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Mortalidad y calidad de vida al año del alta de una unidad de cuidados intensivos en pacientes mayores de 65 años
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Clinical evolution, safety and efficacy in a sample of 198 patients" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antoni Gual Solé" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Antoni Gual" "apellidos" => "Solé" ] 1 => array:1 [ "colaborador" => "en representación del Equipo Investigador sobre alcoholismo y naltrexona" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775301718945?idApp=UINPBA00004N" "url" => "/00257753/0000011600000014/v1_201307291441/S0025775301718945/v1_201307291441/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>" "titulo" => "Mortalidad y calidad de vida al año del alta de una unidad de cuidados intensivos en pacientes mayores de 65 años" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "521" "paginaFinal" => "525" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisca García Lizana, José Luis Manzano Alonso, Pedro Saavedra Santana" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Francisca" "apellidos" => "García Lizana" "email" => array:1 [ 0 => "fglizana@idecnet.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "José" "apellidos" => "Luis Manzano Alonso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Pedro" "apellidos" => "Saavedra Santana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Medicina Intensiva. Hospital Nuestra Señora del Pino." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Medicina Intensiva. Hospital Universitario Insular. Las Palmas de Gran Canaria." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Medicina Intensiva. Departamento de Matemáticas. Universidad de las Palmas." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dra. F. García Lizana. Juan Manuel Durán, 46, 1.° izqda. 35010 Las Palmas de Gran Canaria." ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-04-27" "fechaAceptado" => "2000-09-05" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec221151" "palabras" => array:4 [ 0 => "Calidad de vida" 1 => "Factores predictores" 2 => "Resultados" 3 => "Cuidados intensivos" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El tratamiento intensivo de los pacientes de más de 65 años es un tema controvertido, puesto que tienen una alta mortalidad y una esperanza de vida limitada. Sin embargo, debido al aumento de la longevidad cada día se tratan más pacientes en estas unidades, por lo que consumen una buen parte de sus recursos. Con este trabajo hemos querido conocer la mortalidad y calidad de vida (CDV), al año de alta de una unidad de cuidados intensivos (UCI), de los pacientes mayores de 65 años, y sus factores predictores.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de los pacientes de 65 años o más, ingresados en un UCI polivalente. Se analizan la mortalidad y la CDV al año del alta de la UCI (con el cuestionario EuroQOL modificado). Con objeto de conocer los factores predictores de mortalidad y CDV al año, se estimaron dos modelos de regresión logística múltiple.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De los 313 pacientes estudiados, 95 (50%) fallecieron en la UCI, 32 (10%) en el hospital y 34 (11%) tras el alta. La disfunción orgánica (p < 0,0000; odds ratio [OR], 2,9), la afección respiratoria (p < 0,0000; OR, 0,15) y la cirugía cardíaca (p < 0,01; OR, 2,8) fueron los únicos factores predictores de mortalidad. De los 152 pacientes supervivientes al año, el 21% empeoraron la CDV que tenían previamente, y sólo el 17% de los pacientes eran incapaces de vivir de una forma independiente. Los predictores de CDV fueron la CDV previa (p < 0,0002; OR, 10,2) y la edad (p < 0,002; OR, 0,09).