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Revista Colombiana de Reumatología
versión impresa ISSN 0121-8123
Resumen
MUNOZ-URBANO, Marcela; MORALES, Mónica Andrea y ARBELAEZ-CORTES, Álvaro. Hospital outcomes in patients evaluated by rheumatology in a Colombian historical cohort. Rev.Colomb.Reumatol. [online]. 2022, vol.29, n.3, pp.160-170. Epub 24-Abr-2023. ISSN 0121-8123. https://doi.org/10.1016/j.rcreu.2021.02.012.
Introduction:
Hospitalized patients with systemic autoimmune rheumatic diseases (SARDs) generate high impact in clinical terms.
Objectives:
To characterize the study population and estimate risk factors associated with the presence of adverse outcomes in hospitalized patients consulting rheumatology at Clínica Imbanaco between January 2013 and December 2019.
Methods:
We analyzed a historical cohort of hospitalized patients who were evaluated by rheumatology. The population was classified as follows: group 1, patients with new onset diagnosed SARDs; group 2, patients with known diagnosed SARDs; group 3, patients without diagnosed SARDs; and group 4, patients with unconfirmed suspicion of SARDs. A composite adverse outcome was defined if at least one of the following occurred: (1) hospital mortality, (2) admission to the intensive care unit, (3) hospital infection, or (4) readmission.
Results:
Information was collected from 327 hospitalization events (307 patients). The median age was 48 (34-63) years and 222 (72.3%) were women. The composite adverse outcome occurred in 136 (41.5%) hospitalization events. Group 2 had the highest number of adverse outcomes (61/128; 47.6%). The variables associated with the worst outcomes were cardiovascular diagnosis at admission (OR = 4.63; CI: 1.60-13.43; p = 0.005), longer hospital stay (OR = 1.04; CI: 1.01-1.07; p = 0.005), and a treating specialty other than internal medicine (OR = 2.79; CI: 1.26-6.17; p = 0.011). Male sex (OR = 0.29; CI: 0.12-0.66; p = 0.004), having special health coverage (OR = 0.39; CI: 0.15-.099; p = 0.047), and hemoglobin > 11.4 g/dL (OR = 0.82; CI: 0.69-0.99; p = 0.039) were the factors associated with lower odds of developing the composite outcome.
Conclusions:
In this historical cohort, the group of patients with known diagnosed SARDs presented a higher number in percentage terms of adverse outcomes. The most frequent adverse outcomes were admission to the ICU and hospital readmission.
Palabras clave : Rheumatic diseases; Referral and consultation; Hospital mortality; Hospital infection; Intensive care unit; Patient readmission.