{"title":"Detection of atrial fibrillation in patients with retinal vascular occlusions: a meta-analysis","authors":"X. Chen , Y. Zhou , X. Li , W. Zhu","doi":"10.1016/j.rceng.2025.502309","DOIUrl":"10.1016/j.rceng.2025.502309","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between atrial fibrillation (AF) and retinal vascular occlusions has been inconsistently reported. Therefore, we conducted a systematic review and meta-analysis to evaluate the occurrence of AF in individuals with and without retinal vascular occlusions.</div></div><div><h3>Methods</h3><div>A thorough search of the PubMed database was conducted for relevant studies published from its inception through November 2023. Inclusion criteria were set for studies that reported on AF occurrence in patients with retinal vascular occlusions. The pooled effect sizes were determined using either a fixed-effects or random-effects model, as dictated by the I<sup>2</sup> statistic.</div></div><div><h3>Results</h3><div>Our meta-analysis included 12 studies. In the meta-analysis, five studies (9418 retinal artery occlusion [RAO] patients and 26,116,452 controls) showed a significantly higher prevalence of AF in RAO patients (odds ratio [OR]<!--> <!-->=<!--> <!-->1.74, 95% confidence interval [CI] 1.15–2.63, <em>P</em> <!-->=<!--> <!-->0.009, I<sup>2</sup> <!-->=<!--> <!-->94%). Four studies (1622 retinal vein occlusion [RVO] patients and 92,910 controls) indicated a higher prevalence of AF in RVO patients (OR<!--> <!-->=<!--> <!-->2.28, 95% CI 1.93–2.69, <em>P</em> <!--><<!--> <!-->0.00001, I<sup>2</sup> <!-->=<!--> <!-->0%). For follow-up incidence, two studies (806 RAO patients and 7840 controls) reported a higher rate of AF detection in RAO patients (hazard ratios [HR]<!--> <!-->=<!--> <!-->1.60, 95% CI 1.25–2.04, <em>P</em> <!-->=<!--> <!-->0.0002, I<sup>2</sup> <!-->=<!--> <!-->0%). Similarly, two studies (2330 RVO patients and 8641 RVO controls) revealed a higher rate of AF detection in RVO patients (HR<!--> <!-->=<!--> <!-->1.25, 95% CI 1.04–1.51, <em>P</em> <!-->=<!--> <!-->0.02, I<sup>2</sup> <!-->=<!--> <!-->49%).</div></div><div><h3>Conclusions</h3><div>Our evidence from this study suggests a significantly elevated prevalence and incidence of AF in patients with retinal vascular occlusions, indicating a potential association that warrants further investigation.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 6","pages":"Article 502309"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Pagán Escribano , L. Castilla Guerra , E. Guitierrez-Sánchez , A. Gómez-Escobar , R. García Alonso , L. Arias-Barquet , O. Madridano Cobo , M. Martín Asenjo , E. Rubio Velázquez , A. Lorenzo Hernández , G. Puche Palao
{"title":"Position paper on retinal vein occlusion. SEMI-SERV","authors":"J. Pagán Escribano , L. Castilla Guerra , E. Guitierrez-Sánchez , A. Gómez-Escobar , R. García Alonso , L. Arias-Barquet , O. Madridano Cobo , M. Martín Asenjo , E. Rubio Velázquez , A. Lorenzo Hernández , G. Puche Palao","doi":"10.1016/j.rceng.2025.502307","DOIUrl":"10.1016/j.rceng.2025.502307","url":null,"abstract":"<div><div>Retinal vein occlusion (RVO) is associated with both local and systemic factors such as hypertension, diabetes mellitus, dyslipidemia, and thrombophilias. In addition to specific recommendations for ophthalmological management, a comprehensive systemic approach is crucial, with rigorous control of cardiovascular risk factors, which are implicated in approximately 90% of RVO cases. In cases where it is necessary, an in-depth differential diagnosis should also be performed. This position paper aims to provide a thorough review of this common condition, including its pathophysiology, clinical manifestations, diagnosis, and treatment, based on the latest scientific evidence and expert recommendations.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 6","pages":"Article 502307"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L.S. Briongos Figuero , J.P. Miramontes González , M. Gabella Martín , L. Corral Gudino , G. López Muñiz , J.C. Martín Escudero
