medigraphic.com
ISSN 1029-3035 (Electronic)

2015, Number 1

<< Back Next >>

Mediciego 2015; 21 (1)

Diagnostic efficacy of a scale for the prognosis of death by pneumonia in geriatric patients hospitalized in the service of internal medicine in Ciego de Ávila

Castellanos VL, Terry MR, Paéz OL, Pérez AJJ, Abogadro DYG

Language: Spanish
References: 16
Page:
PDF size: 92.92 Kb.


ABSTRACT

Introduction: The acquired pneumonia in the community represents the most frequent cause of death of infectious etiology in the XXIst century.
Objective: To establish the diagnostic efficacy of a scale for the death prognosis for pneumonia in geriatric patients.
Method: A study of diagnostic efficiency was carried out to evaluate the predictive value of the prognostic scale of severity for pneumonia. The sample was composed of 64 patients older than 60 years.
Results: A major frequency was verified in masculine patients that in feminine, 33,3 % with included ages from 60 to 69 years and from 80 to 89 (38,7 %) years respectively. Less mortality rates among patients younger than 75 years than in those older than 75 years with a statistical significance (p ≤ 0.05) were observed. For the risk definition in the class moderated or superior, the sensibility was 100 % and VPN was 100 %, with a validity index of 33 %. In the high risk class the sensibility and the VPN behaved equaly with a validity index of 47 %, in the very high risk class 75 % it was obtained a sensibility of 80 % VPN of 92 % and a correct adapted proportion of wise moves (index of validity).
Conclusions: It concludes that a punctuation of the risk scale with a cutpoint greater than 71 could be reasonable to guide a hospitable treatment in patients older than 65 years.


REFERENCES

  1. Pedro Pons A, Farreras Valentí P, Foz Tena A. Tratado de Patología y Clínicas Médicas. La Habana: Ciencia y Técnica; 1969.

  2. Butt S, Swiatlo E. Treatment of community-acquired pneumonia in an ambulatory setting. Am J Med [Internet]. 2011 [citado 12 Jun 2014]; 124(4):297-300. Disponible en: http://www.scie ncedirect.com/science/article/pii/S0002934310010478

  3. National Center for Health Statistics [Internet]. Atlanta, GA: Centers for Disease control and Prevention; 2012 [actualizado 23 Ene 2012; citado 15 Feb 2012] [aprox. 2 pantallas]. Disponible en: http://www.cdc.gov/nchs/index.htm

  4. Calbo E, Ochoa de Echagüen A, Rodríguez Carballeira M, Ferrer C, Garau J. Ingresos, estancia y mortalidad de las neumonías adquiridas en la comunidad en un hospital de agudos. Correlación entre el índice pronóstico de severidad y los criterios clínicos tradicionales de valoración de la gravedad. Enferm Infecc Microbiol Clin [Internet]. 2004; 22:64-9. Disponible en: http://www.sciencedirect.com/science/article/pii/S0213005X04730360

  5. Monge V, González A. Hospital admissions for pneumonia in Spain. Infection [Internet]. 2011[citado 12 Jun 2014]; 29:3-6. Disponible en: http://link.springer.com/article/10.1007/s15010-001-0024-2#page-1

  6. Miller J, Petrie J. Development of practice guideline. Lancet [Internet]. 2000 [citado 12 Jun 2014]; 355:82-83. Disponible en: http://cid.oxfordjournals.org/content/32/6/851.short

  7. España PP, Capelastegui A, Gorordo I. Development and validation of a clinical prediction rule for severe community acquired pneumonia. Am J Respir Crit Care Med [Internet]. 2008 [citado 12 Jun 2014]; 174:1249-56. Disponible en: http://www.researchgate.net/publication/ 6817362_Development_and_validation_of_a_clinical_prediction_rule_for_severe_communityacquired_ pneumonia/file/d912f509028cc7922d.pdf

  8. Álvarez Lerma F, Torres A. Severe community acquired pneumonia. Curr Opin Crit Care [Internet]. 2009 [citado 12 Jun 2014]; 10:369-374. Disponible en: http://xa.yimg.com/kq/gr oups/16749867/2132571936/name/Severe%20Community-%20Acquired%20Pneumonia.pdf

  9. Ciego de Ávila. Hospital Provincial General Docente “Dr. Antonio Luaces Iraola”. Departamento de Registros Médicos. Sistema movimiento hospitalario; 2012 [documento no publicado].

  10. Mederos Sust S, Corona Martínez LA, González Morales I, Fragoso Marchante MC, Hernández Abreus C. Letalidad hospitalaria por neumonía adquirida en la comunidad según el tratamiento antimicrobiano inicial. Rev Cubana Med [Internet]. 2014 [citado 13 Oct 2014]; 53(2):144-164. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-7 5232014000200005&lng=es.

  11. Yealy DM, Auble TE, Stone RA. The emergency department community-acquired pneumonia trial: methodology of a quality improvement intervention. Ann Emerg Med [Internet]. 2010 [citado 12 Jun 2014]; 43:770-782. Disponible en: http://www.annemergmed.com/article/S0196-0644%2803%2901005-9/abstract

  12. Preventing seasonal flu with vaccination. Centers for Disease control and Prevention [Internet]. Atlanta, GA: Centers for Disease control and Prevention; 2010 [actualizado 23 Feb 2010; citado 1 Mar 2014] [aprox. 4 pantallas]. Disponible en: http://www.cdc.gov/flu/protect/preventing.htm

  13. Julián Jiménez A, Parejo Miguez R, Cuena Boy R. Intervenciones para mejorar el manejo de la neumonía adquirida en la comunidad desde el servicio de urgencias. Emergencias [Internet]. 2013 [citado 12 Jun 2014]; 25: 379-392. Disponible en: http://www.semes.org/revista_EMER GENCIAS/descargar/intervenciones-para-mejorar-el-manejo-de-la-neumonia-adquirida-en-lacomunidad- desde-el-servicio-de-urgencias/force_download/english/

  14. Vila AC. Utilidad de la escala CRB-65 en la evaluación pronóstica de los pacientes mayores de 65 años con neumonía adquirida en la comunidad. Med Clin (Barc) [Internet]. 2010 [citado 12 Jun 2014]; 135(3):97–102. Disponible en: http://zl.elsevier.es/es/revista/medicina-clinica- 2/linkresolver/utilidad-escala-crb-65-evaluacion-pronostica-13151379

  15. Rico Méndez FG, Barquera S, Múgica Hernández JJ, Espinosa Pérez JL, Ortega S, Ochoa LG. Supervivencia en una cohorte con EPOC. Análisis comparativo entre el primer y tercer niveles de atención. Arch Bronconeumol [Internet]. 2010 [citado 12 Jun 2014]; 41(5):[aprox. 8 p.]. Disponible en: www.archbronconeumol.org/es/supervivencia-una-cohorte-con-epoc-/articulo/ 13074592/

  16. Capelastegui A, España PP, Quintana JM, Gorordo I, Ortega M, Idoiaga I, et al. Improvement of process-of-care and outcomes after implementing a guideline for the management of community acquired pneumonia: a controlled before and after design study. Clin Infect Dis [Internet]. 2012 [citado 12 Jun 2014]; 39(7):955. Disponible en: http://cid.oxfordjournals.org/content/39/7/955.full.pdf+html




2020     |     www.medigraphic.com