Estado funcional y mortalidad en pacientes neoplásicos hospitalizados
Objectives: To assess the performance status and its relationship to morbid-mortality in hospitalized oncological patients in an internal medical service. Material and methods: Descriptive, protocolized and observational study. We analyzed clinical parameters, performance and emotional status, mo...
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| Publicado en: | Revista Médica Universitaria |
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| Autores principales: | , , , |
| Materias: | |
| Acceso en línea: | https://bdigital.uncu.edu.ar/fichas.php?idobjeto=3750 |
| descriptores_str_mv |
Datos estadísticos Estado funcional Indicadores de morbimortalidad Medicina clínica Mendoza (Argentina) Neoplasias Paciente oncológico Quimioterapia |
|---|---|
| todos_str_mv |
1221 3745 HospLagClinMed spa UNCuyo FCM Dto. Medicina Interna UNCuyo FCM Dto. Medicina Interna UNCuyoFCMClMed |
| autor_str_mv |
Carena, José Alberto Degiorgi, C. Mosso, Marcelo Salomón, Susana Elsa |
| disciplina_str_mv |
Ciencias médicas |
| titulo_str_mv |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados |
| description_str_mv |
Objectives: To assess the performance status and its relationship to morbid-mortality
in hospitalized oncological patients in an internal medical service.
Material and methods: Descriptive, protocolized and observational study. We analyzed
clinical parameters, performance and emotional status, morbidity and mortality during
a three month period. We carried out a comparative analysis between patients with
Karnofsky index <40 points (group A) and >40 points (group B). Data was analyzed
with Epi Info 6.04, and the criteria of statistical significance was p<0.05.
Results: We included 66 oncological patients, 21 (31.8%) in group A, with an average
Karnofsky index of 25 points (DS±12.09) and 45 (68.2%) in B, with a Karnofsky index
of 77 points (DS±16.65). 77.3% had solid neoplasm and 22.7% hematological. The
most frequent solid tumors were gastrointestinal (19.6%), breast (12.1%), lung
(9.1%) and carcinomas of unknown origin (7.6%) and acute leukemia (73.3%) in the
hematological group (73.3%). The majority of the patients in both groups were in an
advanced tumoral stage, 89.5% in A and 88.9% in B were in stage IV (pNS). The
average age was 59.57 years in A (DS±13.71) and 52.48 years in B (DS±15.65)
(pNS). The male sex was significantly more common in A (66.7% versus 44.4%
respectively) (p<0.05). The average length of stay was 17.57 days in A (DS±20.84)
and 13.53 in B (DS±16.29) (pNS). The evaluation of Diary Life Basic Activities [0.81
(DS±1.25) versus 4.57 points (DS±1.15)] and Instrumental Activities [0.57 (DS±0.74)
versus 4 points (DS±1.37)] were, as expected, superior in B (p<0.05). No differences
were found with respect to the co-morbidities between both groups (85.7% versus
82.2%) (pNS). Infections (52.4% versus 26.7%), poor social conditions (38.1%
versus 4.4%), neoplastic complications (81% versus 51.1%) and pain (81% versus
51.1%) were significantly more frequent due to hospitalization in group A (p<0.05).
Group A patients needed more frequent palliative care (90.5% versus 46.7%) and
received chemotherapy (90.5% versus 46.7%) (p<0.05), without differences in
radiotherapy (23.8% versus 13.3%) and surgery (33.3 versus 33.3%) (pNS). The
incidence of clinical depression and weight lost were similar in both groups (69.9%
versus 53.3%) (86.4% versus 84.2%) (pNS) respectively. Delirium, (85.7% versus
11.1%), prostration (61.9% versus 6.7%) and pressure ulcers (23.8% versus 4.4%)
were found in higher frequency in A (p<0.005). In-hospital mortality was greater in A
(52.4% versus 8.9%) (p<0.05).
Conclusion: The performance status evaluated by Karnofsky Index <40 in oncological
hospitalized patients resulted in an indicator of very bad prognosis.