{"title":"Synergistic factors impacting quality-adjusted life years in the frail elderly population","authors":"L.S. Briongos Figuero , J.P. Miramontes González , M. Gabella Martín , L. Corral Gudino , G. López Muñiz , J.C. Martín Escudero","doi":"10.1016/j.rceng.2025.502297","DOIUrl":"10.1016/j.rceng.2025.502297","url":null,"abstract":"<div><h3>Introduction</h3><div>We aim to analyse which factors predominantly influence the QALYs related to geriatric frailty syndrome (QALYs-frail) in octogenarians.</div></div><div><h3>Materials and methods</h3><div>Prospective observational study of 63 frail octogenarian patients admitted to the medical area. Clinical-demographic variables were collected, as well as quality of life (EuroQoL-5D-5L), nutritional status (MNA-SF), dependence (Barthel scale), comorbidity, and the ADLs related to frailty. Statistical models were carried out to study the association between the different variables and to find predictive factors.</div></div><div><h3>Results</h3><div>Patients with better nutritional status showed a positive correlation with the AVACs-frail (<em>r</em> <!-->=<!--> <!-->0.4, <em>p</em> <!-->=<!--> <!-->0.003), as did patients with a lower degree of dependence (<em>r</em> <!-->=<!--> <!-->0.71, <em>p</em> <!--><<!--> <!-->0.001). When adding multimorbidity, a significant negative correlation was identified (<em>r</em> <!-->=<!--> <!-->−0.16, <em>p</em> <!-->=<!--> <!-->0.002). The same happened with age (<em>r</em> <!-->=<!--> <!-->−0.43, <em>p</em> <!--><<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>Managing fragility poses a challenge, but specific interventions could have an impactful and cost-effective effect on this vulnerable subgroup of the population.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 6","pages":"Article 502297"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Llorens , A. Haro , V. Gil , A. Alquézar-Arbé , J. Jacob , B. Espinosa , M.Á. González de la Torre , J. Núñez , X. Rossello , Ò. Miró , en representación del grupo de investigación ICA-SEMES
{"title":"Factors associated with the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors after an episode of acute heart failure and prognostic impact","authors":"P. Llorens , A. Haro , V. Gil , A. Alquézar-Arbé , J. Jacob , B. Espinosa , M.Á. González de la Torre , J. Núñez , X. Rossello , Ò. Miró , en representación del grupo de investigación ICA-SEMES","doi":"10.1016/j.rceng.2025.502300","DOIUrl":"10.1016/j.rceng.2025.502300","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the factors associated with the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and the association between use SGLT2i and post discharge adverse clinical endpoints (composite of 30-day visit to emergency department or acute heart failure -AHF- readmission or death) and 1-year mortality.</div></div><div><h3>Methods</h3><div>We included all patients diagnosed with AHF in 40 Spanish emergency departments (ED) in November-December 2022 with available data on chronic treatment and at discharge and grouped them according to whether they received iSGLT2 at discharge. Treatment with SGLT2i was categorized in never user, prior use and initiation during decompensation. In multivariable models adjusted for 31 independent variables, we investigated factors associated with iSGLT2 use at discharge and with new initiation of iSGLT2 treatment at discharge, and the relationship between iSGLT2 treatment and 30-day adverse events and 1-year mortality.</div></div><div><h3>Results</h3><div>3554 patients were included (median age: 85 years, 56% women, 71% hospitalized): 495 (13.9%) were already receiving iSGLT2 before decompensation and 733 (20.6%) were discharged with iSGLT2. The use of iSGLT2 at discharge was directly associated with prior iSGLT2 treatment, diabetes mellitus, hospitalization, and discharge prescription of other drugs recommended for heart failure, and inversely with previous episodes of AHF and dementia. Initiation of iSGLT2 during decompensation was inversely associated with these factors and also inversely associated with chronic renal failure. Treatment with iSGLT2 at discharge was associated with a lower risk of adverse events at 30 days (adjusted HR 0.80, 95%CI 0.65−0.99) and death at 1 year (0.78, 0.63−0.96). These beneficial effects were also observed when iSGLT2 was initiated during decompensation (0.65, 0.49−0.87; and 0.71, 0.54−0.93; respectively), and the reduction in adverse events at 30 days was even better in new-onset cases (interaction p: 0.02).</div></div><div><h3>Conclusion</h3><div>The use of iSGLT2 after an AHF episode is low, is higher in patients who were hospitalized, and is associated with fewer 30-day adverse events and deaths at 1 year compared with patients not receiving iSGLT2. Patients who initiate iSGLT2 during decompensation have an even greater decrease in 30-day adverse events than patients on chronic therapy.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 6","pages":"Article 502300"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J.C. Arévalo-Lorido , F. Alonso Ecenarro , P. Luque-Linero , D. García Calle , J.F. Varona , E. Gañán Moreno , B. Seoane González , J. Carretero Gomez , A. Gullón , L. Castilla Guerra
