Revista clinica espanola最新文献_第2页

GRADE methodology in consensus and clinical practice guidelines for the management of retinal vein occlusion. GRADE方法在视网膜静脉闭塞治疗的共识和临床实践指南。

Revista clinica espanola

Pub Date : 2026-02-02 DOI: 10.1016/j.rceng.2026.502469

C Burgueño-Montañes, R Bouchikh-El Jarroudi, M Zavaleta-Mercado, J Galvez-Olortegui

引用次数: 0

Current situation and role of internists in healthcare ethics committees in Spain. PANACEAS study. 西班牙内科医生在医疗伦理委员会中的现状和作用。灵丹妙药。

Revista clinica espanola

Pub Date : 2026-02-02 DOI: 10.1016/j.rceng.2026.502483

P Durán Del Campo, G Solano Iturri, B Alonso Ortiz, J Bertran Muñoz, A M Bravo Blanco, L Briongos Figuero, C Carrera García, A D Chacón Moreno, A Blanco Portillo, J M Galván-Román

Objectives: To analyze the current situation of Healthcare Ethics Committees (HECs) in Spain, their composition and functions, as well as the implementation of Clinical Ethics Consultancy (CEC). Finally, to assess the involvement of internists in HECs.

Materials and methods: A cross-sectional descriptive study conducted through a self-administered online survey distributed between February and May 2025 to all identified HECs in the country.

Results: A total of 112 HECs (47.66%) out of the 235 accredited nationwide participated. The average number of members per committee was 16 (range: 6-29). The most represented professional profiles were nursing and medicine. In 99.1% of the committees, at least one member had postgraduate training in Bioethics. The most frequent range of meetings per year was between 7 and 12 (46.8%). Most HECs (91.1%) were involved in educational activities, and 58% had produced ethical documents. The majority reviewed between 1 and 5 cases annually (69.6%). The CEC role was established in 40.2% of HECs and in the process of implementation in 18.8%. Internists were present in 54% of HECs. In 65% of cases, the internist is part of the CEC.

Conclusions: HECs in Spain demonstrate significant involvement in educational activities and the development of ethical documents; however, they receive a relatively low number of annual consultations. Clinical Ethics Consultancy is gradually being integrated into the structure of HECs, which may enhance the management of ethical inquiries. Internists are members of more than half of the HECs and play a very active role in their operations.

目的：分析西班牙医疗伦理委员会（HECs）的现状、组成和职能，以及临床伦理咨询（CEC）的实施情况。最后，评估内科医生参与高等专科医院的情况。材料和方法：一项横断面描述性研究，通过一项自我管理的在线调查进行，该调查于2025年2月至5月分发给全国所有确定的hec。结果：在全国235家经认证的高等学校中，共有112家（47.66%）参与。每个委员会的平均成员人数为16人（范围：6-29人）。最具代表性的专业是护理和医学。在99.1%的委员会中，至少有一名成员接受过生物伦理学研究生培训。每年最频繁的会议范围是7至12次（46.8%）。大多数高等学校（91.1%）参与了教育活动，58%的高等学校制定了伦理文件。大多数病例每年复查1 - 5例（69.6%）。40.2%的高等教育中心确立了中央协调委员会的作用，18.8%的高等教育中心处于执行过程中。内科医生出现在54%的hec中。在65%的病例中，内科医生是CEC的一部分。结论：西班牙的高等教育机构在教育活动和道德文件的制定方面表现出了显著的参与；但是，他们每年接受的咨询次数相对较少。临床伦理咨询正逐渐纳入高等医院的架构，这可能会加强对伦理咨询的管理。内科医生是超过一半的高等医疗保健委员会的成员，在这些委员会的运作中发挥着非常积极的作用。

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引用次数: 0

Procalcitonin and midregional proadrenomedullin (MR-proADM) could help make home hospitalization of patients seen for suspected infection in the Emergency department safer. 降钙素原和中部肾上腺髓质素原（MR-proADM）可使在急诊科就诊的疑似感染患者更安全地在家住院。

Revista clinica espanola

Pub Date : 2026-02-02 DOI: 10.1016/j.rceng.2026.502472

J Cabañas Morafraile, L S Martín, E de Rafael González, A Julián-Jiménez

引用次数: 0

Heart failure with preserved ejection fraction: updated diagnostic and therapeutic strategies. SEMI consensus document. 保留射血分数的心力衰竭：最新的诊断和治疗策略。SEMI共识文件。

