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array:23 [ "pii" => "S0025775300714497" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71449-7" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71449" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:15-20" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2064 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 1930 "PDF" => 128 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300714503" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71450-3" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71450" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:21-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3803 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 3673 "PDF" => 125 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Relación entre los depósitos de hierro y la diabetes mellitus en pacientes infectados por el virus de la hepatitis C: estudio de casos y controles" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "21" "paginaFinal" => "22" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Relationship between iron stores and diabetes mellitus in patients infected by hepatitis C virus: a case-control study" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "Cristina Hernández, Rafael Simó" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Cristina" "apellidos" => "Hernández" ] 1 => array:2 [ "nombre" => "Rafael" "apellidos" => "Simó" ] ] ] 1 => array:2 [ "autoresLista" => "Joan Genescà, J. Ignasi Esteban, Lydia García" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Joan" "apellidos" => "Genescà" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Ignasi Esteban" ] 2 => array:2 [ "nombre" => "Lydia" "apellidos" => "García" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300714503?idApp=UINPBA00004N" "url" => "/00257753/0000011500000001/v1_201307291641/S0025775300714503/v1_201307291641/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0025775300714485" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71448-5" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71448" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:7-14" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3599 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 3448 "PDF" => 145 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Consumo, hábitos alimentarios y estado nutricional de la población de Reus (X): evolución de la ingestión alimentaria y de la contribución de los macronutrientes al aporte energético (1983–1999), según edad y sexo" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "14" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Food intake, dietary habits and nutritional status of the population of Reus (Catalonia, Spain) (X): evolution of the diet and macronutrients contribution to energy intake (1983–1999), by age and sex" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francesca Capdevila, Dolors Llop, Núria Guillén, Verònica Luque, Susana Pérez, Vicenç Sellés, Joan Fernández-Ballart, Carles Martí-Henneberg" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Francesca" "apellidos" => "Capdevila" ] 1 => array:2 [ "nombre" => "Dolors" "apellidos" => "Llop" ] 2 => array:2 [ "nombre" => "Núria" "apellidos" => "Guillén" ] 3 => array:2 [ "nombre" => "Verònica" "apellidos" => "Luque" ] 4 => array:2 [ "nombre" => "Susana" "apellidos" => "Pérez" ] 5 => array:2 [ "nombre" => "Vicenç" "apellidos" => "Sellés" ] 6 => array:2 [ "nombre" => "Joan" "apellidos" => "Fernández-Ballart" ] 7 => array:2 [ "nombre" => "Carles" "apellidos" => "Martí-Henneberg" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300714485?idApp=UINPBA00004N" "url" => "/00257753/0000011500000001/v1_201307291641/S0025775300714485/v1_201307291641/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Estudio prospectivo de los enfermos que abandonan un servicio de urgencias antes de ser atendidos por el médico" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "15" "paginaFinal" => "20" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Mar Ortega, María J. Esteban, Òscar Miró, Miquel Sánchez, José Millá" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Mar" "apellidos" => "Ortega" ] 1 => array:2 [ "nombre" => "María J." "apellidos" => "Esteban" ] 2 => array:4 [ "nombre" => "Òscar" "apellidos" => "Miró" "email" => array:1 [ 0 => "omiro@clinic.ub.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 3 => array:2 [ "nombre" => "Miquel" "apellidos" => "Sánchez" ] 4 => array:2 [ "nombre" => "José" "apellidos" => "Millá" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unitat d'Urgències de Medicina Servei d'Urgències Hospital Clínic Barcelona." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. O. Miró. Servei d'Urgències. Hospital Clinic. Villarroel, 170. 