Revista clinica espanola最新文献

英文中文

Secondary adrenal insufficiency due to ipilimumab/nivolumab treatment for metastatic renal cancer 易匹单抗/纳武单抗治疗转移性肾癌导致继发性肾上腺功能不全。

Revista clinica espanola

Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.12.003

D. Rico-López , A. Ortiz-Parra , F. Vázquez-Alonso , R. Roa-Chamorro

引用次数: 0

Malnutrition in heart failure. The importance of assessing for congestion and sarcopenia 营养不良导致心力衰竭。充血和肌肉减少评估的重要性。

Revista clinica espanola

Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.11.005

J. Carretero Gómez , T.F. Galeano Fernández , A.S. Vidal Ríos , S. Tolosa Álvarez , M. Sánchez Herrera , C. García Carrasco , F.J. Monreal Periañez , P. González González , J.C. Arévalo Lorido

Aim

This work aims to describe nutrition and sarcopenia in inpatients with heart failure (HF). It also aims to assess factors associated with in-hospital and short-term prognosis related to nutrition and sarcopenia.

Methods

We collected data on consecutive HF patients admitted to a single center’s internal medicine ward. Patients were recruited in May and October 2021. Malnutrition was determined by the Mini Nutritional Assessment-Short Form (MNA-SF) and sarcopenia by the screening test, SARC-F scale, and handgrip strength test.

Results

190 patients were analyzed, mean age 82.1 (±8.2), 54.2% women, median follow up 106 days. Patients were classified into three groups based on MNA-SF score: group 1 (12–14 points, no risk) included 50 patients, group 2 (8–12 points, high risk of malnutrition) included 81 patients, group 3 (0–7 points, malnourished) included 59 patients. Group 3 had significantly more inflammation (lower albumin and higher C-reactive Protein (CRP)) and congestion (measured by NT-ProBNP levels). In-hospital mortality was related to poor muscle function, CRP, and NT-ProBNP, but not to malnutrition. The poorest short-term outcomes were related to malnutrition and comorbidity. However, when the variable of muscle function was introduced, it could act as a poor prognostic factor related to CRP and NT-ProBNP, which were the main determinants of survival.

Conclusion

In malnourished patients with HF, inflammation and congestion were related to in-hospital mortality. Malnutrition along with comorbidity may play a role in decreasing short-term survival. Early identification through proactive nutritional and functional screenings should be a key element of assessing HF patients.

目的：本研究旨在描述心力衰竭（HF）住院患者的营养和肌肉减少。它还旨在评估与营养和肌肉减少症相关的住院和短期预后相关的因素。方法：我们收集了在单一中心内科病房住院的连续心衰患者的数据。患者于2021年5月和10月招募。营养不良通过迷你营养评估简表（MNA-SF）确定，肌肉减少症通过筛选试验、SARC-F量表和握力测试确定。结果：分析190例患者，平均年龄82.1（±8.2）岁，女性54.2%，中位随访106天。根据MNA-SF评分将患者分为3组：1组（12-14分，无风险）50例，2组（8-12分，营养不良高风险）81例，3组（0-7分，营养不良）59例。第3组明显有更多的炎症（白蛋白降低，c反应蛋白（CRP）升高）和充血（通过NT-ProBNP水平测量）。住院死亡率与肌肉功能差、CRP和NT-ProBNP有关，但与营养不良无关。最糟糕的短期结果与营养不良和合并症有关。然而，当引入肌肉功能变量时，它可能作为与CRP和NT-ProBNP相关的不良预后因素，而CRP和NT-ProBNP是生存的主要决定因素。结论：在营养不良的心衰患者中，炎症和充血与住院死亡率有关。营养不良与合并症可能在降低短期生存率中起作用。通过积极的营养和功能筛查进行早期识别应该是评估心衰患者的关键因素。

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引用次数: 0

Failure of LDL-C goals achievement and underuse of lipid-lowering therapies in patients at high and very high cardiovascular risk: Spanish subset from the European SANTORINI study 来自欧洲SANTORINI研究的西班牙亚组：高和极高心血管风险患者LDL-C目标实现失败和降脂治疗使用不足

Revista clinica espanola

Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.11.004

J.M. Mostaza , L. García-Ortiz , M.A. Suárez Tembra , P. Talavera Calle , J. Chimeno García , V. Escolar Pérez , J.L. Díaz-Díaz , L. Manzano-Espinosa , A.L. Catapano , K.K. Ray , G. Díaz Moya , J. Pedro-Botet Montoya , en representación del grupo de investigadores de SANTORINI España

Introduction

There are very few studies evaluating lipid-lowering treatments (LLTs) and low-density lipoprotein-cholesterol (LDL-C) goal attainment after the release of the 2019 guidelines of the European Societies of Cardiology (ESC) and Atherosclerosis (EAS). This manuscript shows baseline data of the Spanish subset from SANTORINI study (namely SANTORINI Spain) on LDL-C goal attainment and use of LLTs in patients at high and very high cardiovascular risk.