</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A pesar de que la mortalidad al año fue alta (51%), el 83% de los supervivientes eran capaces de vivir independientemente. Dado que la mortalidad depende del desarrollo de disfunción multiorgánica durante la estancia en la UCI y no de la edad, ésta no puede ser el factor determinante de los cuidados.</p> <span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Intensive care in elderly patients is a subject of controversy, because they generally present a high rate of mortality and short epxectation of life. Due to the increasing life expectancy, more elderly patients will be treated in Intensive Care Unit (ICU) with an increasing consume of resources. The present study considers the mortality and quality of life (QOL) of patients beyond 65 years after ICU, and theirs predictors.</p> <span class="elsevierStyleSectionTitle">Patients and Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of patients = 65 years admitted in multidisciplinaire ICU. Mortality and QOL (with modified EuroQOL Instrument) one year after dischage were studied. To determine mortality and QOL one year independent predicting factors, multiple logistic regression models were used.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Of 313 patients studied, 95 (30%) died in ICU, 32 (10%) in hospital and 34 (11%) died after dischage. The independient predicting factors of mortality one year after ICU discharge were: organ failure (p < 0.000; odds ratio [OR], 2.9), cardiac surgery (p < 0.0000; OR, 0.15) and respiratory disease (p < 0.01; OR, 2.8). Of the 152 surviving patients, 21% got worse their previous QOL and only 17% were severely discapacitated. The independent predicting factors of QOL one year after ICU discharge were: prior QOL (p < 0.0002; OR, 10.2) and age (p < 0.002; OR, 0.09).</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Despite the high one year after ICU discharge mortality rate (51%), 83% of the survivors were able to live independently. Due to dependence between mortality and multiorganic failure during ICU stay and not age, this latter annot be the determining factor of the care level.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "El coste de la muerte" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.I. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2017 Octubre | 3 | 2 | 5 |
| 2017 Septiembre | 6 | 4 | 10 |
| 2017 Agosto | 4 | 9 | 13 |
| 2017 Julio | 12 | 2 | 14 |
| 2017 Junio | 16 | 10 | 26 |
| 2017 Mayo | 10 | 15 | 25 |
| 2017 Abril | 12 | 33 | 45 |
| 2017 Marzo | 25 | 5 | 30 |
| 2017 Febrero | 19 | 1 | 20 |
| 2017 Enero | 8 | 1 | 9 |
| 2016 Diciembre | 27 | 7 | 34 |
| 2016 Noviembre | 24 | 4 | 28 |
| 2016 Octubre | 45 | 6 | 51 |
| 2016 Septiembre | 28 | 2 | 30 |
| 2016 Agosto | 13 | 2 | 15 |
| 2016 Julio | 15 | 5 | 20 |
| 2016 Junio | 30 | 8 | 38 |
| 2016 Mayo | 26 | 17 | 43 |
| 2016 Abril | 15 | 7 | 22 |
| 2016 Marzo | 24 | 11 | 35 |
| 2016 Febrero | 22 | 9 | 31 |
| 2016 Enero | 26 | 10 | 36 |
| 2015 Diciembre | 25 | 9 | 34 |
| 2015 Noviembre | 27 | 10 | 37 |
| 2015 Octubre | 33 | 13 | 46 |
| 2015 Septiembre | 27 | 7 | 34 |
| 2015 Agosto | 21 | 0 | 21 |
| 2015 Julio | 26 | 6 | 32 |
| 2015 Junio | 17 | 1 | 18 |
| 2015 Mayo | 21 | 5 | 26 |
| 2015 Abril | 24 | 10 | 34 |
| 2015 Marzo | 31 | 4 | 35 |
| 2015 Febrero | 27 | 5 | 32 |
| 2015 Enero | 36 | 10 | 46 |
| 2014 Diciembre | 62 | 4 | 66 |
| 2014 Noviembre | 31 | 2 | 33 |
| 2014 Octubre | 36 | 2 | 38 |
| 2014 Septiembre | 35 | 1 | 36 |
| 2014 Agosto | 47 | 2 | 49 |
| 2014 Julio | 39 | 2 | 41 |
| 2014 Junio | 50 | 1 | 51 |
| 2014 Mayo | 43 | 2 | 45 |
| 2014 Abril | 33 | 1 | 34 |
| 2014 Marzo | 28 | 2 | 30 |
| 2014 Febrero | 29 | 2 | 31 |
| 2014 Enero | 34 | 2 | 36 |
| 2013 Diciembre | 36 | 1 | 37 |
| 2013 Noviembre | 28 | 1 | 29 |
| 2013 Octubre | 28 | 3 | 31 |
| 2013 Septiembre | 20 | 4 | 24 |
| 2013 Agosto | 38 | 3 | 41 |
| 2013 Julio | 23 | 3 | 26 |
| 2001 Abril | 1324 | 0 | 1324 |
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