Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Virtualización de afloramientos geológicos mediante herramientas digitales de muy alta resolución: una nueva aproximación virtual al trabajo de campo

El uso de imágenes de Gigapan en la enseñanza de la Geología facilita el estudio de contenidos de campo mediante imágenes de muy alta resolución de afloramientos geológicos, que pueden ser utilizadas como herramienta de docencia virtual

Aplicación didáctica mediante virtualización de afloramientos geológicos por medio herramientas digitales de muy alta resolución

Tras la situación sanitaria del curso 2019-2020 y a través del Proyecto INNOVA Gestión 223 de la convocatoria del año 2020-2021, la Facultad de Ciencias Geológicas ha adquirido una herramienta para la virtualización de afloramientos geológicos. Durante el curso 2020-2021 se ha virtualizado una salida de campo de cada uno de los grados que se imparten en la Facultad, Grado en Geología y Grado en Ingeniería Geológica. Además, la mayor parte de la actividad de campo de este curso tendrá lugar durante el mes de mayo, por lo que los profesores van a poder realizar la virtualización de sus salidas de campo mientras realizan la salida presencial con los estudiantes, o incluso en algunas asignaturas los propios estudiantes van a ser los responsables de la virtualización de las mismas. Por ello, la herramienta GIGAPAN no sólo es de elevada utilidad en momentos en los que las restricciones de movilidad impiden la realización del campo sino que también permiten aplicar metodologías docentes invertidas durante la realización de los campamentos. De este modo los estudiantes pasan a tener un papel activo en relación a su proceso de aprendizaje. La herramienta GIGAPAN permite que se combinen imágenes fotográficas de megapíxeles de alta resolución para crear imágenes panorámicas de gigapíxeles que luego se pueden explorar a muchas escalas haciendo zoom y visión panorámica. Los GigaPans son gigapíxeles panorámicos, imágenes digitales con billones de píxeles. Gigapan crea panorámicas enormes, para conseguir elevado detalle con mucha nitidez. Además de proporcionar una experiencia de aprendizaje alternativa, estos recursos permiten una visita 'virtual' que puede ser una herramienta de aprendizaje útil en cualquier escenario docente. La utilidad del material generado tiene validez más allá de la pandemia, ya que puede ser utilizado por los estudiantes en el estudio de las asignaturas de la titulación, con un enorme potencial didáctico hasta ahora poco explorado. Hasta la fecha el GIGAPAN se ha venido utilizando con cámaras personales de profesores de la Facultad, por lo que se hace necesario completar esta herramienta con una cámara compatible con el módulo que permita ser usada tanto por profesores que no dispongan de la misma como por estudiantes de la Facultad

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Role of age and comorbidities in mortality of patients with infective endocarditis.

The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: A total of 3120 patients with IE (1327  There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in th