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Soto ME, Fuentevilla-Alvarez G, Koretzky SG, Vargas-Alarcón G, Torres-Paz YE, Meza-Toledo SE, Pérez-Torres I, Huesca-Gómez C, Gamboa R. Analysis of GPR126 polymorphisms and their relationship with scoliosis in Marfan syndrome and Marfan-like syndrome in Mexican patients. Biomol Biomed 2023; 23:976-983. [PMID: 37270806 PMCID: PMC10655884 DOI: 10.17305/bb.2023.9268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/25/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
Marfan syndrome (MFS) is an inherited connective tissue disorder. As the spinal growth depends on delicate balance of forces, conditions that affect musculoskeletal matrix often lead to spinal deformities. A large cross-sectional study revealed a 63% prevalence of scoliosis among patients with MFS. Multi-ethnic genome-wide association studies and analyses of human genetic mutations showed that variations and mutations of G protein-coupled receptor 126 (GPR126)locus are associated with multiple skeletal defects, including shorter stature and adolescent idiopathic scoliosis. The study included 54 patients with MFS and 196 control patients. The DNA was extracted from peripheral blood using the saline expulsion method and single nucleotide polymorphism (SNP) determination was carried out using TaqMan probes. Allelic discrimination was performed by RT-qPCR. Significant differences in genotype frequencies were found for SNP rs6570507 in relation to MFS and sex (recessive model, OR 2.46, 95% CI 1.03 -5.87; P = 0.03) and rs7755109 (overdominant model, OR 0.39, 95% CI 0.16-0.91; P = 0.03). The most significant association was found in SNP rs7755109, where the frequency of genotype AG was significantly different between MFS patients with scoliosis and those without (OR 5.68, 95% CI 1.09-29.48; P=0.04). This study, for the first time, examined the genetic association of SNP GPR126 with the risk of scoliosis in patients with connective tissue diseases. The study revealed that SNP rs7755109 is associated with the presence of scoliosis in Mexican patients with MFS.
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Affiliation(s)
- Maria Elena Soto
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, México City, México
- Cardiovascular Line Department in American British Cowdray (ABC) Medical Center, México City, México
| | - Giovanny Fuentevilla-Alvarez
- Department of Physiology, Instituto Nacional de Cardiología Ignacio Chávez, México City, México
- Department of Biochemistry, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (IPN), México City, México
| | | | | | | | - Sergio Enrique Meza-Toledo
- Department of Biochemistry, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (IPN), México City, México
| | - Israel Pérez-Torres
- Department of Cardiovascular Biomedicine, Instituto Nacional de Cardiología Ignacio Chávez, México City, México
| | - Claudia Huesca-Gómez
- Department of Physiology, Instituto Nacional de Cardiología Ignacio Chávez, México City, México
| | - Ricardo Gamboa
- Department of Physiology, Instituto Nacional de Cardiología Ignacio Chávez, México City, México
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Koretzky SG, Olivar-López V, Chávez-López A, Sienra-Monge JJ, Klünder-Klünder M, Márquez-González H, Salazar-García M, de la Rosa-Zamboni D, Parra-Ortega I, López-Martínez B. Behavior of immunoglobulin G antibodies for SARS-COV-2 in Mexican pediatric patients with comorbidities: a prospective comparative cohort study. Transl Pediatr 2023; 12:1319-1326. [PMID: 37575905 PMCID: PMC10416121 DOI: 10.21037/tp-22-454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 04/18/2023] [Indexed: 08/15/2023] Open
Abstract
Background More than two years after the pandemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) there is a great lack of information. The presence of immunoglobulin G (IgG) have been related with disease severity. Patients with comorbidities could develop more severe infection; however, the evaluation of the humoral response in pediatric population are needed especially in patients with comorbidities. Our aim was to describe the behavior of IgG in pediatric patients and to know if there is a difference between patients with comorbidities. Methods A prospective comparative cohort study was carried out in a single center from June 2020 to January 2021, with a follow-up of 6 months. The study included all the subjects with confirmatory test for SARS-CoV-2 from 1 month