Methods

SANTORINI was a multinational, prospective, observational study involving patients at high and very high cardiovascular risk from 14 European countries in primary care and specialized healthcare settings. Sociodemographic data, blood lipid levels, and lipid treatments from the 1018 Spanish participants were separately analyzed and were put into perspective with the European cohort without Spanish participants.

Results

According to physicians, 295 (29.0%) subjects were classified as high, and 723 (71.0%) as very high cardiovascular risk. Overall, 26.5% attained risk-based LDL-C targets recommended by 2019 European guidelines, with 23.1% of patients at high cardiovascular risk and 27.9% at very high cardiovascular risk. High-intensity statin therapy in monotherapy was used in 21.8%, LLT combination therapy in 41.2%, and 10.7% were not receiving any LLT.

Conclusions

Baseline data from SANTORINI Spain population show that only about one-fourth of patients attain LDL-C targets recommended by the 2019 ESC/EAS guidelines in patients at high and very high risk. Despite their cardiovascular risk, patients appear to be not adequately treated, and high-intensity and combination LLT seem to be underused for cardiovascular disease prevention in the real-world setting. ClinicalTrials.gov Identifier: NCT04271280.

导读：在欧洲心脏病学会（ESC）和动脉粥样硬化学会（EAS） 2019年指南发布后，很少有研究评估降脂治疗（llt）和低密度脂蛋白-胆固醇（LDL-C）目标的实现。本文显示了来自SANTORINI研究（即SANTORINI西班牙）的西班牙亚群的基线数据，该数据涉及心血管风险高和极高的患者LDL-C目标的实现和llt的使用。方法：SANTORINI是一项多国、前瞻性、观察性研究，涉及来自14个欧洲国家初级保健和专业医疗机构的高危和极高心血管风险患者。对1018名西班牙参与者的社会人口统计数据、血脂水平和血脂治疗进行了单独分析，并与没有西班牙参与者的欧洲队列进行了比较。结果：医生认为295人（29.0%）心血管风险高，723人（71.0%）心血管风险极高。总体而言，26.5%的患者达到了2019年欧洲指南推荐的基于风险的LDL-C目标，其中23.1%的患者心血管风险高，27.9%的患者心血管风险极高。21.8%的患者在单药治疗中使用高强度他汀类药物治疗，41.2%的患者使用LLT联合治疗，10.7%的患者未接受任何LLT治疗。结论：来自圣托里尼西班牙人群的基线数据显示，在高风险和极高风险患者中，只有约四分之一的患者达到了2019年ESC/EAS指南推荐的LDL-C目标。尽管存在心血管风险，但患者似乎没有得到充分治疗，高强度和联合LLT似乎没有充分用于现实环境中的心血管疾病预防。临床试验：gov标识符：NCT04271280。

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引用次数: 0

Ethics education into Internal Medicine residency training: a survey by the Spanish Society of Internal Medicine Working Group in Bioethics 内科住院医师培训中的伦理教育：西班牙内科学会生物伦理工作组的调查。

Revista clinica espanola

Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.12.002

P. Martínez de la Cruz , C. Font Puig , S. Ibáñez Barceló , A. Blanco Portillo

引用次数: 0

Comparative study of the effectiveness of tolvaptan versus urea in patients with hyponatremia caused by SIADH 托伐普坦与尿素治疗SIADH所致低钠血症疗效的比较研究。

Revista clinica espanola

Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.12.001

Á. Martínez González , M. González Nunes , P. Rodeiro Escobar , J. Llópiz Castedo , A. Cabaleiro Loureiro , R.P. Martínez Espinosa , R. Ruades Patiño , G. Lorenzo Canda , J. Aguayo Arjona , S. Rodríguez Zorrilla

Background and objectives

Hyponatraemia is common in elderly and hospitalised patients, often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study evaluates the efficacy and safety of tolvaptan and urea in patients with hyponatraemia and SIADH.