{"title":"Profile of patients with atrial fibrillation treated in internal medicine departments in spain. SUMAMOS-FA-SEMI registry","authors":"J.C. Arévalo-Lorido , F. Alonso Ecenarro , P. Luque-Linero , D. García Calle , J.F. Varona , E. Gañán Moreno , B. Seoane González , J. Carretero Gomez , A. Gullón , L. Castilla Guerra","doi":"10.1016/j.rceng.2025.502283","DOIUrl":"10.1016/j.rceng.2025.502283","url":null,"abstract":"<div><h3>Aim</h3><div>To update the profile of patients with atrial fibrillation (AF) who are treated in internal medicine wards according to characteristics implicit in elderly patients.</div></div><div><h3>Material and methods</h3><div>Multicenter national registry with one-year follow-up that includes adult patients diagnosed with AF. The sample is divided into three groups based on comorbidity and dependency (group 1, functional patients with little comorbidity; group 2, partially dependent patients with comorbidity; group 3, dependent patients with comorbidity) and their characteristics are described, differentiating between inpatients and outpatients.</div></div><div><h3>Results</h3><div>1215 subjects were analyzed (mean age 81.5 ± 8.7, with 52.1% women). An increase in comorbidities associated with AF is observed compared to previous analyses in the same setting. There is a high rate of frailty (44.4%), and risk of malnutrition (52.9%) with significant differences between the established groups. An increase in baseline anticoagulant therapy was observed with fewer individuals treated in group 3, and a greater use of direct anticoagulants (62.3%) than anti-vitamin K drugs (22.2%), especially in group 3.</div></div><div><h3>Discussion</h3><div>The current profile of AF patients treated in internal medicine shows an aged but heterogeneous population with a higher rate of baseline anticoagulant therapy than in previous records with a greater use of direct anticoagulants, especially in the more comorbid and dependent population. We observed a high prevalence of frailty and malnutrition with differences between the established groups. This situation could have implications for establishing differentiated approaches.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 5","pages":"Article 502283"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Yield of ultrasound-guided biopsies of focal lesions in an Internal Medicine Department","authors":"L. Porcel , S. Alas , S. Bielsa , J.M. Porcel","doi":"10.1016/j.rceng.2025.502285","DOIUrl":"10.1016/j.rceng.2025.502285","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasound-guided biopsy (UGB) is a diagnostic procedure that is usually performed by radiologists; however, its use by internists has been poorly studied. This study evaluated the diagnostic yield, accuracy, and safety of UGB for focal lesions with a high suspicion of malignancy in an Internal Medicine Department.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 255 UGB in 248 patients between 2021 and 2024. Solid organ biopsies were performed to evaluate diagnostic yield, complications, and factors associated with success.</div></div><div><h3>Results</h3><div>The overall diagnostic yield was 84% with an accuracy of 83% for malignancy and 89% for benignity. The biopsies predominantly comprised of hepatic, pulmonary, and lymph node specimens. Major complications occurred infrequently (3%). Factors such as sample size and accumulated experience improved the results.</div></div><div><h3>Conclusions</h3><div>UGBs performed by internists for focal lesions suspected of malignancy are safe and effective. Its implementation can reduce diagnostic time and improve patient care.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 5","pages":"Article 502285"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Sánchez Martínez , J. Solís García del Pozo , L. Cabeza Osorio , J. Gómez Garrido , M. Méndez Bailón , J.J. Alfaro Martínez
