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Álvarez-Dobaño JM, Rodríguez-García C, Atienza G, Toubes ME, Rodríguez-Núñez N, Zamarrón C, Novo-Platas JÁ, Soto-Feijóo R, Landín E, Carreiras-Cuiña M, Martínez-Martínez HJ, Carbajales MC, Otero B, Valdés L. Analysis of the quality of e-Consultations in chronic obstructive pulmonary disease. Respir Med 2024; 222:107514. [PMID: 38171405 DOI: 10.1016/j.rmed.2023.107514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/22/2023] [Accepted: 12/25/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION The quality of e-Consultations in the COPD is unknown. The objectives of this study were (i) to evaluate the quality of referrals; (ii) to define the characteristics of patients referred from Primary Care (PC) to the Unit of Pulmonology; and (iii) to describe differences between accepted and rejected patients. METHODS A retrospective, observational study of e-Consultations requested by PC for suspected COPD throughout 2022. To quantify the quality of the e-Consultations, an arbitrary scale of 12 variables (score 0-10) was created. RESULTS In total, 384 e-Consultations were reviewed, of which 167 (43.5 %) resulted in a face-to-face visit, and 217 (56.5 %) were rejected. No differences were observed between the two types of patients, except for confirmations of diagnostic suspicion of COPD [significantly higher in accepted patients (p = 0.042)]; physical examination data of rejected patients (more data provided; p = 0.015); and lung function (significantly better in rejected patients). The mean quality of referrals was acceptable (5.6 ± 2.1 score): 121 (31.3 %) had insufficient quality; 118 (30.5 %) acceptable; 75 (19.4 %) good, and 30 (7.8 %) excellent. Quality was low in half of the variables analyzed (6/12); acceptable in 3, and good in another 3. The capacity of resolution of referrals was good (one e-Consultation) in 199 requests (66.1 %); deficient (two e-Consultations) in 72 (23.9 %), and poor (≥3 e-Consultations) in 30 (10 %). Overdiagnosis was 40.2 % (86/214 e-Consultations). The risk could be classified in 247 patients (64.3 %; 135 low-risk; 90 high-risk). CONCLUSIONS When adequate information is provided, e-Consultations help identify different levels of severity. However, the quality and capacity of resolution of referrals were suboptimal, with a high percentage of overdiagnoses.
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Affiliation(s)
- José M Álvarez-Dobaño
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Spain.
| | - Carlota Rodríguez-García
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Spain.
| | - Gerardo Atienza
- Unidad de Calidad y Seguridad Del Paciente, Subdirección de Calidad, Gerencia Área Sanitaria de Santiago de Compostela y Barbanza, Spain.
| | - María E Toubes
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain.
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain.
| | - Carlos Zamarrón
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain.
| | - José Ángel Novo-Platas
- Servicio de Control y Gestión, Gerencia Área Sanitaria de Santiago de Compostela y Barbanza, Spain.
| | - Roi Soto-Feijóo
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain.
| | - Elisa Landín
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain.
| | - María Carreiras-Cuiña
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain.
| | | | | | | | - Luis Valdés
- Servicio de Neumología, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Santiago de Compostela, Spain.
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Cequier Á, Bueno H, Macaya C, Bertomeu V, González-Juanatey JR, Íñiguez A, Anguita M, Cruz I, Calvo D, Gómez-Doblas JJ, de la Torre Hernández JM, Del Prado N, Rodríguez Padial L, Pérez-Villacastín J, Bernal JL, Fernández Pérez C, Elola J. Trends in cardiovascular care in the National Health System in Spain. Data from the RECALCAR project 2011-2020. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022:S1885-5857(22)00318-8. [PMID: 36493955 DOI: 10.1016/j.rec.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/26/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION AND OBJECTIVES The RECALCAR project (Resources and Quality in Cardiology), an initiative of the Spanish Society of Cardiology, aims to standardize information to generate evidence on cardiovascular health outcomes. The objective of this study was to analyze trends in the resources and activity of cardiology units and/or services and to identify the results of cardiovascular care during the last decade in Spain. METHODS The study was based on the 2 annual data sources of the RECALCAR project: a survey on resources and activity of cardiology units and/or services (2011-2020) and the minimum data set of the National Health System (2011-2019), referring to heart failure (HF), STEMI, and non-STEMI. RESULTS The survey included 70% of cardiology units and/or services in Spain. The number of hospital beds and length of stay decreased, while there was a notable increase in the number of cardiac imaging studies and percutaneous therapeutic procedures performed. Age- and sex-adjusted admissions for HF tended to decrease, despite an increase in mortality and the percentage of readmissions. In contrast, the trend in mortality and readmissions was highly favorable in STEMI; in non-STEMI, although positive, the trend was less marked. CONCLUSIONS The information provided by the RECALCAR project shows a favorable trend in the last decade in resources, activity and results of certain cardiovascular processes and constitutes an essential source for future improvements and decision-making in health policy.
