Search

There are studies that evaluate the association between chronic obstructive pulmonary disease (COPD) and heart failure (HF) but there is little evidence regarding the prognosis of this comorbidity in older patients admitted for acute HF. In addition, little attention has been given to the extracardiac and extrapulmonary symptoms presented by patients with HF and COPD in more advanced stages. The aim of this study was to evaluate the prognostic impact of COPD on mortality in elderly patients with acute and advanced HF and the clinical manifestations and management from a palliative point of view. Methods: The EPICTER study (“Epidemiological survey of advanced heart failure”) is a cross-sectional, multicenter project that consecutively collected patients admitted for HF in 74 Spanish hospitals. Demographic, clinical, treatment, organ-dependent terminal criteria (NYHA III-IV, LVEF

La insuficiencia cardiaca (IC) es una enfermedad cuya prevalencia va en aumento. Los tratamientos incorporados recientemente a las guías clínicas, como son los fármacos Inhibidores de la Neprilisina y de los Receptores de Angiotensina (ARNIs) y los inhibidores de cotransportador Sodio-Glucosa-2 (iSGLT2), suponen un cambio en el paradigma de tratamiento y pronóstico de esta entidad, especialmente en determinados subgrupos de pacientes.Dada su reciente introducción, no es infrecuente encontrar en las consultas de IC enfermos potencialmente tratables y que, por la razón que sea, no reciben estos fármacos. Así, este estudio pretende analizar la adecuación terapéutica de las últimas guías de insuficiencia cardiaca en pacientes ambulatorios controlados en una consulta monográfica de IC.

(1) Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5–58.9) to 57.1 (44.1–67.1) vs. 71.5 (59.5–81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10–0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17–1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26–2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21–1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often.

There is some evidence that male gender could have a negative impact on the prognosis and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of the present study was to compare the characteristics of coronavirus disease 2019 (COVID-19) between hospitalized men and women with confirmed SARS-CoV-2 infection. This multicenter, retrospective, observational study is based on the SEMI-COVID-19 Registry. We analyzed the differences between men and women for a wide variety of demographic, clinical, and treatment variables, and the sex distribution of the reported COVID-19 deaths, as well as intensive care unit (ICU) admission by age subgroups. This work analyzed 12,063 patients (56.8% men). The women in our study were older than the men, on average (67.9 vs. 65.7 years; p < 001). Bilateral condensation was more frequent among men than women (31.8% vs. 29.9%; p = 0.007). The men needed non-invasive and invasive mechanical ventilation more frequently (5.6% vs. 3.6%, p < 0.001, and 7.9% vs. 4.8%, p < 0.001, respectively). The most prevalent complication was acute respiratory distress syndrome, with severe cases in 19.9% of men (p < 0.001). In men, intensive care unit admission was more frequent (10% vs. 6.1%; p < 0.001) and the mortality rate was higher (23.1% vs. 18.9%; p < 0.001). Regarding mortality, the differences by gender were statistically significant in the age groups from 55 years to 89 years of age. A multivariate analysis showed that female sex was significantly and independently associated with a lower risk of mortality in our study. Male sex appears to be related to worse progress in COVID-19 patients and is an independent prognostic factor for mortality. In order to fully understand its prognostic impact, other factors associated with sex must be considered.

En este estudio se pretende, mediante el uso de la herramienta informática ODIMET, realizar un estudio comparativo caso-control del estado nutricional de los pacientes ingresados por insuficiencia cardiaca (IC), y valorar la utilidad que presenta en la práctica clínica diaria. Estudio realizado en el Servicio de Medicina Interna del Hospital Clínico Universitario Lozano Blesa, en Zaragoza. Como resultados se demostraron que existen diferencia significativas, con desnutrición, en los pacientes ingresados por IC en nuestra unidad, respecto a los controles pareados por edad y sexo. Los pacientes con IC aguda presentan una deficiencia no solo en la ingesta calórica sino en lo referente a hidratos de carbono, aminoácidos esenciales, vitaminas del grupo B y C e ingesta proteica respecto a los sujetos control. Este estudio se ha realizado mediante una nueva herramienta sencilla, sin coste, no invasiva, rápida y reproducible, ODIMET, que nos proporcional información clave en lo referente al estado nutricional de los pacientes con insuficiencia cardiaca, con las implicaciones que esto tiene en cuanto al tratamiento, evolución y pronóstico de estos pacientes.