Materials and methods

An observational cohort study was conducted on 198 patients with SIADH and hyponatraemia (Na+ <135 mmol/L) at the Complejo Hospitalario Universitario de Pontevedra from January 2015 to May 2022. Of these, 86 were treated with tolvaptan (average dose of 7.5 mg) and 112 with urea (average dose of 15 g). The primary outcome was the normalization of sodium levels (Na ≥ 135 mmol/L).

Results

The tolvaptan group showed higher sodium concentrations at the end of therapy compared to the urea group (ME = 136, IQR = 135–137 vs. ME = 134, IQR = 132–137; p < 0.001). The time to normalise sodium was shorter with tolvaptan (4 ± 3.4 days) compared to urea (6 ± 3.6 days; p = 0.03). A higher percentage of patients achieved sodium normalization with tolvaptan (83.72% vs. 59.82%; p = 0.005). Tolvaptan had more adverse effects, such as dry mouth, thirst, and sodium overcorrection, while urea caused dysgeusia, abdominal pain, and diarrhea. There were no significant differences in mortality between the groups.

Conclusions

Tolvaptan was more effective and quicker than urea in normalising sodium levels, though it showed a higher percentage of adverse effects, which did not require discontinuation of the drug.

背景和目的：低钠血症常见于老年和住院患者，通常由不适当的抗利尿激素分泌综合征（SIADH）引起。本研究评价托伐普坦和尿素在低钠血症和SIADH患者中的疗效和安全性。材料与方法：对198例SIADH合并低钠血症（Na+）患者进行了一项观察性队列研究。结果：托伐普坦组治疗结束时钠浓度高于尿素组(ME = 136, IQR = 135-137 vs ME = 134, IQR = 132-137；结论：托伐普坦比尿素更有效、更快地使钠水平正常化，尽管它显示出更高比例的不良反应，但不需要停药。

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引用次数: 0

Which one is a better predictor of prognosis in COVID-19: analytical biomarkers or PaO2/FiO2? 分析生物标志物和 PaO2/FiO2 哪个更能预测 COVID-19 的预后？

Revista clinica espanola

Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.11.003

M. Rubio-Rivas , J.M. Mora-Luján , A. Montero Sáez , M.D. Martín-Escalante , V. Giner Galvañ , G. Maestro de la Calle , M.L. Taboada Martínez , A. Muiño Míguez , C. Lumbreras-Bermejo , J.-M. Antón-Santos , on behalf of the SEMI-COVID-19 Network

Background

The study aimed to describe patient characteristics and outcomes by PaO2/FiO2 (PAFI) and degree of inflammation.

Methods

Retrospective cohort study with data on patients collected from March 1st, 2020 to March 1st, 2023, from the Spanish SEMI-COVID-19 Registry. Non-nosocomial patients with data on PAFI (<100 vs. 100−200 vs. 200−300 vs. >300) who received corticosteroids (CS) for COVID-19 in the first 48 h of admission were included in the study. 5314 patients met the inclusion criteria for the present study. The primary outcome was in-hospital mortality.

Results

Higher in-hospital mortality was found in the groups with PAFI < 100 (51.5% vs. 41.2% vs. 25.8% vs. 12.3%, P < .001). They also required more NIMV, IMV, and ICU admission, and had longer hospital stays. Those patients with PAFI > 300 and 4–5 high-risk criteria presented higher mortality than the patients with PAFI 200−300 and only 1−2 criteria of analytical inflammation. Risk factors associated with higher in-hospital mortality were age [OR = 1.06 (1.05−1.06)], moderate [OR = 1.87 (1.49−2.33)] and severe [OR = 2.64 (1.96−3.55)] degree of dependency, dyslipidemia [OR = 1.20 (1.03−1.39)], higher Charlson index [OR = 1.19 (1.14−1.24)], tachypnea on admission [2.23 (1.91−2.61)], the higher number of high-risk criteria on admission, and lower PAFI on admission. Female gender [OR = 0.77 (0.65−0.90)] and the use of RDSV [OR = 0.72 (0.56−0.93)] were found to be protective factors.

Conclusions

The lower the PAFI and the higher the degree of inflammation in COVID-19, the higher the in-hospital mortality. Inflammatory escalation precedes respiratory deterioration and should serve as an early predictor of severity to deciding the use of anti-inflammatory/immunosuppressive therapy.

