Revista clinica espanola最新文献

{"title":"Detección incidental de niveles de vitamina B12 elevados y su relación con neoplasias","authors":"J. Pardo Lledias ,&nbsp;M. Martín Millán ,&nbsp;J.A. Mazariegos Cano ,&nbsp;C. Aibar Marco ,&nbsp;N. Arias Martínez ,&nbsp;B. San Pedro Careaga ,&nbsp;E. Urizar Ursua ,&nbsp;M.C. Insua García ,&nbsp;B.A. Lavin Gómez ,&nbsp;J.L. Hernández Hernández","doi":"10.1016/j.rce.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.rce.2023.11.003","url":null,"abstract":"<div><h3>Background and objective</h3><p>Elevated serum levels of vitamin<!--> <!-->B12 have been associated with oncohematological diseases. However, the relevance of its incidental detection in subjects without a previous diagnosis of cancer is unknown. The aim of this study was to evaluate the relationship between incidental hypercobalaminemia (vitamin<!--> <!-->B12 &gt;<!--> <!-->1000<!--> <!-->pg/mL) and the diagnosis of a tumor process in patients without a diagnosis and to establish the risk factors.</p></div><div><h3>Material and methods</h3><p>Retrospective observational study of a cohort of patients with hypercobalaminemia. The incidence of neoplasms was compared with a cohort of patients with vitamin<!--> <!-->B12 levels &lt;<!--> <!-->1000<!--> <!-->pg/mL.</p></div><div><h3>Results</h3><p>Vitamin B12 determinations of 4800 subjects were selected. Of them, 345 (7.1%) had levels &gt;<!--> <!-->1000<!--> <!-->pg/ml; 68 (28.4%) were excluded due to exogenous administration, 12 (5%) due to insufficient data, and 15 (3%) due to having an active neoplasia, selecting 250 patients, with a median follow-up of 22 (IQR: 12-39) months. Structural liver disease was detected in 59 (23.6%). 18.2% (44 patients) had solid organ cancer and 17 (7.1%) had malignant hemopathy. The average time from the detection of hypercobalaminemia to the diagnosis of cancer was about 10<!--> <!-->months. The median until the diagnosis of neoplasia was higher in the high vitamin<!--> <!-->B12 group (13 vs 51<!--> <!-->months; <em>P</em> <!-->&lt;<!--> <!-->.001). Hypercobalaminemia (HR: 11.8; 95%<!--> <span>C</span>I<span>:</span> 2.8-49.6; <em>P</em> <!-->=<!--> <!-->.001) and smoking (HR: 4.0; 95%<!--> <!-->CI: 2.15-7.59; <em>P</em> <!-->&lt;<!--> <!-->.001) were independent predictors of neoplasia in the multivariate analysis.</p></div><div><h3>Conclusions</h3><p>Incidental detection of serum vitamin<!--> <!-->B12 levels &gt;<!--> <!-->1000<!--> <!-->pg/ml is high in the population. The diagnosis of solid organ and hematological neoplasia is frequent during the following year of follow-up, with hypercobalaminemia and smoking being predictors of a higher risk of cancer.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 10-16"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139480009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factores relacionados con la no adherencia a la rehabilitación cardiaca en pacientes con insuficiencia cardiaca","authors":"J. Betancourt-Peña ,&nbsp;I. Portela-Pino ,&nbsp;M. Amaral-Figueroa","doi":"10.1016/j.rce.2023.11.006","DOIUrl":"10.1016/j.rce.2023.11.006","url":null,"abstract":"<div><h3>Introduction</h3><p>In heart failure, cardiac rehabilitation has been recommended as an intervention strategy that improves functional capacity, health-related quality of life and survival. However, adherence to these programs is low. The objective was to determine the factors related to non-adherence to cardiac rehabilitation in patients with heart failure in Colombia.</p></div><div><h3>Method</h3><p>Observational and retrospective study. Patients with heart failure were linked in a clinic in Colombia, adherence to cardiac rehabilitation was measured with ≥<!--> <!-->80% of scheduled sessions. Sociodemographic and clinical variables, functional aerobic capacity (Sit to Stand and 6-minute walk test), Duke Activity Status Index (DASI), quality of life Minnesota Living with Heart Failure Questionnaire (MLFHQ) and depression Patient health questionnaire 9 (PHQ-9) were taken into account.