{"title":"Analysis of the Internal Medicine specialty demand in Spanish exam for accessing to the Resident Physicians Training Program through the quotation index (2001–2024)","authors":"S. Sánchez Martínez , J. Solís García del Pozo , L. Cabeza Osorio , J. Gómez Garrido , M. Méndez Bailón , J.J. Alfaro Martínez","doi":"10.1016/j.rceng.2025.102278","DOIUrl":"10.1016/j.rceng.2025.102278","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite internal medicine’s importance in our health system, there has been an impression of a lower demand for the choice of specialty in recent years. Our objective is to know the evolution of the choice of Internal Medicine places between 2001 and 2024 among medical graduates who aspire to specialized training in Spain through new parameters based on quotation and demand.</div></div><div><h3>Material and methods</h3><div>Based on the data published by the Ministry of Health, we analyze the index and the order of quotation, the order of demand, and the total demand for the period studied.</div></div><div><h3>Results</h3><div>The internal medicine quotation remained relatively stable throughout the period until the years 2022–2024, when it declined. The number of internal medicine places awarded when the first specialty is exhausted also remains stable. However, the overall demand has deteriorated in recent years, although it continues to maintain an order of total demand above other medical specialties.</div></div><div><h3>Conclusion</h3><div>Internal medicine has maintained a very stable quotation and demand for years despite the development of different specialties, until the last three years when this quotation and demand worsened. It is essential to make medical students aware of the fundamental role that Internal Medicine plays in our health and hospital system to promote the paradigm shift from the disease to the sick person.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 5","pages":"Article 102278"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Escorial-Moya C. , Lobo-Matas I. , Calderón-Sandubete E. , Medrano-Ortega F.J. , Varela-Aguilar J.M. , Delgado-Cuesta J.
{"title":"High diagnostic yield of ultrasound-guided core needle biopsy of lymphadenopathy performed in an internal medicine department","authors":"Escorial-Moya C. , Lobo-Matas I. , Calderón-Sandubete E. , Medrano-Ortega F.J. , Varela-Aguilar J.M. , Delgado-Cuesta J.","doi":"10.1016/j.rceng.2025.502282","DOIUrl":"10.1016/j.rceng.2025.502282","url":null,"abstract":"<div><h3>Background</h3><div>Core needle biopsy (CNB) is often the initial test for polyadenopathic syndrome and is usually performed by radiologists. The objectives of this study are to determine the diagnostic yield of ultrasound-guided CNB of lymph nodes performed by internists at a tertiary care hospital, the most frequent etiological diagnoses, and the safety of this technique.</div></div><div><h3>Materials</h3><div>Observational, descriptive study in which we included all patients over 17 years of age who had undergone ultrasound-guided CNB of lymphadenopathy by a member of the internal medicine service of the Virgen del Rocío University Hospital in Seville from 2021 to 2023.</div></div><div><h3>Results</h3><div>A total of 76 patients were included, 49 (64.5%) were male and the median age [IQR] was 64 [42–75] years. The most frequent location of lymphadenopathy was inguinal (38.2%). This test allowed a definitive diagnosis in 71 (93.4%) of the patients. Of the 5 in whom the diagnosis was not reached by the CNB, three required an open biopsy, one was diagnosed with <em>Bartonella henselae</em> by serology and in a fifth the diagnosis was not reached. The median delay for the BAG[IQR] was 1[0–3] days. No patient had complications. The most frequent diagnosis was lymphoma in 31 (41.8%) patients.</div></div><div><h3>Conclusions</h3><div>Ultrasound-guided CNB performed by internists is a safe, feasible test with very little delay. These data support the extension of this practice to the rest of the internal medicine services.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 5","pages":"Article 502282"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Ena , J. Carretero Gómez , M. Suárez Tembra , L. Lajara Villar , C. Fernández Peña , A. Rosales Castillo , N. Domínguez Pinilla , F.J. Carrasco Sánchez , A. Bustos Merlo , A. Rabassa Soler