背景：该研究旨在通过PaO2/FiO2（PAFI）和炎症程度描述患者的特征和预后：该研究旨在通过PaO2/FiO2（PAFI）和炎症程度描述患者特征和预后：西班牙 SEMI-COVID-19 登记处从 2020 年 3 月 1 日至 2023 年 3 月 1 日收集的患者数据进行回顾性队列研究。研究纳入了在入院后 48 小时内因 COVID-19 而接受皮质类固醇（CS）治疗、有 PAFI 数据（300 例）的非院内患者。共有 5314 名患者符合本研究的纳入标准。主要结果是院内死亡率：结果：与PAFI为200-300且仅有1-2项分析性炎症标准的患者相比，PAFI为300且有4-5项高风险标准的患者院内死亡率更高。与较高院内死亡率相关的风险因素有年龄[OR = 1.06（1.05-1.06）]、中度[OR = 1.87（1.49-2.33）]和重度[OR = 2.64（1.96-3.55）]依赖程度、血脂异常[OR = 1.20 (1.03-1.39)]、较高的 Charlson 指数[OR = 1.19 (1.14-1.24)]、入院时呼吸过速[2.23 (1.91-2.61)]、入院时高危标准数量较多、入院时 PAFI 较低。女性[OR=0.77（0.65-0.90）]和使用RDSV[OR=0.72（0.56-0.93）]是保护因素：结论：COVID-19中PAFI越低、炎症程度越高，院内死亡率越高。炎症升级先于呼吸恶化，应作为严重程度的早期预测指标，以决定是否使用抗炎/免疫抑制疗法。

{"title":"Which one is a better predictor of prognosis in COVID-19: analytical biomarkers or PaO2/FiO2?","authors":"M. Rubio-Rivas , J.M. Mora-Luján , A. Montero Sáez , M.D. Martín-Escalante , V. Giner Galvañ , G. Maestro de la Calle , M.L. Taboada Martínez , A. Muiño Míguez , C. Lumbreras-Bermejo , J.-M. Antón-Santos , on behalf of the SEMI-COVID-19 Network","doi":"10.1016/j.rceng.2024.11.003","DOIUrl":"10.1016/j.rceng.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>The study aimed to describe patient characteristics and outcomes by PaO2/FiO2 (PAFI) and degree of inflammation.</div></div><div><h3>Methods</h3><div>Retrospective cohort study with data on patients collected from March 1st, 2020 to March 1st, 2023, from the Spanish SEMI-COVID-19 Registry. Non-nosocomial patients with data on PAFI (<100 vs. 100−200 vs. 200−300 vs. >300) who received corticosteroids (CS) for COVID-19 in the first 48 h of admission were included in the study. 5314 patients met the inclusion criteria for the present study. The primary outcome was in-hospital mortality.</div></div><div><h3>Results</h3><div>Higher in-hospital mortality was found in the groups with PAFI < 100 (51.5% vs. 41.2% vs. 25.8% vs. 12.3%, <em>P</em> < .001). They also required more NIMV, IMV, and ICU admission, and had longer hospital stays. Those patients with PAFI > 300 and 4–5 high-risk criteria presented higher mortality than the patients with PAFI 200−300 and only 1−2 criteria of analytical inflammation. Risk factors associated with higher in-hospital mortality were age [OR = 1.06 (1.05−1.06)], moderate [OR = 1.87 (1.49−2.33)] and severe [OR = 2.64 (1.96−3.55)] degree of dependency, dyslipidemia [OR = 1.20 (1.03−1.39)], higher Charlson index [OR = 1.19 (1.14−1.24)], tachypnea on admission [2.23 (1.91−2.61)], the higher number of high-risk criteria on admission, and lower PAFI on admission. Female gender [OR = 0.77 (0.65−0.90)] and the use of RDSV [OR = 0.72 (0.56−0.93)] were found to be protective factors.</div></div><div><h3>Conclusions</h3><div>The lower the PAFI and the higher the degree of inflammation in COVID-19, the higher the in-hospital mortality. Inflammatory escalation precedes respiratory deterioration and should serve as an early predictor of severity to deciding the use of anti-inflammatory/immunosuppressive therapy.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 57-69"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ecological study to estimate the prevalence of patients with acid sphingomyelinase deficiency in Spain. PREVASMD study 估计西班牙酸性鞘磷脂酶缺乏症患者患病率的生态学研究。PREVASMD研究。

Revista clinica espanola

Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.11.007

J. Villarrubia , M. Morales , L. Ceberio , I. Vitoria , M. Bellusci , I. Quiñones , L. Peña-Quintana , M. Ruiz de Valbuena , M. O’Callaghan

Background and objective

Prevalence studies of acid sphingomyelinase deficiency (ASMD) are scarce and different in Spain. The objective of the present study was to determine the estimated prevalence of patients diagnosed with ASMD (types A/B and B) in Spain.

