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Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: The prevalence and incidence of heart failure (HF) have been increasing in recent years as the population ages. These patients show a distinct profile of comorbidity, which makes their care more complex. In recent years, the PROFUND index, a specific tool for estimating the mortality rate at one year in pluripathology patients, has been developed. The aim of this study was to evaluate the prognostic value of the PROFUND index and of in-hospital and 30-day mortality after discharge of patients admitted for acute heart failure (AHF). Materials and Methods: A prospective multi center longitudinal study was performed that included patients admitted with AHF and ≥2 comorbid conditions. Clinical, analytical, and prognostic variables were collected. The PROFUND index was collected in all patients and rates of in-hospital and 30-day mortality after discharge were analyzed. A bivariate analysis was performed with quantitative variables between patients who died and those who survived at the 30-day follow-up. A logistic regression analysis was performed with the variables that obtained statistical significance in the bivariate analysis between deceased and surviving subjects. Results: A total of 128 patients were included. Mean age was 80.5 +/− 9.98 years, and women represented 51.6%. The mean PROFUND index was 5.26 +/− 4.5. The mortality rate was 8.6% in-hospital and 20.3% at 30 days. Preserved left ventricular ejection fraction was found in 60.9%. In the sample studied, there were patients with a PROFUND score < 7 predominated (89 patients (70%) versus 39 patients (31%) with a PROFUND score ≥ 7). Thirteen patients (15%) with a PROFUND score < 7 died versus the 13 (33%) with a PROFUND score ≥ 7, p = 0.03. Twelve patients (15%) with a PROFUND score < 7 required readmission versus 12 patients (35%) with a PROFUND score ≥ 7, p = 0.02. The ROC curve of the PROFUND index for in-hospital mortality and 30-day follow-up in patients with AHF showed AUC 0.63, CI: 95% (0.508–0.764), p <0.033. Conclusions: The PROFUND index is a clinical tool that may be useful for predicting shortterm mortality in elderly patients with AHF. Further studies with larger simple sizes are required to validate these results. [ABSTRACT FROM AUTHOR]

Copyright of Galicia Clínica is the property of Sociedad Gallega de Medicina Interna and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: The prevalence and incidence of heart failure (HF) have been increasing in recent years as the population ages. These patients show a distinct profile of comorbidity, which makes their care more complex. In recent years, the PROFUND index, a specific tool for estimating the mortality rate at one year in pluripathology patients, has been developed. The aim of this study was to evaluate the prognostic value of the PROFUND index and of in-hospital and 30-day mortality after discharge of patients admitted for acute heart failure (AHF). Materials and Methods: A prospective multicenter longitudinal study was performed that included patients admitted with AHF and ≥2 comorbid conditions. Clinical, analytical, and prognostic variables were collected. The PROFUND index was collected in all patients and rates of in-hospital and 30-day mortality after discharge were analyzed. A bivariate analysis was performed with quantitative variables between patients who died and those who survived at the 30-day follow-up. A logistic regression analysis was performed with the variables that obtained statistical significance in the bivariate analysis between deceased and surviving subjects. Results: A total of 128 patients were included. Mean age was 80.5 +/− 9.98 years, and women represented 51.6%. The mean PROFUND index was 5.26 +/− 4.5. The mortality rate was 8.6% in-hospital and 20.3% at 30 days. Preserved left ventricular ejection fraction was found in 60.9%. In the sample studied, there were patients with a PROFUND score < 7 predominated (89 patients (70%) versus 39 patients (31%) with a PROFUND score ≥ 7). Thirteen patients (15%) with a PROFUND score < 7 died versus the 13 (33%) with a PROFUND score ≥ 7, p = 0.03. Twelve patients (15%) with a PROFUND score < 7 required readmission versus 12 patients (35%) with a PROFUND score ≥ 7, p = 0.02. The ROC curve of the PROFUND index for in-hospital mortality and 30-day follow-up in patients with AHF showed AUC 0.63, CI: 95% (0.508–0.764), p Conclusions: The PROFUND index is a clinical tool that may be useful for predicting short-term mortality in elderly patients with AHF. Further studies with larger simple sizes are required to validate these results.

Introduction: The purpose of this study was to determine the prevalence of pluripathology and polypharmacy among hospitalized patients in internal medicine wards at an acute care hospital, including their sociodemographic and clinical characteristics., Methods: Observational, prospective, longitudinal, descriptive and analytical study. All patients hospitalized in the internal medicine ward at Hospital Tornú from May to September 2019 were included through consecutive sampling. Data from medical records were collected. Functional dependency and prognosis were assessed using the Barthel, Charlson and PROFUND Indexes., Results: 170 patients (58% male) were registered. Women were significantly older. Pluripathology prevalence: 32%; polypharmacy 38%; high BP: 48%; diabetes: 27%; cognitive impairment 15%; heart failure: 14%; stroke: 12%; anemia: 24%; CKD 10%. Total readmissions 10% (94% with early readmissions; 94% with readmissions related to a previous hospitalization). Global Mortality: 12%. Patients with pluripathology were elderly (78% > 65 years old) with a higher polypharmacy frequency (p < 0.0001) and functional dependence (p = 0.001). Mortality in patients with pluripathology (22%) was higher than in others (p = 0.0095) with higher Charlson and PROFUND scores (p < 0.0001). There were no significant differences in terms of hospital stay or readmissions., Conclusions: Pluripathological patients are common in our inpatient hospital department. This study reveals the importance of considering this type of patients in public hospitals due to its frequency, characteristics and healthcare utilization and costs.