Revista clinica espanola

Pub Date : 2026-02-02 DOI: 10.1016/j.rceng.2026.502471

J M Fernández Rodríguez, M B Alonso-Ortíz, J Casado Cerrada, D Chivite Guillen, P Cubo Romano, R García Alonso, A Lorenzo Almorós, J P Miramontes-González, L Soler Rangel, J Pérez-Silvestre

Heart failure (HF) is associated with high morbidity and mortality. HF with preserved left ventricular ejection fraction (HF-pEF) accounts for up to 50% of all HF cases, being the most common in elderly patients. In addition, these subjects frequently present other comorbidities. For all these reasons, the diagnosis of patients with HF-pEF is complex and requires a careful approach. In addition, there are "secondary" or HF-pEF forms that must also be discarded. The treatment of HF-pEF has evolved very significantly in recent years due to evidence from clinical trials. Until a few years ago, the management was based on the treatment of congestive symptoms with diuretics and comorbidities, to this was added the indication of treatment with SGLT2 inhibitors, after being shown to reduce hospitalizations due to HF, and more recently new evidence of clinical benefit with other drugs such as finerenone, semaglutide or tirzepatide has been published. All this makes it necessary to update the recommendations regarding the management of patients with HF-pEF.

心力衰竭（HF）与高发病率和死亡率相关。保留左心室射血分数（HF- pef）的HF占所有HF病例的50%，在老年患者中最常见。此外，这些受试者经常出现其他合并症。由于所有这些原因，对HF-pEF患者的诊断是复杂的，需要谨慎的方法。此外，还有“次级”或HF-pEF形式也必须丢弃。由于来自临床试验的证据，近年来HF-pEF的治疗有了非常显著的发展。直到几年前，治疗的基础是用利尿剂和合并症治疗充血性症状，在此基础上增加了SGLT2抑制剂治疗的适应症，在被证明可以减少HF的住院治疗后，最近有新的证据表明使用其他药物如芬尼酮、西马鲁肽或替西帕肽有临床益处。所有这些都使得有必要更新有关HF-pEF患者管理的建议。

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引用次数: 0

Prognostic value of clinical judgment versus the ELAN-HF and BCN-Bio-HF risk scores after hospitalization for acute heart failure 急性心力衰竭住院后临床判断与ELAN-HF和BCN-Bio-HF风险评分的预后价值

Revista clinica espanola

Pub Date : 2026-02-01 DOI: 10.1016/j.rceng.2026.502451

A. Fraile Sanz , D. Abad Pérez , M. Álvarez Bello , M. Laserna Martínez , I. Luis Saludes , J.A. Perea Egido , R. Mata Caballero , I.J. Thuissard-Vasallo , J. Casado

Introduction and objectives

Heart failure (HF) is a highly prevalent condition, particularly among the elderly, and is associated with high rates of readmission and mortality. To improve prognosis, risk assessment tools such as ELAN-HF and BCN-Bio-HF have been developed to estimate mortality after a hospitalization for HF. However, in clinical practice, risk evaluation is often based on the physician’s subjective perception. This study aims to compare that perception with the mortality predictions generated by these tools.

Methods

A retrospective, observational study was conducted in a secondary-level hospital between 2019 and 2021, including patients recently discharged after hospitalization for HF. At the first follow-up visit, physicians subjectively classified the patients’ risk into three levels without access to the results of the risk scores. Afterwards, the ELAN-HF and BCN-Bio-HF scores were calculated and compared with clinical outcomes at 12 months. The predictive capacity of each method was evaluated.

Results

A total of 125 patients were included (median age: 76 years [71,5–83], 56% male). The overall mortality rate was 34.4%. The ELAN-HF and BCN-Bio-HF scores better identified high-risk patients than the clinical assessment, which underestimated mortality in the low-risk group. ROC curve analysis showed good predictive ability for mortality, particularly for the BCN-Bio-HF score (AUC: 74.6%).

Conclusions

The results support that risk scores are more accurate than physicians’ subjective evaluation in predicting mortality in patients with HF. Their integration into clinical practice is recommended, given their prognostic value and usefulness in patient follow-up.