to 17 years 11 months, the follow-up of the disease's evolution and measurement of IgG antibodies was collected. We obtained the clinical data, and comorbidities like arterial hypertension, diabetes, obesity, and cancer, the initial symptoms were recorded as well as the evolution regarding the severity of COVID-19 and the need for hospitalization, intensive care unit or mechanical ventilation. The follow up was carried out through medical consultation with an appointment every month that included direct interrogation, examination, and peripheral blood collection for the IgG quantification. The antibodies detection was done through peripheral blood and chemiluminescence microparticle immunoassay. Results A total of 237 patients with positive polymerase chain reaction (PCR) for SARS-COV-2 were included, of which 147 presented IgG antibodies (62%), 112 (76%) without comorbidity and 35 (24%) with comorbidities, by the sixth month only 2.7% continue with positive antibody measurements. Patients with comorbidities reach higher IgG levels than patients without comorbidities the basal titters were: 5.17 for patients without comorbidities vs. 6.96 for the group with comorbidities (P<0.001). Conclusions We found an association between the presence of comorbidities and high levels of IgG units in pediatric patients with COVID-19. Additionally, patients with more severe course of the disease have higher levels of IgG and by the third month less than 35% have immunity.
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Affiliation(s)
| | - Victor Olivar-López
- Pediatric Emergency Service, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Adrián Chávez-López
- Department of Pediatric Intensive Care, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | | | | | | | - Israel Parra-Ortega
- Clinical Laboratory, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Briseida López-Martínez
- Auxiliary Diagnostic Resources, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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Jamaica Balderas LMDC, Navarro Fernández A, Dragustinovis Garza SA, Orellana Jerves MI, Solís Figueroa WE, Koretzky SG, Márquez González H, Klünder Klünder M, Espinosa JG, Nieto Zermeño J, Villa Guillén M, Rosales Uribe RE, Olivar López V. Long COVID in children and adolescents: COVID-19 follow-up results in third-level pediatric hospital. Front Pediatr 2023; 11:1016394. [PMID: 36793333 PMCID: PMC9922986 DOI: 10.3389/fped.2023.1016394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION In children, the manifestations of coronavirus disease 2019 (COVID-19) in the acute phase are considered mild compared with those in adults; however, some children experience a severe disease that requires hospitalization. This study was designed to present the operation and follow-up results of the Post-COVID-19 Detection and Monitoring Sequels Clinic of Hospital Infantil de Mexico Federico Gómez in managing children with a history of SARS-CoV-2 infection. METHODS This was a prospective study conducted from July 2020 to December 2021, which included 215 children aged 0-18 years who tested positive for SARS-CoV-2 on polymerase chain reaction and/or immunoglobulin G test. The follow-up was conducted in the pulmonology medical consultation; ambulatory and hospitalized patients were assessed at 2, 4, 6, and 12 months. RESULTS The median age of the patients was 9.02 years, and neurological, endocrinological, pulmonary, oncological, and cardiological comorbidities were the most commonly observed among the patients. Moreover, 32.6% of the children had persistent symptoms at 2 months, 9.3% at 4 months, and 2.3% at 6 months, including dyspnea, dry cough, fatigue, and runny nose; the main acute complications were severe pneumonia, coagulopathy, nosocomial infections, acute renal injury, cardiac dysfunction, and pulmonary fibrosis. The more representative sequelae were alopecia, radiculopathy, perniosis, psoriasis, anxiety, and depression. CONCLUSIONS This study showed that children experience persistent symptoms, such as dyspnea, dry cough, fatigue, and runny nose, although to a lesser extent than adults, with significant clinical improvement 6 months after the acute infection. These results indicate the importance of monitoring children with COVID-19 through face-to-face consultations or telemedicine, with the objective of offering multidisciplinary and individualized care to preserve the health and quality of life of these children.