08036 Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prospective survey of patients the leaving emergency department without being attended by a physician" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-01-20" "fechaAceptado" => "2000-05-11" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222475" "palabras" => array:2 [ 0 => "Servicio de urgencias" 1 => "Pacientes no atendidos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Definir el perfil epidemiológico, los motivos y la evolución posterior de los enfermos que abandonan la unidad de urgencias de medicina sin ser atendidos.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Durante 26 semanas consecutivas se identificaron de forma prospectiva los pacientes que abandonaron la unidad de urgencias de medicina antes de ser atendidos. Por cada paciente no atendido (NA) se incluyó como control (C) el siguiente enfermo visitado en la unidad. Mediante los datos de la historia clínica y entrevista personal de pacientes NA y C, se recogieron variables clinicoepidemiológicas y, en los pacientes NA, los motivos que le condujeron a abandonar urgencias y su evolución posterior.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De los 21.022 pacientes que acudieron a urgencias, 383 (1,8%) fueron NA. La edad inferior a 50 años, haber acudido a urgencias solo, no haber consultado previamente con un médico y una expectativa de tiempo de espera corto aumentan el riesgo de abandonar urgencias sin ser atendidos (p < 0,01, p < 0,01, p < 0,05 y p < 0,0001, respectivamente). Como razón principal para abandonar el servicio de urgencias, un 35% refirió encontrarse mejor, un 30% se encontraba demasiado mal para esperar más, y el 25% estaba muy enfadado para seguir esperando. Un 46% de NA buscó atención médica durante las siguientes 72 h y, en total, un 6,5% requirió ingresar, resultando ser los pacientes cuyos trastornos fueron valorados a su llegada como graves y los que habían consultado previamente a un médico aquellos con mayor riesgo de ingresar (p = 0,01 y p = 0,001, respectivamente).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El enfermo que se va de urgencias antes de ser atendido suele ser un paciente relativamente joven, con estudios, que acude a urgencias sin consultar previamente con un médico y con síntomas de enfermedad menor. La principal causa de marcharse es la percepción de su propia enfermedad como no grave; menos de la mitad consulta posteriormente con un médico y su índice de ingresos es relativamente bajo. Se debería ser especialmente cauto con los pacientes que son remitidos por otro médico y que se valoran como graves a su llegada al hospital, ya que son los de mayor riesgo de ingresar posteriormente.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To define epidemiological characteristics, the main reasons, and outcome of patients who leave the emergency department (ED) without being seen by a physician.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We performed a prospective survey of patients who left the ED before medical visit over a period of 26 consecutive weeks. For every non-visited patient (NV), the next visited patient (V) was included as a control. Clinical and epidemiological data, reasons to leave ED and outcome were obtained from clinical records and personal telephonic interview.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Out of a total of 21.022 patients who were attended in the ED, 383 (1.8%) were NV. To be under 50-year-old, to come the ED alone, to be previously visited by a community physician, and to previous expect short waiting times for ED visit were associated with higher risk for being NV (p < 0.01, p < 0.01, p < 0.05 and p < 0.0001, respectively). The main reasons noted to leave the ED were: feeling better (35%), feeling too sick to wait longer (30%) and being too angry to wait (25%). Only 46% of the NV looked for medical care in the 72 following hours and 6.5% of them needing to be further to hospital. NV-patients considered as suffering a serious pathology at ED arrival, and those being visited by a community physician previously to go to ED were found to be at increased risk to be subsequently admitted (p = 0.01 and p = 0.001, respectively).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Patients who leave ED department before being seen by a doctor are usually young, literate, have not previously visited their community physician, and consulted for minor complaints. The main reason to leave is their own impression of suffering a minor disease, and less than 50% visit another physician after their leaving, being the rate of hospital admission low. We should be particularly cautious with those patients referred by a community doctor and those identified as to have a seriously affected health status at their arrival at the hospital, since they are at increased risk to be admitted.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio de la mortalidad en un servicio de urgencias de medicina hospitalario: incidencia, causas y consecuencias" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "O. Miró" 1 => "A. De Dios" 2 => "M.T. Antonio" 3 => "M. Sánchez" 4 => "A. Borrás" 5 => "J. 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