前言和目的：心力衰竭（HF）是一种非常普遍的疾病，特别是在老年人中，并与高再入院率和死亡率相关。为了改善预后，已经开发了ELAN-HF和BCN-Bio-HF等风险评估工具来估计HF住院后的死亡率。然而，在临床实践中，风险评估往往是基于医生的主观感知。这项研究旨在将这种看法与这些工具产生的死亡率预测进行比较。方法：2019 - 2021年在某二级医院进行回顾性观察性研究，纳入心力衰竭住院后近期出院的患者。在第一次随访时，医生在无法获得风险评分结果的情况下，主观地将患者的风险分为三个级别。随后，计算ELAN-HF和BCN-Bio-HF评分，并与12个月时的临床结果进行比较。对每种方法的预测能力进行了评价。结果：共纳入125例患者（中位年龄：76岁[71,5-83]，56%为男性）。总死亡率为34.4%。与临床评估相比，ELAN-HF和BCN-Bio-HF评分能更好地识别高危患者，而临床评估低估了低危组的死亡率。ROC曲线分析显示，BCN-Bio-HF评分对死亡率具有较好的预测能力（AUC: 74.6%）。结论：结果支持风险评分比医生的主观评价更准确地预测心衰患者的死亡率。鉴于其预后价值和对患者随访的有用性，建议将其纳入临床实践。

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引用次数: 0

Impact of the UMIPIC model compared with other follow-up approaches after hospitalization for heart failure in patients with multimorbidity UMIPIC模型与其他随访方法在多重疾病心力衰竭患者住院后的影响

Revista clinica espanola

Pub Date : 2026-02-01 DOI: 10.1016/j.rceng.2026.502452

F. Aguilar Rodríguez , C. Díaz Pedroche , A. Guzmán Carreras , B. Sánchez Sauce , J.I. Molina-Puente , A.A. Kishta , M. Méndez Bailón

Background

Follow-up within Integrated Management Units for Heart Failure (UMIPIC) in patients with multiple comorbidities discharged after heart failure (HF) improves outcomes during the acute phase. However, many Internal Medicine departments use alternative models, and it remains unclear whether these alternative approaches provide additional benefits compared to exclusive follow-up in Primary Care (PC), as well as whether hospital-based consultations maintain their impact once patient stability is achieved.

Methods

We analyzed 709 HF discharges from the PROFUND-IC registry. After population weighting using inverse probability weighting (IPW), we assessed HF readmissions and all-cause mortality at 12 months, comparing patients followed in UMIPIC units, Internal Medicine outpatient clinics (non-UMIPIC), and exclusively in PC. Events occurring within the first 6 months after the acute phase were analyzed separately from those in the subsequent 6 months.

Results

Patients managed under the UMIPIC models experienced a lower 12-month risk of events compared with PC (HR 0.56; 95% CI 0.38–0.84; p < 0.01) and non-UMIPIC (HR 0.58; 95% CI 0.36–0.93; p = 0.02); the latter showed no benefit over PC. Event reduction in UMIPIC was significant during the first 6 months (HR 0.56; 95% CI 0.38–0.83; p < 0.01), with no differences between models during the stable phase.

Conclusions. Hospital-based follow-up of patients with multiple comorbidities during the first six months after an HF episode reduces HF readmissions and overall mortality compared with exclusive PC follow-up—provided it is conducted under the UMIPIC model rather than through conventional Internal Medicine consultations.

背景：心力衰竭综合管理单位（UMIPIC）对心力衰竭（HF）后出院的多重合并症患者的随访改善了急性期的预后。然而，许多内科部门使用替代模式，目前尚不清楚这些替代方法是否比初级保健（PC）的独家随访提供额外的好处，以及一旦患者稳定后，基于医院的会诊是否能保持其影响。方法：我们分析了PROFUND-IC登记处的709例hf放电。在使用逆概率加权（IPW）对人群进行加权后，我们评估了12个月时HF再入院率和全因死亡率，比较了在UMIPIC单位、内科门诊诊所（非UMIPIC）和专门在PC进行随访的患者。急性期后6个月内发生的事件与随后6个月内发生的事件分开分析。结果：与PC相比，在UMIPIC模式下管理的患者12个月的事件风险较低（HR 0.56; 95% CI 0.38-0.84; p）。结论：在HF发作后的前6个月内，对患有多种合并症的患者进行基于医院的随访，与单独的PC随访相比，减少了HF再入院率和总死亡率——前提是在UMIPIC模式下进行，而不是通过传统的内科会诊。

