Person:
Fernández Pérez, Cristina

First Name

Cristina

Last Name

Fernández Pérez

URI

https://hdl.handle.net/20.500.14352/77390

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Enfermería, Fisioterapia y Podología

Department

Enfermería

Area

Enfermería

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Now showing 1 - 9 of 9

Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment
(Journal of Clinical Medicine, 2021) Marco Martínez, Javier; Bernal Sobrino, José Luis; Fernández Pérez, Cristina; Elola Somoza, Francisco Javier; Azaña Gómez, Javier; García Klepizg, José Luis; Andrès, Emmanuel; Zapatero Gaviria, Antonio; Barba Martín, Raquel; Marco Martínez, Fernando; Canora Lebrato, Jesus; Lorenzo Villalba, Noel; Méndez Bailón, Manuel
Background: Femoral neck fracture (FNF) is a common condition with a rising incidence, partly due to aging of the population. It is recommended that FNF should be treated at the earliest opportunity, during daytime hours, including weekends. However, early surgery shortens the available time for preoperative medical examination. Cardiac evaluation is critical for good surgical outcomes as most of these patients are older and frail with other comorbid conditions, such as heart failure. The aim of this study was to determine the impact of heart failure on in-hospital outcomes after surgical femoral neck fracture treatment. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2007–2015. We included patients older than 64 years treated for reduction and internal fixation of FNF. Demographic characteristics of patients, as well as administrative variables, related to patient’s diseases and procedures performed during the episode were evaluated. Results: A total of 234,159 episodes with FNF reduction and internal fixation were identified from Spanish National Health System hospitals during the study period; 986 (0.42%) episodes were excluded, resulting in a final study population of 233,173 episodes. Mean age was 83.7 (±7) years and 179,949 (77.2%) were women (p < 0.001). In the sample, 13,417 (5.8%) episodes had a main or secondary diagnosis of heart failure (HF) (p < 0.001). HF patients had a mean age of 86.1 (±6.3) years, significantly older than the rest (p < 0.001). All the major complications studied showed a higher incidence in patients with HF (p < 0.001). Unadjusted in-hospital mortality was 4.1%, which was significantly higher in patients with HF (18.2%) compared to those without HF (3.3%) (p < 0.001). The average length of stay (LOS) was 11.9 (±9.1) and was also significantly higher in the group with HF (16.5 ± 13.1 vs. 11.6 ± 8.7; p < 0.001). Conclusions: Patients with HF undergoing FNF surgery have longer length of stay and higher rates of both major complications and mortality than those without HF. Although their average length of stay has decreased in the last few years, their mortality rate has remained unchanged.
Letter in response to article in journal of infection: “High SARS-CoV-2 antibody prevalence among healthcare workers exposed to COVID-19 patients”
(Journal of infection, 2020) Arriola Villalobos, Pedro; Fernández Pérez, Cristina; Ariño Gutiérrez, Mayte; Fernández Vigo, José Ignacio; Benito Pascual, Blanca; Cabello Clotet, Noemí; Mayol Martínez, Julio; Gegúndez Fernández, José Antonio; Díaz Valle, David; Benítez del Castillo, José Manuel; García Feijoo, Julián
Procalcitonina es superior a recuento linfocitario, índice neutrófilo/linfocito y proteína C reactiva para la predicción de mortalidad a 30 días de pacientes con COVID-19 en el servicio de urgencias