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Affiliation(s)
| | - Amairani Navarro Fernández
- Department of Pulmonology, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | | | - María Isabel Orellana Jerves
- Department of Pulmonology, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | | | - Solange Gabriela Koretzky
- Department of Clinical Research, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | - Horacio Márquez González
- Department of Clinical Research, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | - Miguel Klünder Klünder
- Department of Clinical Research, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | - Juan Garduño Espinosa
- Department of Clinical Research, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | - Jaime Nieto Zermeño
- General Direction, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | - Mónica Villa Guillén
- General Direction, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | - Rómulo Erick Rosales Uribe
- General Direction, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
| | - Victor Olivar López
- Department of Emergency Medicine, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico, Mexico
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Soto ME, Saucedo-Orozco H, Ochoa-Hein E, Eid-Lidt G, Anaya-Ayala JE, Pérez-Torres I, Koretzky SG, Reyes PA, Espinoza-Saquicela ER, Hernandez I, Martinez-Hernandez H. Cardiothoracic surgery and peripheral endovascular intervention in cardiovascular damage from a cohort of orphan rheumatological diseases-epidemiological and survival analysis. J Thorac Dis 2022; 14:1815-1829. [PMID: 35813724 PMCID: PMC9264075 DOI: 10.21037/jtd-21-1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
Background Aortic diseases in some orphan rheumatological diseases require medical, surgical or peripheral endovascular intervention because they can be catastrophic. Objectives: to analyze the main clinical and epidemiological characteristics of patients with Takayasu arteritis (TA), Marfan syndrome (MS) and similar conditions that were treated with cardiothoracic surgery and peripheral endovascular intervention. Methods Retrospective and descriptive cohort study that included patients of any age and gender with TA (as per the criteria of the American College of Rheumatology and EULAR/PRINTO), MS (according to Ghent criteria), and similar conditions who underwent cardiothoracic surgery or peripheral endovascular intervention. Data were collected from electronic charts. Results A total of 77 patients with TA and 135 patients with MS and similar conditions were included. The frequency of surgical or interventional requirements in patients with TA and MS/similar conditions was 77/364 (21.2%) and 135/300 (45%), respectively; such patients were followed for a median of 6 [2–12] and 3.29 (0.42–6.62) years, with (maximum follow-up range of 47 and 21.37 years, respectively). Aneurysms were present in 11 (14.3%) and 66 (48.9%) in patients with TA and MS/similar conditions, respectively. Aortic, mitral and tricuspid valve damage occurred in 8 (10.4%) patients, 4 (5.2%) patients and 1 (1.3%) patient with TA, respectively; corresponding frequencies in patients with MS/similar conditions were 98 (72.6%), 50 (37.0%) and 20 (14.8%). We identified that 20% of patients with TA died after 5.08 years (95% CI: 0.23–25.42 years) and 20 % of the patients with MS and other similar conditions died after 7.52 years (95% CI: 1.10–9.02 years). Conclusions The frequency of surgical intervention was low in this study. Long-term prognosis is good if surgery is performed in a timely manner. Epidemiological studies provide relevant information for public health decisions related to the management of orphan rheumatological diseases.
