6 research outputs found
Biomarkers as prognosis of Covid-19 disease: retrospective cohort study
Coronavirus infection has been the cause of millions of deaths worldwide. Some analytical parameters on admission could help predict prognosis and mortality. This study aims to describe the main Laboratory findings of hospitalized patients with COVID-19 and to identify the relationship between intensive care unit access, length of stay and in-hospital mortality. Methods: A retrospective cohort study was performed. Demographic and analytical variables of all patients diagnosed with COVID-19 hospitalized in Aragon (Spain) between March and June 2020 were analyzed. Results: We describe the characteristics of 2640 patients hospitalized with COVID-19, 85% were significantly older, with a median age of 72.3 ± 16.7 years, predominantly male (52.8%). The in-hospital mortality rate was 30%. Patients admitted to the intensive care unit had significantly higher baseline levels of hematocrit, fibrinogen, lactate dehydrogenase, leukocytes and neutrophils (p<0.001 in all). On the other hand, these patients had lower levels of eosinophils, lymphocytes and monocytes (p<0.001 in all). Only hemoglobin and D-dimer showed a significant and positive correlation with longer hospital and ICU stays (r=0.050 with p=0.031; r=0.203 with p=0.008; r=0.175 with p<0.001 and r=0.199 with p=0.001, respectively. Multivariable regression based on death showed that age, higher values of lactate dehydrogenase, neutrophils and lower values of eosinophils and female sex could explain up to 30% of the probability of death. Conclusion: Laboratory parameters can help clinicians predict the severity of COVID-19 and subsequently improve prognosis and decrease mortality rates. However, more studies are needed to better understand these changes and their relationship to prognosis
Polypharmacy in Older Patients: A Three-Year Longitudinal Analysis in Primary Care Settings of Aragón, Spain
Background Challenges of polypharmacy and the impact of coronavirus disease 2019 (COVID-19) pandemic in older patients require further investigation. This retrospective study analyzed the progression of polypharmacy and anticholinergic burden in older patients in a primary care setting before, during, and after the COVID-19 pandemic. Methods This 3-year cross-sectional study (2019, 2020, and 2021) comprised a dynamic cohort of individuals aged ≥75 years, who attended the Arrabal Primary Care Center in Zaragoza, Spain. Older patients with polypharmacy (≥5 medications) were identified according to their electronic health records. We collected demographic and clinical data, including medication prescriptions, diagnoses, and anticholinergic risks, and performed descriptive and statistical analyses. Results This study included a total of 1,928 patients with a mean age of 83.52±0.30 years. Over the 3-year study period, the mean number of medications prescribed increased, from 9.4 in 2019 to 10.4 in 2021. The prevalence of excessive polypharmacy (≥10 medications) increased from 39% in 2019 to 45% in 2021. The most commonly prescribed drugs were anilides, proton pump inhibitors, benzodiazepine derivatives, and platelet aggregation inhibitors. Women had a higher prevalence of illnesses and anticholinergic drug prescriptions than men. Conclusion The results of this study highlighted an upward trend in polypharmacy and excessive polypharmacy among older patients in primary care settings. Future research should focus on optimizing medication management and deprescribing strategies and minimizing the adverse effects of polypharmacy in this population
Diferencias de género en la relación entre factores personales intrínsecos y la sintomatología ansiosa y depresiva de una población trabajadora
Introduction: Affective disorders are health problems with a significant impact on the psychosocial functioning and quality of life of people who suffer from them. Therefore, the objective of this study was to analyse gender differences in the association between intrinsic personal factors and depressive and anxious symptoms in a working population.
Methods: Descriptive, bivariate, and multivariate analyses were performed on data from 242 individuals of active working age interviewed between July 2021 and July 2022. The primary outcome was the severity of depressive and anxiety symptoms as a continuous variable.
Results: The prevalence of depressive symptoms in our sample is 22.22% in women and 6.54% in men, while the prevalence of anxious symptoms was similar in both sexes (21.50% in men and 25.19% in women). In men, high self-esteem (β = −0.300; p=0.022) and older age (β = −0.210; p=0.031) are protective factors for depressive symptoms, and high self-esteem (β = −0.269; p=0.005) and high activation (β = −0.031; p=0.049) in anxious symptomatology. Meanwhile, in women, greater self-efficacy and a greater sense of coherence are protective factors for depressive (β = −0.250, p=0.004; β = −0.244, p=0.005) and anxious symptoms (β = −0.254, p=0.004; β = −0.178, p=0.040).
Conclusion: Women workers have more depressive and anxious symptoms than their male counterparts. There are differences between men and women in the intrinsic personal factors that influence depressive and anxious symptoms.Introducción: Los trastornos afectivos son un problema de salud con un gran impacto en el funcionamiento psicosocial y calidad de vida de las personas que los sufren. Por ello, el objetivo de este estudio fue analizar la analizar diferencias por género en la asociación entre los factores personales intrínsecos y la sintomatología depresiva y ansiosa de una población trabajadora.