</p></div><div><h3>Results</h3><p>300 patients were linked with heart failure with age 63.16<!--> <!-->±<!--> <!-->12.87; men 194 (64.7%). Adherence to cardiac rehabilitation was 66.67%, there were statistically significant differences between the groups in arterial hypertension, LVEF, cholesterol, LDL, triglycerides, SBP, DBP, distance traveled, VO₂e, METs, DASI and PHQ-9 <em>P</em> <!-->≤<!--> <!-->.05. The logistic regression model adjusted for sex and age showed OR for non-adherence to CR arterial hypertension 2.23 [1.22-4.07], LDL outside of goals 2.15 [1.20-3.88], triglycerides outside goals 2.34 [1.35-4.07], DASI<!--> <!-->&lt;<!--> <!-->4METs 2.38 [1.04-5.45] and PHQ-9 1.06 [1.00-1.12].</p></div><div><h3>Conclusion</h3><p>High blood pressure, LDL, triglycerides, DASI and depression with the PHQ-9 questionnaire are related factors for not having adherence to cardiac rehabilitation in patients with heart failure.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 24-34"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139457408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fumadores y riesgo de muerte hospitalaria por COVID calculado con el procesamiento de lenguaje natural de SAVANA en el ámbito de Castilla-La Mancha","authors":"R. Godoy Mayoral ,&nbsp;M. Benavent Núñez ,&nbsp;J. Cruz Ruiz ,&nbsp;G. López Yepes ,&nbsp;A. Parralejo Jiménez ,&nbsp;F.J. Callejas González ,&nbsp;J.L. Izquierdo Alonso","doi":"10.1016/j.rce.2023.11.007","DOIUrl":"https://doi.org/10.1016/j.rce.2023.11.007","url":null,"abstract":"<div><h3>Introduction</h3><p>During the COVID pandemic, it was speculated that patients with the virus who were smoking-related might have a lower likelihood of disease exacerbation or death. To assess whether there is an association between smoking and risk of in-hospital mortality, SAVANA's big data and natural language processing (NLP) technology is used.</p></div><div><h3>Method</h3><p>A retrospective, observational, non-interventional cohort study was conducted based on real-life data extracted from medical records throughout Castilla-La Mancha using natural language processing and artificial intelligence techniques developed by SAVANA. The study covered the entire population of this region with Electronic Medical Records in SESCAM presenting with a diagnosis of COVID from March 1, 2020 to February 28, 2021.</p></div><div><h3>Results</h3><p>Smokers had a significantly higher percentage of cardiovascular risk factors (hypertension, dyslipidemia and diabetes), COPD, asthma, IDP, IC, CVD, PTE, cancer in general and lung cancer in particular, bronchiectasis, heart failure and a history of pneumonia (<em>P</em> <!-->&lt;<!--> <!-->.0001). Former smokers, current smokers and non-smokers have a significant age difference. As for in-hospital deaths, they were more frequent in the case of ex-smokers, followed by smokers and then non-smokers (<em>P</em> <!-->&lt;<!--> <!-->.0001).</p></div><div><h3>Conclusion</h3><p>There is an increased risk of dying in hospital in SARS-CoV-2-infected patients who are active smokers or have smoked in the past.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 35-42"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139480011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fortalezas sistémicas y necesidades en atención paliativa domiciliaria: explorando la complejidad","authors":"X. Busquet-Duran ,&nbsp;B.M. Carralero ,&nbsp;J. Bielsa-Pascual ,&nbsp;L. Milian-Adriazola ,&nbsp;N. Salamero-Tura ,&nbsp;P. Torán-Monserrat","doi":"10.1016/j.rce.2023.11.004","DOIUrl":"https://doi.org/10.1016/j.rce.2023.11.004","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to investigate the relationship between systemic strengths and complexity in home care of end-of-life patients.</p></div><div><h3>Methods</h3><p>Quantitative descriptive longitudinal study of patients cared for at home by a palliative care team. Place of death was analyzed in relation to complexity, as determined by the HexCom complexity model after the initial home assessment. We used Pearson's chi-square test to analyze the comparison of proportions.