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RISS 인기검색어
- 검색키워드
- 저자 : ( Gabriel Dario Waisman ) (검색결과 3 건)
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( Nora Angelica Fuentes ),( Diego Hernan Giunta ),( Cristina Maria Elizondo ),( Fernan Gonzalez Bernaldo De Quiros ),( Gabriel Dario Waisman ),( Juan Carlos Ayus ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Hip Fracture (HF) is a leading cause of morbidity and mortality in elderly. Related complications are cardiovascular (CVD), sepsis and venous thromboembolism (VTE), deep venous thrombosis (DVT) and pulmonary embolism (PE). In recent studies, chronic hyponatremia was observed to be an independent risk factor for hip fracture, nevertheless there is no evidence on prognosis of these patients compared to patients without hyponatremia. Objective: To compare the prognosis and complications of HF in normonatremic patients (N) and hyponatremic patients (H). Methods: Retrospective cohort of hospitalized patients with HF, followed up to 30 days after diagnosis, at Hospital Italiano of Buenos Aires. Presence of complications (sepsis, DVT, PE, and CVD), hospital length of stay, mortality and readmission were evaluated. Results: 1571 patients were included, 76, 7% (1205) for N and 23, 3% (366) for H. Most patients were female, 82. 5% and 79. 8% for H and N respectively. H were older, 85 vs. 82 years (p<0. 001). Sepsis was the most frequent complication for H (OR 1. 7, 95% CI: 1. 13-2. 6). Length of stay was 7 days vs. 8 days (p=0. 053) for N and H. Readmissions were 12. 9% for N vs. 15. 8% for H (p=0. 14). Hospital mortality was minor for N than for H (14. 7% vs. 19. 9%; p=0. 016), crude OR was 1. 45 (1. 07-1. 96) and adjusted OR was 1. 15 (0. 84-1. 6). Survival was higher for N than for H (p<0. 001). Crude hazard ratio (HR) of death for H compared to N was 1. 8 (1. 4-2. 35) and adjusted HR was 1. 45 (1. 1-1. 9). Conclusions: Hyponatremic patients have higher risk of sepsis, hospital length of stay and mortality. Thus hyponatremia could represent a marker of severity of underlying diseases or be a consequence of treatments during the surgical procedures, it could serve as alert for potential risk on outcome of these patients.
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( Maria Lourdes Posadas Martinez ),( Fernando Javier Vazquez ),( Fernan Gonzalez Bernaldo De Quiros ),( Liliana Paloma Rojas ),( Gabriel Dario Waisman ),( Diego Hernan Giunta ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Venous thromboembolism (VTE) is the most common cause of preventable mortality in hospitalized patients. On plus, pulmonary embolism (PE) is responsible for 5-10% of all hospital deaths. Objective: To estimate the incidence density (ID) and hospital mortality of VTE among clinical and surgical inpatients. Methods: Prospective cohort, during a period of 7 years, of incident cases of VTE, PE, and deep venous thrombosis (DVT), in patients of 17 years and older, hospitalized at the internal medicine and surgery department of a tertiary care hospital in Buenos Aires. Fatality rate of patients with VTE was calculated. Results: 2042 episodes of VTE were registered. Sixty two percent (1258) were patients from the Internal Medicine Service: 635 cases (95%, CI:601-671) presented VTE, 446 cases (95%, CI:418-476) presented DVT and 286 cases (95% CI:264-311) presented PE per 1000 person-days of hospitalization. For patients hospitalized at surgery department: 102 cases (95%, CI:96-110), 83 (95%, CI: 77-90) and 31 cases (95%, CI: 27-35) per 1000 person-days of hospitalization presented VTE, DVT and PE respectively. The VTE represented between 3 to 9 % of hospital deaths, it increases with age independently of being clinical or surgical inpatients. Conclusions: In Argentina, there are few data of incidences of VTD and hospital mortality in patients with VTE. This information may be important when assessing the need for resources for prevention, diagnosis and treatment in hospitals.
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( Javier Nicolas Giunta ),( Daniel Liarte ),( Bruno Rafael Boietti ),( Francisco Carlos Bonofiglio ),( Cristina Maria Elizondo ),( Luis Grosembacher ),( Leon Efrain Litwak ),( Gabriel Dario Waisman ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: It is unknown if values of glycosylated hemoglobin (HbA1c) could predict complications in the immediate postoperative period in diabetic patients. Objective: To compare the incidence of immediate postoperative complications in diabetic patients with controlled (GC) vs. uncontrolled (GUC) HbA1c. Methods: Prospective cohort of type 2 diabetic patients, divided in 2 groups: GC (HbA1c = 7%) and GUC (HbA1c> 7%), followed for 30 days after major elective surgery, through 2012-2013. Considered complications were: readmissions, infections, cardiovascular events, stroke, and mortality. Results: 163 patients were enrolled: 75.5% (123) for GC and 24.5% (40) for GUC. Mean age was 66 years (SD:10) for GC, and 62 years (SD:13) for GUC. 54% and 60% were male for GC and GUC respectively. For GC, main surgeries were: urologic (23,6%); traumatologic (21,9%) and biliar (11.4%); for GUC main surgeries were: traumatologic (25%), urologic (22.5%) and bariatric (17.5%). Variables with no statistically significant differences between groups were: gender (p=0.48), age (p=0.06), Charlson co-morbidity score (p=0.69), BMI (p=0.33), current smoker (p=0.85) or ex-smoker (p=0.18), physical activity (p=0.97), hypertension (p=0.09), dyslipidemia (p=0.34), chronic renal failure (p=0.96), neoplasms (p=0.7), diabetic nephropathy (p=0,84), retinopathy (p=0.09), neuropathy (p=0.22) or peripheral vascular disease (p=0,82). Statistically significant difference was found for coronary disease, 31% vs. 15% (p=0.049), for GC and GUC respectively. The incidence for immediate postoperative complications in GC was 11.4% (14): 9 infections, 8 were readmitted and one cardiovascular event. In GUC, complication incidence was 17.5% (7): 4 infections, 4 readmissions, 1 stroke and 2 deaths. Crude HR control for complications was 0.65% (95%,CI:0,26-1.6, p=0,35). Discussion: Although we did not find a significant incidence of postoperative complications between controlled and uncontrolled groups, the uncontrolled group had more postoperative complications and survival curves were different, although without statistical significance.
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