{"title":"Evaluating chronic kidney disease in Spanish people with diabetes: a study from internal medicine clinics","authors":"J. Ena , J. Carretero Gómez , M. Suárez Tembra , L. Lajara Villar , C. Fernández Peña , A. Rosales Castillo , N. Domínguez Pinilla , F.J. Carrasco Sánchez , A. Bustos Merlo , A. Rabassa Soler","doi":"10.1016/j.rceng.2025.102279","DOIUrl":"10.1016/j.rceng.2025.102279","url":null,"abstract":"<div><h3>Aim</h3><div>To determine the prevalence and characteristics of chronic kidney disease (CKD) in a cross-sectional population of people with type 2 diabetes treated at internal medicine clinics in Spain.</div></div><div><h3>Methods</h3><div>We collected data from 25 hospitals that recruited 354 people with type 2 diabetes in an observational study carried out in May 2024. Information collected included demographic data, comorbidities, nutritional status, presence of sarcopenia and frailty, as well as laboratory data and therapy administered.</div></div><div><h3>Results</h3><div>We included a total of 314 subjects, of whom 185 (58.9%; 95% confidence interval: 53.4–64.3%) had CKD. Compared with people with no CKD, those with CKD were older (77.4 ± 9.7 vs. 65.9 ± 12.5 years; p < 0.001), more often male (53.1% vs. 46.9%; p = 0.021), with more prevalence of ischemic heart disease (22.4% vs. 10.9%; p = 0.006) and longer duration of diabetes disease (14.1 ± 8.6 vs. 10.0 ± 7.0 years; p < 0.001). Malnutrition (37.3% vs. 25%; p = 0.017), sarcopenia (24.6% vs. 11.2%; p = 0.003), and frailty (74.3% vs. 59%; p = 0.006) were more often associated in people with CKD compared with those without CKD.</div></div><div><h3>Conclusion</h3><div>Internal medicine specialists treat a significant number of people with diabetes and CKD. These people are characteristically elderly, with high proportion of cardiovascular disease showing malnutrition, sarcopenia, and frailty, which could determine the target for metabolic control.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 5","pages":"Article 102279"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Fuentes , J. Jacob , J.G.d. Castillo , F.J. Montero-Pérez , A. Alquezar-Arbé , Ò. Miró , en representación del grupo EDEN
{"title":"Short- and long-term characteristics and outcomes in patients aged 65 or older living in nursing homes. EDEN-40 study","authors":"E. Fuentes , J. Jacob , J.G.d. Castillo , F.J. Montero-Pérez , A. Alquezar-Arbé , Ò. Miró , en representación del grupo EDEN","doi":"10.1016/j.rceng.2025.502281","DOIUrl":"10.1016/j.rceng.2025.502281","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the variables associated with living in a care home in patients aged 65 or older who consult in the emergency department (ED), and to assess their outcomes.</div></div><div><h3>Methods</h3><div>Patients aged 65 or older who consulted in 52 Spanish ED during one week in April 2019 were included and classified according to whether they lived in a care home or at their family home. The characteristics of these patients and the differences between the two groups were investigated using a logistic regression model and the calculation of the odds ratio (OR) with its 95% confidence interval (CI). Mortality, ED revisits, and hospitalization rates at 30 days and at 1 year after the index episode were evaluated, calculating the hazard ratios (HR) and their 95% CI, as well as the log-rank statistic with Cox regression.</div></div><div><h3>Results</h3><div>A total of 23,629 patients were analyzed, of which 1569 (6.6%) lived in a care home. Of the 18 variables explored, several were associated with living in a care home in the multivariate model, with the following showing significant results: inability to ambulate, OR 11,330 (95% CI 8967–14,314); ambulation with assistance, OR 5687 (95% CI 4759–6796); cognitive impairment, OR 2802 (95% CI 2448–3208); and age over 85 years, OR 2191 (95% CI 1821–2636). Total mortality at 30 days and 1 year was 4.4% and 13.7%, respectively, both being higher in the care home patients, with an adjusted HR of 1472 (95% CI 1236–1753) and 1421 (95% CI 1282–1576), respectively. There were no differences in ED revisits or hospitalization in 30 days and 1 year in the adjusted global model.</div></div><div><h3>Conclusions</h3><div>Patients aged 65 or older who consult in the ED and live in a care home have a worse baseline condition compared to those living at home. During follow-up at 30 days and 1 year, these patients also have higher overall mortality, although there are no differences in ED revisits or hospitalization.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 5","pages":"Article 502281"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}