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Affiliation(s)
- Ángel Cequier
- Servicio de Cardiología, Hospital Universitario de Bellvitge, Universidad de Barcelona, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Héctor Bueno
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carlos Macaya
- Servicio de Cardiología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Vicente Bertomeu
- Servicio de Cardiología, Instituto Cardiovascular de la Universidad Católica de Murcia (UCAM), Alicante, Spain
| | - José R González-Juanatey
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Andrés Íñiguez
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Instituto de Investigación Biomédica Galicia Sur, Vigo, Pontevedra, Spain
| | - Manuel Anguita
- Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica (IMIBIC), Córdoba, Spain
| | - Ignacio Cruz
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - David Calvo
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Juan José Gómez-Doblas
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Unidad de Gestión Clínica Área del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - José M de la Torre Hernández
- Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación en Santander (IDIVAL), Santander, Cantabria, Spain
| | - Náyade Del Prado
- Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS), Madrid, Spain
| | | | | | - José Luis Bernal
- Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS), Madrid, Spain; Servicio de Información y Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Cristina Fernández Pérez
- Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS), Madrid, Spain; Servicio de Medicina Preventiva, Instituto de Investigación de Santiago, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, A Coruña, Spain
| | - Javier Elola
- Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS), Madrid, Spain
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Álvarez-Dobaño JM, Toubes M, Novo-Platas JÁ, Reyes-Santías F, Atienza G, Portela M, Rábade C, Lourido T, Casal A, Rodríguez-García C, Riveiro V, Abelleira R, Ricoy J, Rodríguez-Núñez N, Zamarrón C, Calle F, Gude F, Valdés L. Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation. Can Respir J 2022; 2022:2423272. [PMID: 36353446 PMCID: PMC9640234 DOI: 10.1155/2022/2423272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/30/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction This study assesses the impact of an electronic physician-to-physician consultation program on the waiting list and the costs of a Pulmonology Unit. Materials and Methods A prepost intervention study was conducted after a new ambulatory pulmonary care protocol was implemented and the capacity of the unit was adopted. In the new model, physicians at all levels of healthcare send electronic consultations to specialists. Results In the preintervention year (2019), the Unit of Pulmonology attended 7,055 consultations (466 e-consultations and 6,589 first face-to-face visits), which decreased to 6,157 (3,934 e-consultations and 2,223 first face-to-face visits; 12.7% reduction) in the postintervention year (all were e-consultations). The mean wait time for the first appointment was 25.7 days in 2019 versus 3.2 days in 2021 (p < 0.001). In total, 43.5% of cases were solved via physician-to-physiciane-consultation. A total of 2,223 patients needed a face-to-face visit, with a mean wait time of 7.5 days. The mean of patients in the waiting listing decreased from 450.8 in 2019 to 44.8 in 2021 (90% reduction). The annual time devoted to e-consultations and first face-to-face visits following an e-consultation diminished significantly after the intervention (1,724 hours versus 2,312.8; 25.4% reduction). Each query solved via e-consultation represented a saving of €652.8, resulting in a total annual saving of €827,062. Conclusions Physician-to-physiciane-consultations reduce waiting times, improve access of complex patients to specialty care, and ensure that cases are managed at the appropriate level. E-consultation reduces costs, which benefits both, society and the healthcare system.
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Affiliation(s)
- José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Malena Toubes
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - José Ángel Novo-Platas
- Servicio de Control de Gestión, Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | | | - Gerardo Atienza
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Gerencia Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Manuel Portela
- Subdirección de Prestación Farmacéutica Formación Docencia Innovación e Investigación, Gerencia Área Sanitaria de Santiago de Compostela y Barbanza, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Carlos Rábade
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Tamara Lourido
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Casal
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Vanessa Riveiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Romina Abelleira
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Jorge Ricoy
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlos Zamarrón
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Felipe Calle
- Subdirección de Processos Asistenciales Sin Ingresso, Gerencia Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Francisco Gude
- Unidad de Epidemiología Clínica, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Cequier Á, Bueno H, Macaya C, Bertomeu V, González-Juanatey JR, Íñiguez A, Anguita M, Cruz I, Calvo D, Gómez-Doblas JJ, de la Torre Hernández JM, del Prado N, Rodríguez Padial L, Pérez-Villacastín J, Bernal JL, Fernández Pérez C, Elola J. Evolución de la asistencia cardiovascular en el Sistema Nacional de Salud de España. Datos del proyecto RECALCAR 2011-2020. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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5
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Álvarez-Dobaño JM, Atienza G, Zamarrón C, Toubes ME, Ferreiro L, Riveiro V, Casal A, Suárez-Antelo J, Rodríguez-Núñez N, Lama-López A, Rábade-Castedo C, Rodríguez-García C, Lourido-Cebreiro T, Ricoy J, Abelleira R, Golpe A, Pais B, González-Barcala FJ, Valdés L. Health outcomes: Towards the accreditation of respiratory medicine departments. Arch Bronconeumol 2021; 57:637-647. [PMID: 35702904 DOI: 10.1016/j.arbr.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/13/2021] [Indexed: 06/15/2023]
Abstract
National health systems must ensure compliance with conditions such as equity, efficiency, quality, and transparency. Since it is the right of society to know the health outcomes of its healthcare system, our aim was to develop a proposal for the accreditation of respiratory medicine departments in terms of care, teaching, and research, measuring health outcomes using quality of care indicators. The management tools proposed in this article should be implemented to improve outcomes and help us achieve our objectives. Promoting accreditation can serve as a stimulus to improve clinical management and enable professionals to take on greater leadership roles and take action to improve outcomes in patient care.