</p></div><div><h3>Results</h3><p>Forty-six hundred patients (74.4% oncologic) with a mean age of 76.2<!--> <!-->years (SD 13.2) participated. Fifty-three percent had complete or severe functional dependence, 30.8% were already bedridden in the first assessment, and 59.7% died at home. Strengths influenced place of death, specifically exosystem (team) strength (OR: 4.07 [1.92-8.63]), microsystem (both patient 0.51 [0.28-0.94]) and caregiver (OR: 3.90 [1.48-10.25]), and chronosystem, related to prediction of progressive course (OR: 2.22 [1.37-3.60]).</p></div><div><h3>Conclusions</h3><p>To improve care for end-of-life patients and their families, a systemic view of dying and death that includes both needs and strengths is necessary. In this sense, the systemic framework proposed by Bonfrenbrenner can be useful for clinical practice.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 1-9"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014256523001959/pdfft?md5=ec8c686cddaf62c5da8ac2867a5bd72a&pid=1-s2.0-S0014256523001959-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139480008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asociación del colesterol remanente con el grado de control glucémico y la presencia de complicaciones microvasculares en personas con diabetes mellitus tipo 1","authors":"J.J. Raposo-López,&nbsp;M.S. Tapia-Sanchiz,&nbsp;V. Navas-Moreno,&nbsp;J.A. Arranz Martín,&nbsp;M. Marazuela,&nbsp;F. Sebastián-Valles","doi":"10.1016/j.rce.2023.11.002","DOIUrl":"10.1016/j.rce.2023.11.002","url":null,"abstract":"<div><h3>Introduction</h3><p>This study examines the relationship between remnant cholesterol, glucose metrics, and chronic complications of type 1 diabetes in users of glucose monitoring systems.</p></div><div><h3>Material and methods</h3><p>Clinical variables and glucose metrics were collected from individuals using glucose sensors. Statistical models were employed to investigate the association of remnant cholesterol with glucose metrics, diabetic retinopathy, and diabetic nephropathy.</p></div><div><h3>Results</h3><p>A total of 383 individuals, aged 48.3<!--> <!-->±<!--> <!-->16.2 years, with 54.1% women, and a remnant cholesterol level of 16<!--> <!-->±<!--> <!-->10<!--> <!-->mg/dL, were included. The results demonstrated that remnant cholesterol was associated with less time within the target range (<em>P</em>=.015) and more time above the target range (<em>P</em>=.003). Diabetic nephropathy was the only complication associated with remnant cholesterol levels exceeding 30<!--> <!-->mg/dL; OR: 8.93; 95% CI: 2.99-26.62, <em>P</em>&lt;.001.</p></div><div><h3>Conclusion</h3><p>Remnant cholesterol is independently associated with hyperglycemia and diabetic nephropathy in individuals with type 1 diabetes.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 43-47"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014256523001935/pdfft?md5=c05f415116a38679e18801cacd2d4bcd&pid=1-s2.0-S0014256523001935-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139457949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comentario al artículo «Trombosis venosa cerebral en adultos: cohorte de 35 casos de un hospital terciario»","authors":"A. Gil-Díaz","doi":"10.1016/j.rce.2023.09.006","DOIUrl":"https://doi.org/10.1016/j.rce.2023.09.006","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Page 64"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139480013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resumen ejecutivo del documento de consenso para la formación y el desarrollo de la ecografía clínica en Medicina Interna: recomendaciones desde el Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna (GTECO-SEMI)","authors":"Y. Tung-Chen ,&nbsp;G. García de Casasola Sánchez ,&nbsp;S. García Rubio ,&nbsp;L. Beltrán Romero ,&nbsp;M. Bernabéu Wittel ,&nbsp;L.S. Briongos Figuero ,&nbsp;J. Canora Lebrato ,&nbsp;D. García Gil ,&nbsp;S. López Palmero ,&nbsp;D. Luordo Tedesco ,&nbsp;P. Martín Rico ,&nbsp;M. Mateos González ,&nbsp;M. Méndez Bailón ,&nbsp;J.M. Porcel ,&nbsp;G. Serralta ,&nbsp;M. Torres Arrese ,&nbsp;J. Oteiza Olaso ,&nbsp;P. Varela García ,&nbsp;J. Torres Macho","doi":"10.1016/j.rce.2023.11.005","DOIUrl":"https://doi.org/10.1016/j.rce.2023.11.