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引用次数: 0

Comprehensive management of infectious cellulitis:From epidemiology to hospital approach in Spain 传染性蜂窝织炎的综合管理：从流行病学到西班牙的医院方法。

Revista clinica espanola

Pub Date : 2026-02-01 DOI: 10.1016/j.rceng.2025.502458

A. Cotos Suárez , M. Alonso-Sardón , V. Velasco Tirado , A. López-Bernus , L. Sancha Domínguez , B. Rodriguez Alonso , J. Pendones Ulerio , J.L. Muñoz Bellido , M. Belhassen-García

Introduction

Cellulitis is a skin and soft tissue infection caused by the entry of a microorganism into the subcutaneous tissue. Nowadays it represents one of the main causes of hospital admission, mainly due to incorrect diagnosis or the need for intravenous treatment. The aim of this study is to observe the characteristics of cellulitis in patients admitted to our hospital during two years in order to determine whether admissions were really necessary.

Methods

Retrospective study of admissions for cellulitis between 2022 and 2023 at the Salamanca University Hospital, classified according to the CREST-SEWS criteria.

Results

During the study period, 332 patients with cellulitis were admitted to the Salamanca University Hospital. 56% of the patients were classified as grade II (those who do not have severe symptoms, but who are usually admitted due to their comorbidities). 70% of the patients had some comorbidity or risk factor such as skin disorders, type II diabetes mellitus or heart failure. The most common site of infection was the lower extremities. The etiologic agent of the infection could be established in 28% of the patients, and the most frequently isolated microorganism was methicillin-sensitive S. aureus. The most common treatment was β-lactams, specifically amoxicillin/clavulanic acid (39.5%) and piperacillin/tazobactam (23.8%).

Conclusions

In order to treat infectious cellulitis, it is essential to carry out a correct etiological diagnosis in order to establish the most appropriate treatment and reduce unnecessary admissions, especially in patients with class II cellulitis.

蜂窝织炎是一种由微生物进入皮下组织引起的皮肤和软组织感染。如今，它是住院的主要原因之一，主要是由于诊断错误或需要静脉注射治疗。本研究的目的是观察两年内住院的蜂窝织炎患者的特点，以确定住院是否真的有必要。方法：回顾性研究萨拉曼卡大学医院2022年至2023年蜂窝织炎住院患者，根据CREST-SEWS标准进行分类。结果：在研究期间，萨拉曼卡大学医院收治了332例蜂窝织炎患者，其中56%的患者被分类为II级（没有严重症状，但通常因合并症而入院）。70%的患者有一些合并症或危险因素，如皮肤病、2型糖尿病或心力衰竭。最常见的感染部位是下肢。28%的患者可以确定感染的病原，最常见的分离微生物是甲氧西林敏感金黄色葡萄球菌。最常见的治疗是β-内酰胺类药物，特别是阿莫西林/克拉维酸（39.5%）和哌拉西林/他唑巴坦（23.8%）。结论：在感染性蜂窝织炎的治疗中，必须进行正确的病因诊断，以便制定最合适的治疗方案，减少不必要的住院，尤其是二类蜂窝织炎患者。

{"title":"Comprehensive management of infectious cellulitis:From epidemiology to hospital approach in Spain","authors":"A. Cotos Suárez , M. Alonso-Sardón , V. Velasco Tirado , A. López-Bernus , L. Sancha Domínguez , B. Rodriguez Alonso , J. Pendones Ulerio , J.L. Muñoz Bellido , M. Belhassen-García","doi":"10.1016/j.rceng.2025.502458","DOIUrl":"10.1016/j.rceng.2025.502458","url":null,"abstract":"<div><h3>Introduction</h3><div>Cellulitis is a skin and soft tissue infection caused by the entry of a microorganism into the subcutaneous tissue. Nowadays it represents one of the main causes of hospital admission, mainly due to incorrect diagnosis or the need for intravenous treatment. The aim of this study is to observe the characteristics of cellulitis in patients admitted to our hospital during two years in order to determine whether admissions were really necessary.</div></div><div><h3>Methods</h3><div>Retrospective study of admissions for cellulitis between 2022 and 2023 at the Salamanca University Hospital, classified according to the CREST-SEWS criteria.</div></div><div><h3>Results</h3><div>During the study period, 332 patients with cellulitis were admitted to the Salamanca University Hospital. 56% of the patients were classified as grade II (those who do not have severe symptoms, but who are usually admitted due to their comorbidities). 70% of the patients had some comorbidity or risk factor such as skin disorders, type II diabetes mellitus or heart failure. The most common site of infection was the lower extremities. The etiologic agent of the infection could be established in 28% of the patients, and the most frequently isolated microorganism was methicillin-sensitive S. aureus. The most common treatment was β-lactams, specifically amoxicillin/clavulanic acid (39.5%) and piperacillin/tazobactam (23.8%).</div></div><div><h3>Conclusions</h3><div>In order to treat infectious cellulitis, it is essential to carry out a correct etiological diagnosis in order to establish the most appropriate treatment and reduce unnecessary admissions, especially in patients with class II cellulitis.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"226 2","pages":"Article 502458"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852036","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

