Being hospitalized might be a dangerous adventure

Tema del mesLos hospitales son instituciones complejas y constituyen un eslabón importante en el sistema de salud. Su objetivo es mejorar la calidad de vida; resolver o controlar las enfermedades de la población, y ser centros de enseñanza y generación de conocimiento científico. Sin embargo, el tránsito de los pacientes en estas instituciones no está exento de riesgos o complicaciones. La seguridad del paciente se reconoce como una prioridad en términos de salud pública a nivel internacional, que requiere vigilancia y medición de manera constante. La participación en conjunto con una visión global, podría ayudar a reducir los riesgos para los pacientes en las instituciones.Hospitals are complex institutions and are an essential pillar for the health system. Their main objective is to preserve the quality of life, to solve or control diseases, to be a teaching centre and generate new scientific knowledge. However, patients are at risk of complications while they are hospitalized. Patient’s security is a public-health priority, therefore health’s systems need to improve and maintain active surveillance systems. It is essential a global health vision, to reduce the risk that face the patients

Drotrecogin alfa (Activated) in adults with septic shock

There have been conflicting reports on the efficacy of recombinant human activated protein C, or drotrecogin alfa (activated) (DrotAA), for the treatment of patients with septic shock.In this randomized, double-blind, placebo-controlled, multicenter trial, we assigned 1697 patients with infection, systemic inflammation, and shock who were receiving fluids and vasopressors above a threshold dose for 4 hours to receive either DrotAA (at a dose of 24 μg per kilogram of body weight per hour) or placebo for 96 hours. The primary outcome was death from any cause 28 days after randomization.At 28 days, 223 of 846 patients (26.4%) in the DrotAA group and 202 of 834 (24.2%) in the placebo group had died (relative risk in the DrotAA group, 1.09; 95% confidence interval [CI], 0.92 to 1.28; P=0.31). At 90 days, 287 of 842 patients (34.1%) in the DrotAA group and 269 of 822 (32.7%) in the placebo group had died (relative risk, 1.04; 95% CI, 0.90 to 1.19; P=0.56). Among patients with severe protein C deficiency at baseline, 98 of 342 (28.7%) in the DrotAA group had died at 28 days, as compared with 102 of 331 (30.8%) in the placebo group (risk ratio, 0.93; 95% CI, 0.74 to 1.17; P=0.54). Similarly, rates of death at 28 and 90 days were not significantly different in other predefined subgroups, including patients at increased risk for death. Serious bleeding during the treatment period occurred in 10 patients in the DrotAA group and 8 in the placebo group (P=0.81).DrotAA did not significantly reduce mortality at 28 or 90 days, as compared with placebo, in patients with septic shock. (Funded by Eli Lilly; PROWESS-SHOCK ClinicalTrials.gov number, NCT00604214.)