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Affiliation(s)
- Maria Elena Soto
- Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, and Research Department, Cardiovascular Line, American British Cowdray Hospital Center, Mexico City, Mexico
| | - Huitzilihuitl Saucedo-Orozco
- Cardioneumology Department, Instituto Nacional de Cardiología Ignacio Chávez and Cardioneumology Department, Specialty Hospital, National Medical Center "La Raza", Mexican Social Security Institute, Mexico City, Mexico
| | - Eric Ochoa-Hein
- Hospital Epidemiology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Guering Eid-Lidt
- Hemodynamics Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Javier E Anaya-Ayala
- Vascular Surgery and Endovascular Therapy, Surgery Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Israel Pérez-Torres
- Cardiovascular Biomedicine Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | | | - Pedro A Reyes
- Research Directorate and Ethics Committee Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | | | - Ivan Hernandez
- Cardiothoracic Surgery Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Humberto Martinez-Hernandez
- Cardiothoracic Surgery Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.,Head of Cardiothoracic Surgery Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
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Márquez-González H, Hernández-Vásquez JG, Del Valle-Lom M, Yáñez-Gutiérrez L, Klünder-Klünder M, Almeida-Gutiérrez E, Koretzky SG. Failures of the Fontan System in Univentricular Hearts and Mortality Risk in Heart Transplantation: A Systematic Review and Meta-Analysis. Life (Basel) 2021; 11:1363. [PMID: 34947894 PMCID: PMC8709145 DOI: 10.3390/life11121363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 02/07/2023] Open
Abstract
The Fontan procedure (FP) is the standard surgical treatment for Univentricular heart diseases. Over time, the Fontan system fails, leading to pathologies such as protein-losing enteropathy (PLE), plastic bronchitis (PB), and heart failure (HF). FP should be considered as a transitional step to the final treatment: heart transplantation (HT). This systematic review and meta-analysis aims to establish the risk of death following HT according to the presence of FP complications. There was a total of 691 transplanted patients in the 18 articles, immediate survival 88% (n = 448), survival from 1 to 5 years of 78% (n = 427) and survival from 5.1 to 10 years of 69% (n = 208), >10 years 61% (n = 109). The relative risk (RR) was 1.12 for PLE (95% confidence interval [CI] = 0.89-1.40, p = 0.34), 1.03 for HF (0.7-1.51, p = 0.88), 0.70 for Arrhythmias (0.39-1.24, p = 0.22), 0.46 for PB (0.08-2.72, p = 0.39), and 5.81 for CKD (1.70-19.88, p = 0.005). In patients with two or more failures, the RR was 1.94 (0.99-3.81, p = 0.05). After FP, the risk of death after HT is associated with CKD and with the presence of two or more failures.
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Affiliation(s)
- Horacio Márquez-González
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
- Centro Médico Nacional Siglo XXI, IMSS, Department Congenital Heart Diseases, Mexico City 06720, Mexico; (L.Y.-G.); (E.A.-G.)
| | - Jose Gustavo Hernández-Vásquez
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
| | - Montserrat Del Valle-Lom
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
| | - Lucelli Yáñez-Gutiérrez
- Centro Médico Nacional Siglo XXI, IMSS, Department Congenital Heart Diseases, Mexico City 06720, Mexico; (L.Y.-G.); (E.A.-G.)
| | - Miguel Klünder-Klünder
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
| | - Eduardo Almeida-Gutiérrez
- Centro Médico Nacional Siglo XXI, IMSS, Department Congenital Heart Diseases, Mexico City 06720, Mexico; (L.Y.-G.); (E.A.-G.)
| | - Solange Gabriela Koretzky
- Department of Clinical Research, Nacional de Cardiología “Ignacio Chávez”, Mexico City 14080, Mexico
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Soto ME, Ochoa-Hein E, Anaya-Ayala JE, Ayala-Picazo M, Koretzky SG. Systematic review and meta-analysis of aortic valve-sparing surgery versus replacement surgery in ascending aortic aneurysms and dissection in patients with Marfan syndrome and other genetic connective tissue disorders. J Thorac Dis 2021; 13:4830-4844. [PMID: 34527322 PMCID: PMC8411183 DOI: 10.21037/jtd-21-789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/15/2021] [Indexed: 01/16/2023]
Abstract