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Given the increasing adoption of clinical ultrasound in medicine, it is essential to standardize its application, training, and research.</p></div><div><h3>Objectives and methods</h3><p>The purpose of this document is to provide consensus recommendations to address questions about the practice and operation of clinical ultrasound units. Nineteen experts and leaders from advanced clinical ultrasound units participated. A modified Delphi consensus method was used.</p></div><div><h3>Results</h3><p>A total of 137 consensus statements, based on evidence and expert opinion, were considered. The statements were distributed across 10 areas, and 99 recommendations achieved consensus.</p></div><div><h3>Conclusions</h3><p>This consensus defines the most important aspects of clinical ultrasound in the field of internal medicine, with the aim of standardizing and promoting this healthcare advancement in its various aspects. The document has been prepared by the Clinical Ultrasound Working Group and endorsed by the Spanish Society of Internal Medicine.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 57-63"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014256523012973/pdfft?md5=c3fd9a4bd983acbd1abe3e652a8e9fa7&pid=1-s2.0-S0014256523012973-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139480012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admisiones en los servicios de urgencias y costes económicos relacionados con procesos susceptibles de atención ambulatoria en adultos mayores que viven en centros residenciales","authors":"F.J. Afonso-Argilés ,&nbsp;M. Comas-Serrano ,&nbsp;X. Castells-Oliveres ,&nbsp;I. Cirera-Lorenzo ,&nbsp;D. García-Pérez ,&nbsp;T. Pujadas-Lafarga ,&nbsp;X. Ichart-Tomás ,&nbsp;M. Puig-Campmany ,&nbsp;A.B. Vena-Martínez ,&nbsp;A. Renom-Guiteras ,&nbsp;en nombre del Grupo Caregency que se indica a continuación","doi":"10.1016/j.rce.2023.09.004","DOIUrl":"10.1016/j.rce.2023.09.004","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess the frequency of emergency department admissions (EDAs) for ambulatory care sensitive conditions (ACSC) and non-ACSC among older adults living in care homes (CH), to describe and compare their demographic and clinical characteristics, the outcomes of the hospitalization process and the associated costs.</p></div><div><h3>Method</h3><p>This multicenter, retrospective and observational study evaluated 2444 EDAs of older adults ≥65 years old living in care homes in five emergency departments in Catalonia (Spain) by ACSC and non-ACSC, in 2017. Sociodemographic variables, prior functional and cognitive status, and information on diagnosis and hospitalization were collected. Additionally, the costs related with the EDAs were calculated, as well as a sensitivity analysis using different assumptions of decreased admissions due to ACSC.</p></div><div><h3>Results</h3><p>A total of 2444 ED admissions were analyzed. The patients’ mean (SD) age was 85.9 (7.2) years. The frequency of ACSC-EDA and non-ACSC-EDA was 56.6% and 43.4%, respectively. Severe dependency and cognitive impairment were present in 56.6% and 78%, respectively, with no differences between the two groups. The three most frequent ACSC were falls/trauma (13.8%), chronic obstructive pulmonary disease/asthma (11.4%) and urinary tract infection (7.4%). The average cost per ACSC-EDA was €1408.24. Assuming a 60% reduction of ACSC-EDA, the estimated cost savings would be €1.2 million.</p></div><div><h3>Conclusions</h3><p>Emergency admissions for ACSC from care homes have a significant impact on both frequency and costs. Reducing these conditions through targeted interventions could redirect the avoided costs toward improving care support in residential settings.