Analysis of social problems for discharge in acute care hospitalization 急症住院出院的社会问题分析。

Revista clinica espanola

Pub Date : 2026-02-01 DOI: 10.1016/j.rceng.2026.502456

A. Jiménez-Puente , M.D. Martín-Escalante , M. Noureddine-López , F. Rivas-Ruiz , A. Rubio-Gallo

Introduction

Patients who remain hospitalized due to the absence of adequate social support for discharge represent a growing challenge in an aging society where traditional family care networks are increasingly weakened.

Methods

We conducted a study in an acute care hospital in southern Spain, focusing on inpatients referred to the Social Work Department in whom social problems were identified as barriers to discharge (SPD). Data were reviewed from 2006 onwards, as well as across two 24-month periods: before and after the COVID-19 pandemic.

Results

2288 discharges with SPD were analyzed. From 2006 to 2024, the number of beds occupied by patients with SPD increased by an average of 0.62 beds per day each year. The rise was particularly marked in 2022 and 2024, when 1.3% of all hospital discharges were delayed due to SPD, equivalent to 11 beds occupied daily. Internal Medicine was the specialty with the highest proportion of patients with SPD: 4%.

Conclusions

Hospital stays prolonged by social problems represent a substantial burden and show a clear upward trend. The underlying causes are multifactorial, mainly related to social circumstances and the clinical complexity of patients.

引言：在传统家庭护理网络日益削弱的老龄化社会中，由于出院时缺乏足够的社会支持而继续住院的患者是一个日益严峻的挑战。方法：我们在西班牙南部的一家急症护理医院进行了一项研究，重点是转介到社会工作部门的住院患者，其中社会问题被确定为出院障碍（SPD）。对2006年以来以及COVID-19大流行前后两个24个月期间的数据进行了审查。结果：对2288例SPD患者进行了分析。从2006年到2024年，SPD患者的床位数平均每年增加0.62张。这一增长在2022年和2024年尤为明显，当时1.3%的医院出院因SPD而推迟，相当于每天占用11张病床。内科是SPD患者比例最高的专业，为4%。结论：因社会问题延长住院时间的负担较大，且呈明显上升趋势。其根本原因是多方面的，主要与社会环境和患者的临床复杂性有关。

{"title":"Analysis of social problems for discharge in acute care hospitalization","authors":"A. Jiménez-Puente , M.D. Martín-Escalante , M. Noureddine-López , F. Rivas-Ruiz , A. Rubio-Gallo","doi":"10.1016/j.rceng.2026.502456","DOIUrl":"10.1016/j.rceng.2026.502456","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients who remain hospitalized due to the absence of adequate social support for discharge represent a growing challenge in an aging society where traditional family care networks are increasingly weakened.</div></div><div><h3>Methods</h3><div>We conducted a study in an acute care hospital in southern Spain, focusing on inpatients referred to the Social Work Department in whom social problems were identified as barriers to discharge (SPD). Data were reviewed from 2006 onwards, as well as across two 24-month periods: before and after the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>2288 discharges with SPD were analyzed. From 2006 to 2024, the number of beds occupied by patients with SPD increased by an average of 0.62 beds per day each year. The rise was particularly marked in 2022 and 2024, when 1.3% of all hospital discharges were delayed due to SPD, equivalent to 11 beds occupied daily. Internal Medicine was the specialty with the highest proportion of patients with SPD: 4%.</div></div><div><h3>Conclusions</h3><div>Hospital stays prolonged by social problems represent a substantial burden and show a clear upward trend. The underlying causes are multifactorial, mainly related to social circumstances and the clinical complexity of patients.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"226 2","pages":"Article 502456"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954908","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