Material and methods

PREVASMD was a descriptive, multicenter, and ecological study involving 21 physicians from different specialties (mainly Internal Medicine, Paediatrics and Hematology), of different autonomous communities, with experience in ASMD management.

Results

Between March and April 2022, specialists were attending a total of 34 patients with ASMD diagnosis, 10 paediatric patients under 18 years of age (29.4%) and 24 adult patients (70.6%). The estimated prevalence of patients (paediatric and adult) diagnosed with ASMD was 0.7 per 1,000,000 inhabitants (95% confidence interval, 95% CI: 0.5-1.0), 1.2 per 1,000,000 (95% CI: 0.6–2.3) in the paediatric population and 0.6 per 1,000,000 inhabitants (95% CI: 0.4–0.9) in the adult population. The most frequent symptoms that led to suspicion of ASMD were: splenomegaly (reported by 100.0% of specialists), hepatomegaly (66.7%), interstitial lung disease (57.1%), and thrombocytopenia (57.1%). According to the specialists, laboratory and routine tests, and assistance in Primary Care were the most relevant healthcare resources in the management of ASMD.

Conclusions

This first study carried out in Spain shows an estimated prevalence of patients of 0.7 per 1,000,000 inhabitants: 1.2 per 1,000,000 inhabitants in the paediatric population and 0.6 per 1,000,000 inhabitants in the adult population.

背景与目的：关于酸性鞘磷脂酶缺乏症（ASMD）患病率的研究在西班牙缺乏且存在差异。本研究的目的是确定西班牙诊断为ASMD （A/B型和B型）的患者的估计患病率。材料和方法：PREVASMD是一项描述性、多中心、生态学研究，涉及来自不同自治区不同专业（主要是内科、儿科和血液）的21名具有ASMD管理经验的医生。结果：2022年3月至4月期间，专家共诊治了34例ASMD诊断患者，其中18岁以下儿童患者10例（29.4%），成人患者24例（70.6%）。诊断为ASMD的患者（儿童和成人）的估计患病率为每100万居民0.7例（95%置信区间，95% CI: 0.5-1.0），儿科人群为每100万居民1.2例（95% CI: 0.6-2.3），成人人群为每100万居民0.6例（95% CI: 0.4-0.9）。导致怀疑ASMD的最常见症状是：脾肿大（100.0%的专家报告）、肝肿大（66.7%）、间质性肺疾病（57.1%）和血小板减少（57.1%）。专家认为，实验室和常规检查以及初级保健援助是ASMD管理中最相关的医疗资源。结论：在西班牙进行的第一项研究显示，估计每100万居民中有0.7名患者，儿科人口每100万居民中有1.2名患者，成人人口中有0.6名患者。

{"title":"Ecological study to estimate the prevalence of patients with acid sphingomyelinase deficiency in Spain. PREVASMD study","authors":"J. Villarrubia , M. Morales , L. Ceberio , I. Vitoria , M. Bellusci , I. Quiñones , L. Peña-Quintana , M. Ruiz de Valbuena , M. O’Callaghan","doi":"10.1016/j.rceng.2024.11.007","DOIUrl":"10.1016/j.rceng.2024.11.007","url":null,"abstract":"<div><h3>Background and objective</h3><div>Prevalence studies of acid sphingomyelinase deficiency (ASMD) are scarce and different in Spain. The objective of the present study was to determine the estimated prevalence of patients diagnosed with ASMD (types A/B and B) in Spain.</div></div><div><h3>Material and methods</h3><div>PREVASMD was a descriptive, multicenter, and ecological study involving 21 physicians from different specialties (mainly Internal Medicine, Paediatrics and Hematology), of different autonomous communities, with experience in ASMD management.</div></div><div><h3>Results</h3><div>Between March and April 2022, specialists were attending a total of 34 patients with ASMD diagnosis, 10 paediatric patients under 18 years of age (29.4%) and 24 adult patients (70.6%). The estimated prevalence of patients (paediatric and adult) diagnosed with ASMD was 0.7 per 1,000,000 inhabitants (95% confidence interval, 95% CI: 0.5-1.0), 1.2 per 1,000,000 (95% CI: 0.6–2.3) in the paediatric population and 0.6 per 1,000,000 inhabitants (95% CI: 0.4–0.9) in the adult population. The most frequent symptoms that led to suspicion of ASMD were: splenomegaly (reported by 100.0% of specialists), hepatomegaly (66.7%), interstitial lung disease (57.1%), and thrombocytopenia (57.1%). According to the specialists, laboratory and routine tests, and assistance in Primary Care were the most relevant healthcare resources in the management of ASMD.</div></div><div><h3>Conclusions</h3><div>This first study carried out in Spain shows an estimated prevalence of patients of 0.7 per 1,000,000 inhabitants: 1.2 per 1,000,000 inhabitants in the paediatric population and 0.6 per 1,000,000 inhabitants in the adult population.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 70-77"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The difficult relationship between research and clinical practice: a survey of Spanish internists