Objetivos: Analizar el estado funcional y su relación con morbimortalidad en pacientes con neoplasias internados en Cínica Médica. Material y métodos: Estudio descriptivo, protocolizado y observacional. Se analizaron variables clínicas, estado funcional, situación anímica y morbimortalidad en pacientes oncológicos hospitalizados y se compararon pacientes con Índice de Karnofsky <40 puntos (grupo A) y >40 puntos (grupo B). Los datos fueron analizados en EPI Info 6.04. Informe de los primeros 3 meses. Resultados: En el período de estudio, ingresaron 66 pacientes con neoplasias, 21 (31.8%) en A, con Karnofsky promedio de 25 puntos (DS±12.09) y 45 (68.2%) en B, con Karnofsky promedio de 77 puntos (DS±16.65). El 77.3% presentó tumores sólidos y el 22.7% hematológicos y las neoplasias más frecuentes fueron del tracto gastrointestinal (19.6%), mama (12.1%), pulmón (9.1%) y primario oculto (7.6%). El estadio tumoral IV fue el más frecuente en ambos grupos (89.5% de A y 88.9% de B)(pNS). La edad media en A fue de 59.57 (DS±13.71) y 52.48 años (DS±15.65) en B (pNS) y el género masculino fue más frecuente en A (66.7 y 44.4% respectivamente) (p<0.05). La permanencia media fue de 17.57 en A (DS±20.84) y de 13.53 días (DS±16.29) en B (pNS). La evaluación de Actividades Básicas de la Vida Diaria [0.81 (DS±1.25) vs 4.57 puntos (DS±1.15)] y Actividades Instrumentales [0.57 (DS±0.74) vs 4 puntos (DS±1.37)] fue superior en B (p<0.05) y no hubo diferencias en la comorbilidad (85.7 vs 82.2%)(pNS). Las infecciones (52.4 vs 26.7%), causa social (38.1 vs 4.4%), complicaciones neoplásicas (81 vs 51.1%) y dolor (81 vs 51.1%) fueron los motivos de internación más frecuentes en A (p<0.05). Los pacientes de A recibieron con mayor frecuencia cuidados paliativos (90.5 vs46.7%) y quimioterapia (90.5 vs 46.7%)(p<0.05), sin diferencias en radioterapia (23.8 vs 13.3%) y cirugía (33.3 vs 33.3%)(pNS). No hubo diferencias entre ambos grupos en la presencia de depresión clínica (69.9 vs 53.3%) y pérdida de peso (86.4 vs 84.2%)(pNS). El síndrome confusional (85.7 vs 11.1%), postración (61.9 vs 6.7%) y escaras (23.8 vs 4.4%) fueron más frecuentes en A (p<0.05). La mortalidad hospitalaria fue 52.4% en A y 8.9% en B (p<0.05). Conclusiones: El grado de estado funcional evaluado por Karnofsky menor de 40 puntos se asoció significativamente a: mayor mortalidad, uso de quimioterapia, cuidados paliativos, internación por infecciones, dolor y complicaciones neoplásicas y presencia de síndrome confusional, postración y escaras de decúbito (p<0.05). |
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Textual: Revistas |
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3750 |
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Artículo de Revista |
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article |
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Revista Médica Universitaria |
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Revista Médica Universitaria |
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r-1221 |
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Revista Médica Universitaria |
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Vol. 5, no. 2 |
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Vol. 5, no. 2 |
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textuales |
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Articulos |
| title_full |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados |
| title_fullStr |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados Estado funcional y mortalidad en pacientes neoplásicos hospitalizados |
| title_full_unstemmed |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados Estado funcional y mortalidad en pacientes neoplásicos hospitalizados |
| description |
Objectives: To assess the performance status and its relationship to morbid-mortality
in hospitalized oncological patients in an internal medical service.
