagnostic_test, Depression, business.industry, Middle Aged, medicine.disease, respiratory tract diseases, 030228 respiratory system, Female, medicine.symptom, business
Abstract

Background It has been documented that anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health care resources, and poor asthma control. Objective To examine the association of asthma diagnosis with symptoms of depression/anxiety and asthma control not only at baseline but also over a 6-month period of specialist supervision. Methods We enrolled 3182 patients with moderate to severe asthma. All were evaluated with spirometry, the Asthma Control Test, and the Hospital Anxiety and Depression Scale at baseline and at 6 months. Treatments were decided by specialists according to published guidelines. Results At baseline, 24.2% and 12% of the patients were diagnosed with anxiety and depression, respectively, according to the Hospital Anxiety and Depression Scale. After 6 months, anxiety and depression improved, affecting 15.3% and 8.1% of patients, respectively (P Conclusion Under standardized asthma care and after a specific visit with the specialist, patients present significant improvement in these psychological disorders and exhibit better asthma control and functional parameters.

Published
2018

2. Half the deaths after surgery for lung cancer occur after discharge.

Author

Quero-Valenzuela F, Piedra-Fernández I, Hernández-Escobar F, Martínez-Ceres M, Romero-Palacios PJ, De Guevara AC, and Torné-Poyatos P

Subjects
Aged, Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Non-Small-Cell Lung surgery, Cohort Studies, Female, Follow-Up Studies, Humans, Length of Stay, Lung Neoplasms pathology, Lung Neoplasms surgery, Male, Prognosis, Survival Rate, Carcinoma, Non-Small-Cell Lung mortality, Lung Neoplasms mortality, Patient Discharge statistics & numerical data, Pneumonectomy mortality, Postoperative Complications mortality, Thoracotomy mortality
Abstract

Introduction: Mortality following surgery for lung cancer increases at 90 days. The objective of this study was to determine the rate, factors, time to death, hospital stay until discharge, time to death after discharge and causes of mortality at 90 days following surgery for lung cancer., Methods: A prospective follow-up study was performed in a cohort of 378 patients who underwent surgery for lung cancer between January 2012 and December 2016. Data on preoperative status, postoperative complications, and mortality were collected., Results: Rates of mortality were 1.6% vs. 3.2% at 30 and 90 days, respectively. Half of deaths occurred between 31 and 90 postoperative days following discharge. The variables found to be related to mortality at 90 days were a Charlson Index >3 (p < 0.001), a history of stroke (p = 0.036), postoperative pneumonia (p = 0.001), postoperative pulmonary or lobar collapse (p = 0.001), reintubation (p < 0.001) and postoperative arrhythmia (p = 0.0029). The risk of mortality was also observed to be associated with the type of surgical technique -being higher for thoracotomy as compared to video-assisted thoracoscopy (VATS) (p = 0.011) -, and hospital readmission after discharge (p < 0.001). Adjusted odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Multivariate analysis revealed that a Charlson Index >3 (p = 0.001) OR 2.0 (1.55,2.78), a history of stroke (p = 0.018) OR 5.1 (1.81, 32.96) and postoperative pulmonary or lobar collapse (p = 0.001) OR 8.5 (2.41,30.22) were independent prognostic factors of mortality. The most common causes of death were related to respiratory (58.3%) and cardiovascular (33.2%) complications., Conclusions: Mortality at 90 days following surgery for lung cancer doubles 30-day mortality, which is a relevant finding of which both, patients and healthcare should be aware. Half the deaths within 90 days after surgery for lung cancer occur after discharge. Specific outpatient follow-up programs should be designed for patients at a higher risk of 90-day mortality., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Published
2018
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3. Predictors for 30-day readmission after pulmonary resection for lung cancer.

Author

Quero-Valenzuela F, Piedra-Fernández I, Martínez-Ceres M, Romero-Palacios PJ, Sánchez-Palencia A, De Guevara AC, and Torné-Poyatos P

Subjects
Aged, Female, Follow-Up Studies, Humans, Lung Neoplasms pathology, Lung Neoplasms surgery, Male, Patient Discharge, Prognosis, Prospective Studies, Risk Factors, Survival Rate, Time Factors, Lung Neoplasms mortality, Patient Readmission statistics & numerical data, Postoperative Complications mortality
Abstract

Background: The purpose of this study was to assess the rate, cause, and factors associated with readmissions following pulmonary resection for lung cancer and their relationship with 90-day mortality., Methods: A prospective cohort study was conducted of 379 patients who underwent surgery for lung cancer at the university hospitals Granada, Spain between 2012 and 2016., Results: The rate of readmissions within 30 postoperative days was 6.2%. The most common reason for readmission was subcutaneous emphysema (21.7%), pneumonia (13%), and pleural empyema (8.5%). A higher probability of requiring urgent readmission was associated with a higher Charlson index (OR 2.0,95% confidence interval 1.50-2.67, P = 0.001); peripheral arterial vasculopathy (OR 4.8, 95%CI 1.27-18.85, P = 0.021); a history of stroke (OR 8.2, 95%CI 1.08-62.37, P = 0.04); postoperative atelectasis (OR 4.7, 95%CI 1.21-18.64, P = 0.026); and air leaks (OR 12.6, 95%CI 4.10-38.91, P = 0.001).The prediction multivariable model for readmission represents an area under the curve (ROC) of 0.90. Mortality at 90 postoperative days in the group of readmitted patients was 13% versus 1.5 for the group of patients who did not require readmission (P < 0.001)., Conclusions: The factors predictive for readmission can help design individualized outpatient follow-up plans and programs for the reduction of readmissions., (© 2018 Wiley Periodicals, Inc.)

Published
2018
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