Factores pronósticos de supervivencia en el alcoholismo crónico en un estudio de seguimiento a 10 años
Manuel Montero Pérez-Barquero
, Juan Antonio Vega Reyes, Pedro Sánchez Guijo
Autor para correspondencia
mmontero@cica.es
Correspondencia: Dr. M. Montero Pérez-Barquero. Servicio de Medicina Interna 1. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba.
Correspondencia: Dr. M. Montero Pérez-Barquero. Servicio de Medicina Interna 1. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba.
Servicio de Medicina Interna 1. Hospital Universitario Reina Sofìa. Córdoba
Bartolomé de la Fuente Dader*
* Centro Provincial de Drogodependencia de Córdoba
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Hospital Universitario Reina Sofìa. Córdoba" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. M. Montero Pérez-Barquero. Servicio de Medicina Interna 1. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba." ] ] ] 1 => array:3 [ "autoresLista" => "Bartolomé de la Fuente Dader" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Bartolomé" "apellidos" => "de la Fuente Dader" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Centro Provincial de Drogodependencia de Córdoba" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2001-01-24" "fechaAceptado" => "2001-06-12" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222627" "palabras" => array:3 [ 0 => "Alcoholismo" 1 => "Mortalidad" 2 => "Factores pronósticos" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec222628" "palabras" => array:2 [ 0 => "Mortality" 1 => "Prognosis factors" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El alcoholismo representa una importante causa de muerte. Existen pocos estudios que hayan investigado los factores asociados con la mortalidad en alcohólicos que ingresan por causas médicas; por ello, el objetivo del trabajo ha sido analizar la supervivencia de estos pacientes alcohólicos e identificar las variables de significado pronóstico.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Desde enero de 1986 a diciembre de 1988, 162 individuos cumplían criterios de inclusión entre los alcohólicos ingresados en el Servicio de Medicina Interna 1 del Hospital Universitario Reina Sofía de Córdoba. La recogida de información se realizó mediante hoja de protocolo, la historia clínica, certificados de defunción y por entrevista al paciente o familiares. Se aplicó un diseño de cohorte prospectivo, así como un estudio estadístico descriptivo, curvas de supervivencia de Kaplan-Meier y regresión de Cox.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad media (DE) de los pacientes fue de 50,7 (10,7) años. De ellos, el 91,4% eran varones; el 69,9%, fumadores; el 65,7% estaban casados, y un 19,8% presentaban ascitis. La mediana de seguimiento fue de 8,7 años. Sobrevivieron 59 pacientes, 56 fallecieron y 47 no completaron el período de estudio. En el análisis bivariante las variables edad, estado civil, tiempo de alcoholismo, bilirrubina, ascitis y albúmina tuvieron significación estadística. Cuatro variables se pudieron incluir en el modelo de regresión: edad (<span class="elsevierStyleItalic">odds ratio</span> [OR], 1,07; 1,03–1,12); ascitis (OR, 2,09; 1,05–4,15); bilirrubina (OR, 1,42; 1,20–1,67) y estado civil (OR, 2,39; 1,17–4,85).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La edad, el incremento de la bilirrubina, la presencia de ascitis y ser soltero, viudo o separado se asocian a una significativamente peor supervivencia en los alcohólicos crónicos de nuestro estudio.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Alcoholism is a major cause of death. To date, there have been reported few studies examining the factors associated with mortality in alcoholics who are hospitalized for medical reasons. The aim of this study was to analyze the survival rate of those alcoholic subjects and to identify outcome variables.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Among all alcoholic patients admitted from January 1986 to December 1988 in the Department of Internal Medicine 1 of the Reina Sofia University Hospital in Córdoba (Spain), 162 met the inclusion criteria. Information was compiled from protocols, medical records, death certificates and interviews to patients and family members. A prospective cohort design was also used.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Average age was 50.7 (10.7) years; 91.4% were males, 69.9% smokers, 65.7% were married, 19.8% had ascites, and the average follow-up was 8.7 years. 59 patients survived, 56 died, and 47 did not complete the study period. In the covariate analysis, age, marital status, alcoholism duration, bilirubin levels, ascites and albumin concentrations had statistical signification. Four variables were included in the regression model: age (OR, 1.07; 1.03–1.12); ascites (OR, 2.09; 1.05–4.15); bilirubin (OR, 1.42; 1.20–1.67) and marital status (OR, 2.39; 1.17–4.85).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In our study, age, an increase in bilirubin level, presence of ascites, and marital status (single, widowed or separated) were associated with a significantly lower survival rate in chronic alcoholics.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 3 | 0 | 3 |
| 2019 Marzo | 1 | 0 | 1 |
| 2017 Octubre | 9 | 0 | 9 |
| 2017 Septiembre | 4 | 3 | 7 |
| 2017 Agosto | 14 | 1 | 15 |
| 2017 Julio | 16 | 4 | 20 |
| 2017 Junio | 19 | 4 | 23 |
| 2017 Mayo | 15 | 5 | 20 |
| 2017 Abril | 19 | 2 | 21 |
| 2017 Marzo | 32 | 16 | 48 |
| 2017 Febrero | 25 | 16 | 41 |
| 2017 Enero | 33 | 11 | 44 |
| 2016 Diciembre | 36 | 6 | 42 |
| 2016 Noviembre | 56 | 6 | 62 |
| 2016 Octubre | 59 | 3 | 62 |
| 2016 Septiembre | 23 | 9 | 32 |
| 2016 Agosto | 13 | 4 | 17 |
| 2016 Julio | 25 | 2 | 27 |
| 2016 Junio | 40 | 10 | 50 |
| 2016 Mayo | 41 | 10 | 51 |
| 2016 Abril | 26 | 10 | 36 |
| 2016 Marzo | 41 | 4 | 45 |
| 2016 Febrero | 28 | 15 | 43 |
| 2016 Enero | 40 | 11 | 51 |
| 2015 Diciembre | 39 | 10 | 49 |
| 2015 Noviembre | 54 | 5 | 59 |
| 2015 Octubre | 43 | 5 | 48 |
| 2015 Septiembre | 36 | 6 | 42 |
| 2015 Agosto | 54 | 5 | 59 |
| 2015 Julio | 65 | 3 | 68 |
| 2015 Junio | 48 | 3 | 51 |
| 2015 Mayo | 65 | 5 | 70 |
| 2015 Abril | 62 | 11 | 73 |
| 2015 Marzo | 64 | 7 | 71 |
| 2015 Febrero | 58 | 5 | 63 |
| 2015 Enero | 38 | 2 | 40 |
| 2014 Diciembre | 49 | 3 | 52 |
| 2014 Noviembre | 27 | 1 | 28 |
| 2014 Octubre | 35 | 2 | 37 |
| 2014 Septiembre | 39 | 0 | 39 |
| 2014 Agosto | 36 | 5 | 41 |
| 2014 Julio | 40 | 0 | 40 |
| 2014 Junio | 46 | 1 | 47 |
| 2014 Mayo | 49 | 2 | 51 |
| 2014 Abril | 37 | 0 | 37 |
| 2014 Marzo | 42 | 0 | 42 |
| 2014 Febrero | 36 | 2 | 38 |
| 2014 Enero | 33 | 3 | 36 |
| 2013 Diciembre | 32 | 3 | 35 |
| 2013 Noviembre | 31 | 3 | 34 |
| 2013 Octubre | 52 | 2 | 54 |
| 2013 Septiembre | 38 | 6 | 44 |
| 2013 Agosto | 38 | 7 | 45 |
| 2013 Julio | 29 | 2 | 31 |
| 2001 Septiembre | 1014 | 0 | 1014 |
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