Revista clinica espanola

Pub Date : 2025-01-31 DOI: 10.1016/j.rceng.2025.01.009

J.C. Trullàs , A. Maestre

引用次数: 0

Alkaptonuria. Description of 2 cases of a rare entity 钾通尿症。描述两例罕见病例。

Revista clinica espanola

Pub Date : 2025-01-29 DOI: 10.1016/j.rceng.2025.01.008

A. Rosales-Castillo, A. Bustos-Merlo, J. Escobar Sevilla

引用次数: 0

Diabetic foot infections in Internal Medicine services in Spain (2018–2022) 西班牙内科服务中的糖尿病足感染（2018-2022 年）。

Revista clinica espanola

Pub Date : 2025-01-27 DOI: 10.1016/j.rceng.2025.01.006

C. Fuentes Santos , J.A. Rueda Camino , Á. Asenjo Mota , A. Castaneda Pastor , A. Zapatero Gaviria , J. Canora Lebrato , R. Barba-Martín

Introduction

Diabetic foot infections represent a common and serious complication of diabetes mellitus, with a wide range of clinical presentations. Despite their significance, uncertainties persist regarding their management and impact on Internal Medicine services.

Materials and methods

A retrospective cohort study was conducted using data from the Registry of Specialized Healthcare Activity (RAE-CMBD) over a five-year period (2018−22). Patients discharged from Internal Medicine with a diagnosis of diabetic foot were included. Demographic, clinical, and activity data were collected, and the cumulative incidence of diabetic foot, in-hospital mortality, need for amputation, and associated costs of hospitalization were analyzed.

Results

15,402 episodes with a diagnosis of diabetic foot were identified, representing 0.41% of Internal Medicine, which implies an age-adjusted incidence rate of between 2 and 3 cases per 1000 admissions in these services. These patients had a high in-hospital mortality rate (16%) and a significant percentage required amputation (8.25%). Advanced age, the presence of comorbidities, and complications during admission were associated with a higher risk of mortality and amputation. The average cost per admission is over ;6000.

Conclusions

Diabetic foot is a pathology with a high impact on Internal Medicine services, both due to the volume of activity and the high mortality and cost generated by this condition.

{"title":"Diabetic foot infections in Internal Medicine services in Spain (2018–2022)","authors":"C. Fuentes Santos , J.A. Rueda Camino , Á. Asenjo Mota , A. Castaneda Pastor , A. Zapatero Gaviria , J. Canora Lebrato , R. Barba-Martín","doi":"10.1016/j.rceng.2025.01.006","DOIUrl":"10.1016/j.rceng.2025.01.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetic foot infections represent a common and serious complication of diabetes mellitus, with a wide range of clinical presentations. Despite their significance, uncertainties persist regarding their management and impact on Internal Medicine services.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted using data from the Registry of Specialized Healthcare Activity (RAE-CMBD) over a five-year period (2018−22). Patients discharged from Internal Medicine with a diagnosis of diabetic foot were included. Demographic, clinical, and activity data were collected, and the cumulative incidence of diabetic foot, in-hospital mortality, need for amputation, and associated costs of hospitalization were analyzed.</div></div><div><h3>Results</h3><div>15,402 episodes with a diagnosis of diabetic foot were identified, representing 0.41% of Internal Medicine, which implies an age-adjusted incidence rate of between 2 and 3 cases per 1000 admissions in these services. These patients had a high in-hospital mortality rate (16%) and a significant percentage required amputation (8.25%). Advanced age, the presence of comorbidities, and complications during admission were associated with a higher risk of mortality and amputation. The average cost per admission is over ;6000.</div></div><div><h3>Conclusions</h3><div>Diabetic foot is a pathology with a high impact on Internal Medicine services, both due to the volume of activity and the high mortality and cost generated by this condition.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 3","pages":"Pages 125-130"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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