Background Aortic aneurysm and dissection are important causes of morbimortality in patients with Marfan syndrome (MFS) and other connective tissue diseases that affect the cardiovascular tissues. Timely intervention through different surgical techniques improves the prognosis. Both sparing and replacement-type interventions of the aortic valve are used, but selection depends on the condition of the patient at the time of diagnosis, the patient's emergency condition, surgeon preference and hospital resources. Previous meta-analyses have suggested an advantage with the use of sparing-type interventions, but this finding must be updated and extended to patients with other connective tissue disorders. The objetive of this study is to evaluate the outcomes of valve-sparing root replacement versus aortic root replacement procedures in patients with MFS and similar connective tissue diseases that present with aortic aneurysm or dissection. Methods A systematic review of cohort studies that evaluated sparing-type (preserving, remodeling, reimplantation, Yacoub, David or Florida Sleeve) or replacement-type (repair, Bentall, Button-Bentall, composite valve graft or Cabrol) procedures in patients with Marfan, Loeys-Dietz, Beals-Hecht or Ehlers-Danlos syndromes was done. Studies were retrieved from the SCOPUS, MEDLINE, CINAHL, EMBASE and LILACS electronic databases up to January 2020 without language restrictions. Only studies that directly compared sparing- versus replacement-type procedures were included in the meta-analysis. Results A total of 33 studies (n=1,807 subjects) reported sparing-type surgical interventions and 26 studies (n=2,218 subjects) reported replacement-type surgical interventions. Pooled rates of endocarditis, thromboembolism and aneurysm were higher in replacement-type surgical intervention studies. Sixteen studies were included in the meta-analysis. Sparing-type interventions were associated with a reduced risk of endocarditis (RR =0.13, 95% CI: 0.03-0.61); however, replacement-type interventions favored freedom from valve reoperation (RR =2.39, 95% CI: 1.24-4.60). All studies were at low risk of bias. Conclusions The choice of the best surgical technique is dependent on the type of disease (MFS or other connective tissue diseases) as well as the accompanying aortic and cardiovascular damage, since these key factors are heterogeneous. Although the results of this meta-analysis tend to show some advantages for one type of surgical intervention over the other and viceversa, the surgeon can only make the best decision during the surgical act.
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Affiliation(s)
- Maria Elena Soto
- Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, México.,American British Cowdray Medical Center, Mexico City, México
| | - Eric Ochoa-Hein
- Hospital Epidemiology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | - Javier E Anaya-Ayala
- Section of Vascular Surgery and Endovascular Therapy, Surgery Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | - Micaela Ayala-Picazo
- Library Department, American British Cowdray Medical Center, Mexzico City, Mexico
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García Calderón V, Figueiras Huante IA, Carbajal Martínez M, Yacaman Handal RE, Palami Antunez D, Soto ME, Koretzky SG. The impact of improving the quality of coding in the utilities of Diagnosis Related Groups system in a private healthcare institution. 14-year experience. Int J Med Inform 2019; 129:248-252. [PMID: 31445263 DOI: 10.1016/j.ijmedinf.2019.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND PROJECT AIM The American British Cowdray Medical Center is a private healthcare institution in Mexico City. One of the many tools that we use and help us to achieve a high standard of quality and recognition worldwide is the clinical coding and Diagnosis Related Groups (DRG). To help the readers to improve the process of clinical coding, we will share the challenges, changes and different applications of the generation of DRG in the private healthcare institution. METHODS AND RESULTS A retrospective, descriptive study to demonstrate the changes on the process of coding and measure the outcome of clinical coding, precision of data and better quality in the generations of DRGs. Initially, less than 2 diagnoses and 1 procedure were coded per discharge, using partial medical records. By the second half of 2007, a different coding procedure was implemented, and the complete medical records started being used; also, comorbid conditions were included in coding. Nowadays, the average number of coded diagnoses is 5.4 and the average number of coded procedures is 4.2, with a coding error rate of 0.68% and a DRG outliers' rate of 0.45%. DISCUSSION AND CONCLUSIONS While many countries use DRG for reimbursement, we exploit the clinical data registration and the DRGs for the economic and organizational. Through more efficient and accurate coding, DRGs are useful within the institution to generate indicators on resources, cost, length of stay and goals for each service. Having better quality clinical data has allowed for improved service line management, which has translated into patient-oriented services. Prospective studies are necessary to keep evaluating in a objective way the utilities of the DRG in healthcare private institutions.
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Affiliation(s)
| | | | | | | | - Diana Palami Antunez
- Quallity Control Department, American British Cowdray Medical Center, CDMX, Mexico
| | - Maria Elena Soto
- Research Department of American British Cowdray Medical Center, México CDMX and Immunology Department, Instituto Nacional de Cardiología "Ignacio Chávez", CDMX, Mexico
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