Tendencia temporal de letalidad por insuficiencia cardíaca en brasil entre 2000 y 2018

Objective: To analyze the temporal trend of lethality due to Heart Failure (HF) in Brazil between 2000 and 2018. Method: Ecological study of time series. Hospitalizations and deaths from HF in patients aged 50 years and over, from 2000 to 2018 in Brazil, were analyzed. Lethality rates were calculated and stratified by sex, age group and region. To estimate a trend, a simple linear regression was performed, considering a significant value p <0,05. Results: Brazil showed an increase in the lethality rate due to HF (=0,262; p <0,001). The increase is greater in the North (= 0,379) and smaller in the South (= 0,193). Trend is to increase for both sexes, greater for women (= 0,286); and as rates increased according to age, more pronounced after the age of 80. Conclusion: Temporal trend of increased mortality rates due to HF between 2000 and 2018 in Brazil in all variables analyzed.RESUMO Objetivo: Analisar a tendência temporal de letalidade por Insuficiência Cardíaca (IC) no Brasil entre 2000 e 2018. Método: Estudo ecológico de séries temporais. Foram analisados internações e óbitos por IC em pacientes a partir de 50 anos, no período de 2000 a 2018 no Brasil. As taxas de letalidade foram calculadas e estratificadas por sexo, faixa etária por sexo e região. Para estimar a tendência, foi realizado regressão linear simples, considerando significativo p<0,05. Resultados: Tendência temporal de aumento da taxa de letalidade hospitalar por IC no Brasil (=0,262; p <0,001), para ambos os sexos (Feminino: β= 0,286 Masculino: β= 0,239; p<0,001), todas as faixas etárias (p<0,001) e regiões (p<0,001). Conclusão: Comportamento temporal de incremento das taxas de letalidade por IC entre 2000 e 2018 no Brasil, segundo sexo, faixa etária por sexo e região

Tendência temporal das internações por condições sensíveis à atenção primária em idosos no Brasil

Objetivo: Avaliar a tendência temporal das ICSAP, em idosos, segundo sua estrutura, magnitude e causas, no Brasil, entre 2000 e 2018. Método: Estudo ecológico com base em dados do Sistema de Informação Hospitalar do SUS e Sistema de Informação da Atenção Básica referentes a indivíduos com 60 anos ou mais. Calculados os coeficientes brutos e específicos de hospitalizações segundo sexo, faixa etária e região. Estimadas a cobertura da Estratégia de Saúde da Família e o número de consultas médicas na atenção primária. Para análise da série temporal foi utilizado o método de regressão linear simples, e testada a correlação a partir do Coeficiente de Correlação de Pearson (

Clinical characteristics and outcomes of hospital-manifested COVID-19 among Brazilians

ABSTRACT: Objectives: To analyze the clinical characteristics and outcomes of admitted patients with the hospital- versus community-manifested COVID-19 and to evaluate the risk factors related to mortality in the first population. Methods: This retrospective cohort included consecutive adult patients with COVID-19, hospitalized between March and September 2020. The demographic data, clinical characteristics, and outcomes were extracted from medical records. Patients with hospital-manifested COVID-19 (study group) and those with community-manifested COVID-19 (control group) were matched by the propensity score model. Logistic regression models were used to verify the risk factors for mortality in the study group. Results: Among 7,710 hospitalized patients who had COVID-19, 7.2% developed symptoms while admitted for other reasons. Patients with hospital-manifested COVID-19 had a higher prevalence of cancer (19.2% vs 10.8%) and alcoholism (8.8% vs 2.8%) than patients with community-manifested COVID-19 and also had a higher rate of intensive care unit requirement (45.1% vs 35.2%), sepsis (23.8% vs 14.5%), and death (35.8% vs 22.5%) (P <0.05 for all). The factors independently associated with increased mortality in the study group were increasing age, male sex, number of comorbidities, and cancer. Conclusion: Hospital-manifested COVID-19 was associated with increased mortality. Increasing age, male sex, number of comorbidities, and cancer were independent predictors of mortality among those with hospital-manifested COVID-19 disease

ABC-SPH risk score for in-hospital mortality in COVID-19 patients : development, external validation and comparison with other available scores

The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March-July, 2020. The model was validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Median (25-75th percentile) age of the model-derivation cohort was 60 (48-72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO/FiO ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829-0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833-0.885]) and Spanish (0.894 [95% CI 0.870-0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19

ABC₂-SPH risk score for in-hospital mortality in COVID-19 patients

Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients. Results: Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.</p