Material and methods: Descriptive, protocolized and observational study. We analyzed
clinical parameters, performance and emotional status, morbidity and mortality during
a three month period. We carried out a comparative analysis between patients with
Karnofsky index <40 points (group A) and >40 points (group B). Data was analyzed
with Epi Info 6.04, and the criteria of statistical significance was p<0.05.
Results: We included 66 oncological patients, 21 (31.8%) in group A, with an average
Karnofsky index of 25 points (DS±12.09) and 45 (68.2%) in B, with a Karnofsky index
of 77 points (DS±16.65). 77.3% had solid neoplasm and 22.7% hematological. The
most frequent solid tumors were gastrointestinal (19.6%), breast (12.1%), lung
(9.1%) and carcinomas of unknown origin (7.6%) and acute leukemia (73.3%) in the
hematological group (73.3%). The majority of the patients in both groups were in an
advanced tumoral stage, 89.5% in A and 88.9% in B were in stage IV (pNS). The
average age was 59.57 years in A (DS±13.71) and 52.48 years in B (DS±15.65)
(pNS). The male sex was significantly more common in A (66.7% versus 44.4%
respectively) (p<0.05). The average length of stay was 17.57 days in A (DS±20.84)
and 13.53 in B (DS±16.29) (pNS). The evaluation of Diary Life Basic Activities [0.81
(DS±1.25) versus 4.57 points (DS±1.15)] and Instrumental Activities [0.57 (DS±0.74)
versus 4 points (DS±1.37)] were, as expected, superior in B (p<0.05). No differences
were found with respect to the co-morbidities between both groups (85.7% versus
82.2%) (pNS). Infections (52.4% versus 26.7%), poor social conditions (38.1%
versus 4.4%), neoplastic complications (81% versus 51.1%) and pain (81% versus
51.1%) were significantly more frequent due to hospitalization in group A (p<0.05).
Group A patients needed more frequent palliative care (90.5% versus 46.7%) and
received chemotherapy (90.5% versus 46.7%) (p<0.05), without differences in
radiotherapy (23.8% versus 13.3%) and surgery (33.3 versus 33.3%) (pNS). The
incidence of clinical depression and weight lost were similar in both groups (69.9%
versus 53.3%) (86.4% versus 84.2%) (pNS) respectively. Delirium, (85.7% versus
11.1%), prostration (61.9% versus 6.7%) and pressure ulcers (23.8% versus 4.4%)
were found in higher frequency in A (p<0.005). In-hospital mortality was greater in A
(52.4% versus 8.9%) (p<0.05).
Conclusion: The performance status evaluated by Karnofsky Index <40 in oncological
hospitalized patients resulted in an indicator of very bad prognosis.
|
| dependencia_str_mv |
Facultad de Ciencias Médicas |
| title |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados |
| spellingShingle |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados Datos estadísticos Estado funcional Indicadores de morbimortalidad Medicina clínica Mendoza (Argentina) Neoplasias Paciente oncológico Quimioterapia Carena, José Alberto Degiorgi, C. Mosso, Marcelo Salomón, Susana Elsa |
| topic |
Datos estadísticos Estado funcional Indicadores de morbimortalidad Medicina clínica Mendoza (Argentina) Neoplasias Paciente oncológico Quimioterapia |
| topic_facet |
Datos estadísticos Estado funcional Indicadores de morbimortalidad Medicina clínica Mendoza (Argentina) Neoplasias Paciente oncológico Quimioterapia |
| author |
Carena, José Alberto Degiorgi, C. Mosso, Marcelo Salomón, Susana Elsa |
| author_facet |
Carena, José Alberto Degiorgi, C. Mosso, Marcelo Salomón, Susana Elsa |
| title_sort |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados |
| title_short |
Estado funcional y mortalidad en pacientes neoplásicos hospitalizados |
| url |
https://bdigital.uncu.edu.ar/fichas.php?idobjeto=3750 |
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3 |
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Biblioteca Digital |
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Biblioteca Digital |
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Artículo de Revista |
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Sistema Integrado de Documentación |
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2023-04-25 00:38 |
| _version_ |
1764120327902724096 |