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"223 10","pages":"Pages 585-595"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135615536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valoración nutricional por ecografía del recto femoral y el tejido adiposo preperitoneal como predictores del riesgo de complicaciones del paciente hospitalizado","authors":"R. Marín-Baselga ,&nbsp;C. Sanz-Ortega ,&nbsp;L. Platero-Dueñas ,&nbsp;R. Sorriguieta-Torre ,&nbsp;S. Palma-Milla ,&nbsp;Y. Tung-Chen","doi":"10.1016/j.rce.2023.09.001","DOIUrl":"10.1016/j.rce.2023.09.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Malnutrition and sarcopenia are associated with increased risk of adverse events and worse outcome in hospitalised patients. Ultrasonography is a useful tool in the assessment of body composition.</p></div><div><h3>Patients and methods</h3><p>Twenty-three patients admitted to a hospital ward were recruited. Ultrasonographic variables of muscle tissue and adipose tissue were collected, as well as their variation during admission. These were correlated with anthropometric, clinical and analytical data.</p></div><div><h3>Results</h3><p>We observed a correlation of ultrasound measurements with length of hospitalisation (maximum preperitoneal fat −0.585, rectus femoris thickness [RF] −0.539, RF area −0.540), frailty (RF −0.599) and dependency (RF 0.628). RF contractile capacity correlated with reported weekly exercise (0.642).</p></div><div><h3>Conclusion</h3><p>RF and preperitoneal fat thickness correlate with the number of days of admission and functional capacity, emerging as prognostic variables.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"223 10","pages":"Pages 640-646"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Riesgo de hemorragia cerebral en el traumatismo craneal leve y tratamiento antitrombótico","authors":"J.J. Martínez-Rivas ,&nbsp;F. Rodríguez-Lucas ,&nbsp;G. Planells ,&nbsp;D. Corrales ,&nbsp;D. Cocho","doi":"10.1016/j.rce.2023.09.005","DOIUrl":"10.1016/j.rce.2023.09.005","url":null,"abstract":"<div><h3>Introduction</h3><p>The observation time in mild traumatic brain injury (mTBI) is controversial. Our aim was to assess the risk of neurological complications in mTBI with and without antithrombotic treatment.</p></div><div><h3>Method</h3><p>We retrospectively evaluated patients with mTBI seen in the emergency room for 3 years. We considered MTBI those with Glasgow ≥13 at admission. A cranial CT was performed in all cases with <u>&gt;</u>1 risk factor at admission and at 24<!--> <!-->h in those with neurological impairment or initial pathological cranial CT. Complications in the following 3 months were retrospectively reviewed.</p></div><div><h3>Results</h3><p>We evaluated 907 patients with a mean age of 73<!--> <!-->±<!--> <!-->19 years. Ninety-one percent presented risk factors, with 60% on antithrombotic treatment. We detected 11% of initial brain hemorrhage, 0.4% at 24<!--> <!-->h, and no cases at 3 months. Antithrombotic treatment was not associated with an increased risk of brain hemorrhage (9.9% with vs. 11.9% without treatment, <em>P</em>=.3). 39% of the hemorrhages presented neurological symptoms (18% post-traumatic amnesia, 12% headache, 8% vomiting, 1% seizures), with 78.4% having mild symptoms. Of the 4 hemorrhages detected at 24<!--> <!-->h, 3 were asymptomatic and one case that worsened the initial headache. No asymptomatic patient without lesion on initial clinical cranial CT presented at 24<!--> <!-->h.</p></div><div><h3>Conclusions</h3><p>Our study suggests that patients with asymptomatic mTBI, without a lesion on the initial cranial CT, would not require the observation period or CT control regardless of antithrombotic treatment or INR level.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"223 10","pages":"Pages 604-609"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135615280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}