Case series of SMART syndrome in a tertiary hospital in Gran Canaria 大加那利岛某三级医院SMART综合征病例系列。

Revista clinica espanola

Pub Date : 2026-02-01 DOI: 10.1016/j.rceng.2026.502454

A. Relloso de la Fuente , J.F. García Granado , O.G. Quesada Morales , M.d.C. Pérez Vieitez , M.J. Alemany Rodríguez , A.N. González Hernández

Introduction

SMART (stroke-like migraine attacks after radiation therapy) syndrome is a possible complication of radiotherapy used in the treatment of brain tumours. The current prevalence is not well known, partly because it is underdiagnosed.

Material and Methods

A descriptive, prospective study was designed over a period of 18 months. Demographic, clinical, analytical and neuroimaging variables were collected.

Results

Three patients were included who, after receiving holocranial radiotherapy, developed focal neurological symptoms after a variable latency period. After ruling out other possible aetiologies, the diagnosis of SMART syndrome was established.

Conclusion

This case series aims to raise awareness among professionals of the importance of training in this pathology, especially in view of the advances in oncological treatments and the expected increase in its incidence.

简介：SMART（卒中样偏头痛放疗后发作）综合征是脑肿瘤放疗治疗中可能出现的并发症。目前的流行情况尚不清楚，部分原因是诊断不足。材料和方法：设计了一项为期18个月的描述性前瞻性研究。收集人口学、临床、分析和神经影像学变量。结果：3例患者在接受颅放射治疗后出现局灶性神经系统症状。排除其他可能的病因后，确定SMART综合征的诊断。结论：本病例系列旨在提高专业人员对该病理学培训重要性的认识，特别是考虑到肿瘤治疗的进步和其发病率的预期增加。

引用次数: 0

Real-world evidence on the use of SGLT2 inhibitors in elderly patients with acute heart failure 老年急性心力衰竭患者使用SGLT2抑制剂的真实世界证据

Revista clinica espanola

Pub Date : 2026-02-01 DOI: 10.1016/j.rceng.2026.502453

M. Raya-Cruz , A. Bustos-Merlo , M.J. Soriano-Pérez , D. Rico-López , R. Córdoba-Peinado , A.J. Pardo-Cabello , F. Gómez-Delgado , En representación del grupo estudio EMRIC

Introduction

Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) have proven effective in chronic heart failure (CHF). However, evidence regarding their use in acute heart failure (AHF), particularly among elderly patients, is limited. This study aimed to assess the safety and tolerability of SGLT-2i in elderly patients hospitalized for AHF.

Methods

We conducted a multicenter retrospective study including 192 patients admitted with AHF, with a mean age of 83.3 ± 8.3 years, of whom 57.3% were female. The initiation of SGLT-2i during hospitalization, adverse events, mortality, and readmission rates were analyzed.

Results

SGLT-2i therapy was initiated within the first 48 h of admission in 31.3% of patients. Only 5.7% experienced drug-related adverse effects. During follow-up, 10.4% of patients died and 25% required hospital readmission.

Conclusions

SGLT-2i treatment in elderly patients with AHF demonstrated good tolerance and safety, even in those with multiple comorbidities. These findings suggest that early initiation of SGLT-2i during hospitalization for AHF may represent an effective and safe therapeutic strategy, supporting the optimization of clinical management in this high-risk population.

钠-葡萄糖共转运蛋白2抑制剂（SGLT-2i）已被证明对慢性心力衰竭（CHF）有效。然而，关于它们在急性心力衰竭（AHF），特别是老年患者中的应用的证据是有限的。本研究旨在评估SGLT-2i在AHF住院老年患者中的安全性和耐受性。方法：我们对192例AHF患者进行多中心回顾性研究，平均年龄83.3±8.3岁，其中57.3%为女性。分析住院期间SGLT-2i的起始、不良事件、死亡率和再入院率。结果：31.3%的患者在入院前48小时内开始SGLT-2i治疗。只有5.7%的人经历过与药物相关的不良反应。在随访期间，10.4%的患者死亡，25%需要再次住院。结论：SGLT-2i治疗老年AHF患者表现出良好的耐受性和安全性，即使在患有多种合并症的患者中也是如此。这些发现表明，在AHF住院期间早期开始SGLT-2i可能是一种有效和安全的治疗策略，支持优化这一高危人群的临床管理。

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引用次数: 0