Métodos: Se realizaron análisis descriptivo, bivariante y multivariante de datos de 242 individuos en edad laboral activa, entrevistados entre julio de 2021 y julio de 2022. El resultado primario fue la gravedad de la sintomatología depresiva y ansiosa como variable continua.
Resultados: La prevalencia de síntomas depresivos en nuestra muestra es del 22,22% en mujeres y del 6,54 en varones, mientras la prevalencia de sintomatología ansiosa fue similar en ambos sexos (21,50% en varones y 25,19% en mujeres). En varones, la alta autoestima (β = −0,300; p=0,022) y una mayor edad (β = −0,210; p=0,031) son factores protectores de sintomatología depresiva y, la alta autoestima (β = −0,269; p=0,005) y la alta activación (β = −0,031; p=0,049) en la sintomatología ansiosa. Mientras, en las mujeres, una mayor autoeficacia y un mayor sentido de coherencia son factores protectores de la sintomatología depresiva (β = −0,250, p=0,004; β = −0,244, p=0,005) y ansiosa (β = −0,254, p=0,004; β = −0,178, p=0,040).
Conclusión: Las mujeres trabajadoras tienen más sintomatología depresiva y ansiosa que sus homólogos masculinos. Existen diferencias entre hombres y mujeres en los factores personales intrínsecos que influyen en los síntomas depresivos y ansiosos
Desempeño Laboral del Capital Humano en las Universidades de la Ciudad de Cuenca
The research objective was based on analyzing the Labor performance of Human Capital in the Universities of the City of Cuenca - Ecuador. It was carried out from a descriptive perspective with a non-experimental cross-sectional design. 42.91% of those surveyed agree that sometimes they have all the resources, supplies, equipment, as well as an adequate infrastructure to carry out their daily activities. 61% of the personnel surveyed do not perceive that their institutions are providing adequate attention in this matter as their priority, arguing that they do not consider themselves identified with the institutional objectives and goals given. It is very important that staff are trained in what should be used today, thanks to the benefits of technology every day it is easier to be able to educate themselves and better meet the needs of each job, as well as the demands that they are imposed by superiors.El objetivo de investigación se basó en analizar el desempeño Laboral del Capital Humano en las Universidades de la Ciudad de Cuenca – Ecuador. Se realizó desde una perspectiva descriptiva con diseño no experimental transversal. El 42.91% de los encuestados coinciden que a veces cuentan con todos los recursos, insumos, equipos, así como también con una infraestructura adecuada para desarrollar sus actividades diarias. El 61% del personal encuestados no perciben que sus instituciones estén brindando la atención adecuada en este tema como su prioridad, argumentando que no se consideran identificados con los objetivos y metas institucionales dadas. Es muy importante que el personal esté capacitado lo que se debe aprovechar en la actualidad, gracias a los beneficios de la tecnología cada día es más fácil poder auto educarse y satisfacer de mejor manera las necesidades de cada puesto de trabajo, así como las exigencias que son impuestas por los superiores
Health Outcomes for Older Patients with Chronic Diseases During the First Pandemic Year
Background: Worldwide, chronic diseases are prevalent among the older adults, significantly affecting their health and healthcare system. The COVID-19 pandemic exacerbated these challenges, disrupting healthcare services. Our study assesses the impact on older individuals with chronic diseases who were not infected with COVID-19, analyzing comorbidities, medication use, mortality rates, and resource utilization using real data from Aragon, Spain.
Methods: A retrospective observational study, conducted in Aragon, Spain, focused on individuals aged 75 and older with at least one chronic disease, who were not infected of COVID-19. The research used actual data collected during three distinct periods: the first covered the six months prior to the pandemic, the second the six months after the lockdown, and the third the period between six and twelve months. Key variables included socio-demographics, comorbidities, clinical parameters, medication use, and health services utilization.
Results: We included 128.130 older adults. Mean age was 82.88 years, with 60.3% being women. The most common chronic diseases were hypertension (73.2%), dyslipidemia (52.5%), and dorsopathies (31.5%). More than 90% had more than 2 conditions. A notable decline in new chronic disease diagnoses was observed, particularly pronounced in the six to twelve months period after lockdown. Although statistically significant differences were observed in all clinical variables analyzed, they were considered clinically irrelevant. Furthermore, a decrease in healthcare services utilization and medication prescriptions was reported.
Conclusion: Our study highlights a decrease in new chronic disease diagnoses, ongoing reductions in healthcare utilization, and medication prescriptions for older adults with pre-existing chronic conditions, unaffected by COVID-1
Antimicrobial Agent Use for Urinary Tract Infection in Long-Term Care Facilities in Spain: Results from a Retrospective Analytical Cohort Analysis
Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This is a retrospective analytical cohort analysis using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study, we present the results of the first audit including 719 UTI cases collected between February and April 2023, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, and that of urine culture was only 16%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on the management of UTIs to mitigate indiscriminate antibiotic use in asymptomatic cases