Introduction: heart failure (HF) is a health problem in Spain where the prevalence rate for this disease is correlated with aging. Heart failure related mortality and hospital readmissions are high. The purpose of this study was to evaluate the clinical features of patients with HF hospitalized in the Department of Internal Medicine as well as factors associated with readmission and intra-hospital mortality. Methods: we conducted a cross-sectional, descriptive, and retrospective study based on the review of the clinical records of patients with primary diagnosis of HF in the Basic Minimum Set of Data (BMSD, Conjunto Mínimo Básico de Datos), who were discharged from the Department of Internal Medicine of the San Carlos Clinical Hospital (HCSC) in 2014. Results: the study involved 199 patients, with an average age of 82.7 years (61.8% were females); 85% of them had left ventricular ejection fraction (LVEF) > 40%, with an average pro-BNP of 9.101,3 pg/ml and 64.3% had ongoing atrial fibrillation. Thirty point two percent of patients were readmitted within 30 days, with an average rate of readmission/year of 1.45 (±0.86). Twenty five percent of patients died during the follow-up period in hospital. Among factors associated with intra-hospital mortality, older age was an associated variable (OR 1,050)(1,002-1,101) (p = 0.04). The most important factors associated with early readmission were polypharmacy (p = 0.024) as well as pluripathology based on Ollero criteria 4,974 (1,396-17,730) (p = 0.024). Patients hospitalized for HF in our Department are elderly patients treated with polymedication. Conclusion: patients hospitalized for cardiac insufficiency are older and are characterized by pluripathology and polypharmacy. Short-term prognosis is associated with high rates of readmission and mortality in hospital mainly for patients suffering from kidney disease and/or neurological disorders. [ABSTRACT FROM AUTHOR]

En este artículo científico se patentiza el método holístico del proceso salud-enfermedad, lo cual permite definir la tipología y naturaleza crónica o aguda de la afección, el estado clínico y el pronóstico médico-social del enfermo, en este caso del niño pluripatológico, así como establecer si su proceso morboso es de origen orgánico o si el trastorno funcional depende de condiciones o factores determinantes dañinos (biológicos, ambientales, socioeconómicos e higienosanitarios) para finalmente asumir adecuadas conductas médicas y sociales integradas.This scientific article licenses the holistic method of health-disease process, which allows to define the typology and chronic or severe nature of the disease, the clinical status and the social-clinic diagnosis of the patient, in this case of the pluripathologic child, such as to establish if his morbid process originates from organic issues or if the functional disorder depends on the conditions or damaging determinant factors (biological, environmental, socioeconomic, and hygienic factors) to finally assume proper medical socially integrated behaviour.

Introduction: Heart failure (HF) is a health problem in Spain where the prevalence rate for this disease is correlated with aging. Heart failure-related mortality and hospital readmissions are high. The purpose of this study was to evaluate the clinical features of patients with HF hospitalized in the Department of Internal Medicine as well as factors associated with readmission and intra-hospital mortality., Methods: We conducted a cross-sectional, descriptive, and retrospective study based on the review of the clinical records of patients with primary diagnosis of HF in the Basic Minimum Set of Data (BMSD, Conjunto Mínimo Básico de Datos),who were discharged from the Department of Internal Medicine of the San Carlos Clinical Hospital (HCSC) in 2014., Results: The study involved 199 patients, with an average age of 82.7 years (61.8% were females); 85% of them had left ventricular ejection fraction (LVEF) > 40%, with an average pro-BNP of 9.101,3 pg/ml and 64.3% had ongoing atrial fibrillation. Thirty point two percent of patients were readmitted within 30 days, with an average rate of readmission/year of 1.45 (±0.86). Twenty five percent of patients died during the follow-up period in hospital. Among factors associated with intra-hospital mortality, older age was an associated variable (OR 1,050)(1,002-1,101) (p = 0.04). The most important factors associated with early readmission were polypharmacy (p = 0.024) as well as pluripathology based on Ollero criteria 4,974 (1,396-17,730) (p = 0.024). Patients hospitalized for HF in our Department are elderly patients treated with polymedication., Conclusion: Patients hospitalized for cardiac insufficiency are older and are characterized by pluripathology and polypharmacy. Short-term prognosis is associated with high rates of readmission and mortality in hospitalmainly for patients suffering from kidney disease and/or neurological disorders., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Noel Lorenzo Villalba et al.)