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Affiliation(s)
- José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Gerardo Atienza
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, Spain
| | - Carlos Zamarrón
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - María Elena Toubes
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Lucía Ferreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain.
| | - Vanessa Riveiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Casal
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Juan Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Adriana Lama-López
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Jorge Ricoy
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Romina Abelleira
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Antonio Golpe
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Beatriz Pais
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, Spain
| | - Francisco Javier González-Barcala
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
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Álvarez-Dobaño JM, Atienza G, Zamarrón C, Toubes ME, Ferreiro L, Riveiro V, Casal A, Suárez-Antelo J, Rodríguez-Núñez N, Lama-López A, Rábade-Castedo C, Rodríguez-García C, Lourido-Cebreiro T, Ricoy J, Abelleira R, Golpe A, Pais B, González-Barcala FJ, Valdés L. Health Outcomes: Towards the Accreditation of Respiratory Medicine Departments. Arch Bronconeumol 2021; 57:S0300-2896(21)00029-6. [PMID: 33678474 DOI: 10.1016/j.arbres.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/04/2021] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
National health systems must ensure compliance with conditions such as equity, efficiency, quality, and transparency. Since it is the right of society to know the health outcomes of its healthcare system, our aim was to develop a proposal for the accreditation of respiratory medicine departments in terms of care, teaching, and research, measuring health outcomes using quality of care indicators. The management tools proposed in this article should be implemented to improve outcomes and help us achieve our objectives. Promoting accreditation can serve as a stimulus to improve clinical management and enable professionals to take on greater leadership roles and take action to improve outcomes in patient care.
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Affiliation(s)
- José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Gerardo Atienza
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, España
| | - Carlos Zamarrón
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - María Elena Toubes
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Lucía Ferreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.
| | - Vanessa Riveiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Ana Casal
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Juan Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Adriana Lama-López
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Jorge Ricoy
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Romina Abelleira
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Antonio Golpe
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Beatriz Pais
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, España
| | - Francisco Javier González-Barcala
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
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Martín-Sánchez FJ, Fernández-Alonso C, Hormigo AI, Jiménez-Díaz G, Roiz H, Bermejo-Boixareu C, Rodríguez-Salazar J, Fernández Pérez C, Gil-Gregorio P. [Clinical profile and 90-day mortality in centenarian patients attended in emergency departments]. Rev Esp Geriatr Gerontol 2016; 51:196-200. [PMID: 26916908 DOI: 10.1016/j.regg.2015.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/04/2015] [Accepted: 12/11/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To determine the clinical profile and to develop a model to predict 90-day mortality in centenarian patients attended in emergency departments (ED). METHODOLOGY This was an observational, retrospective, multicentre cohort study including patients >99years attended in 5 ED in the Community of Madrid from January to December 2012. Demographic variables were recorded, as well as, comorbidities, cognitive, functional, social basal status, geriatric syndromes, acute episode, and hospital and social resources use, and 90-day mortality. RESULTS The study included 209patients aged 101years (SD 1.7) of whom 161 (77.0%) were female. Sixty four (32.5%) had severe comorbidity (Charlson index≥3), 101 (49.8%) on multiple medication, 100 (52.6%) had cognitive impairment, 82 (42.3%) had severe functional dependence, 85 (40.7%) were institutionalised, and 190 (94.5%) had a geriatric syndrome. Dyspnoea (26.8%), followed by falls (12.4%) were the most common causes of attendance. One hundred and eighteen (56.5%) were admitted, and 58 out of 174 (33.3%) died in the first 90days. The model to predict 90-day overall mortality included male sex (OR 2.42 95% CI=0.97-6.04; P=.059), emergency care in the previous 3months (OR 4.08 95% CI=1.26-13.16; P=.019) and the hospitalization by index event (OR 8.63 95% CI=3.25-22.9; P<.001) and this model had an area under ROC curve of 0.776 (95% CI=0.70-0.85; P<.001). CONCLUSIONS Centenarian patients attended in ED had a significant frailty and one in three cases died in the first 90days after being attended, and this was associated with male sex, emergency care in the previous 3months, and hospitalisation.
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Affiliation(s)
| | | | | | - Gregorio Jiménez-Díaz
- Servicio de Urgencias, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - Honan Roiz
- Servicio de Urgencias, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, España
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Cequier Á, Ortiga B. Clinical management levels. ACTA ACUST UNITED AC 2015; 68:465-8. [PMID: 25920365 DOI: 10.1016/j.rec.2015.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 02/11/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Ángel Cequier
- Área de Enfermedades del Corazón, Hospital Universitario de Bellvitge, IDIBELL, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Berta Ortiga
- Subdirección de Gerencia, Hospital Universitario de Bellvitge, IDIBELL, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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