(Emergencias, 2021) López Ayala, Pedro; Alcaraz Serna, Ana; Valls Carbó, Adrián; Torrejón Martínez, María José; López Picado, Amanda; Martínez Valero, Carmen; Miranda, Juande D.; Cozar López, Gabriel; Suárez Cadenas, María del Mar; Jerez Fernández, Pablo; Angós, Beatriz; Rodríguez Adrada, Esther; Cardassay, Eduardo; Toro, Enrique del; Cuadrado Cenzual, María Ángeles; Díaz Del Arco, Cristina; Chaparro, David; Montalvo Moraleda, María Teresa; Espejo Paeres, Carolina; García Briñón, Miguel Ángel; Hernández Martín-Romo, Víctor; Ortega, Luis; Fernández Pérez, Cristina; Martínez Novillo, Mercedes; González Armengol, Juan Jorge; González del Castillo, Juan; Mueller, Christian E.; Martín Sánchez, Francisco Javier
Introducción. Existen múltiples variables demográficas y clínicas predictivas demortalidadenpacientes con COVID-19. Sin embargo, hay menos información sobre el valor pronóstico de los biomarcadores inflamatorios. Métodos. Estudio de cohorte retrospectivo. Se incluyeron de forma consecutiva todos los pacientes con COVID-19, confirmado por laboratorio, atendidos en un servicio de urgencias hospitalario (SUH) y con valor basal de los siguientes biomarcadores: recuento linfocitario, índice neutrófilo/linfocito (INL), proteína C reactiva (PCR) y procalcitonina (PCT). La relación entre los biomarcadores y la mortalidad total a 30 días se analizó mediante una regresión de Cox y gráficos de dosis-respuesta. Resultados. Se incluyeron 896 pacientes, 151 (17%) fallecieron en los primeros30 días. La mediana de edad fue de 63 años (51-78) y 494 (55%) eran hombres. El valor de INL, PCR y PCT fue mayor, mientras que el recuento linfocitario fue menor, en los pacientes que fallecieron respecto a los que sobrevivieron (p < 0,001). La PCT fue superior al recuento linfocitario, INL y PCR en la predicción de mortalidad a 30 días (ABC 0,79 [IC 95%: 0,75-0,83] vs 0,70 [IC 95%: 0,65-0,74], p<0,001; 0,74 [IC 95%: 0,69-0,78], p=0,03; y 0,72 [IC 95%: 0,68-0,76], p<0,001). Los puntos de decisión de PCT propuestos, 0,06 ng/l para exclusión y 0,72 ng/l para inclusión de muerte a 30 días, podrían facilitar la toma de decisiones en urgencias. Hubo 357 pacientes (40%) con valores de PCT en estas categorías. El análisis multivariable mostró una mayor asociación con la mortalidad para PCT que en los otros biomarcadores estudiados. Conclusión. PCT es el biomarcador con mejor capacidad para predecir mortalidad a 30 días por cualquier causa en pacientes con COVID-19 valorados en un SUH.
Identificación y cuantificación del efecto fin de semana y festivos en la atención del síndrome coronario agudo en el Sistema Nacional de Salud
(2022) Fernández Ortiz, Antonio Ignacio; Bas Villalobos, Marian Cristina; García Márquez, María; Bernal Sobrino, José Luis; Fernández Pérez, Cristina; Prado González, Náyade del; Viana Tejedor, Ana Teresa; Núñez Gil, Iván; Macaya Miguel, Carlos; Elola Somoza, Francisco Javier
Introducción y objetivos Analizar si el ingreso en fin de semana o festivo (IFSF), frente al ingreso en días laborables, influye en el tratamiento (angioplastia, intervención coronaria percutánea [ICP]) y los resultados (mortalidad hospitalaria) de los pacientes hospitalizados por síndrome coronario agudo en el Sistema Nacional de Salud. Métodos Estudio observacional retrospectivo de pacientes ingresados por infarto agudo de miocardio con elevación del segmento ST (IAMCEST) o con síndrome coronario agudo sin elevación del segmento ST (SCASEST) en los hospitales del Sistema Nacional de Salud durante el periodo 2003-2018. Resultados Se seleccionaron 438.987 episodios de IAMCEST y 486.565 de SCASEST, de los cuales fueron IFSF el 28,8 y el 26,1% respectivamente. El IFSF se mostraba como un factor de riesgo de mortalidad hospitalaria en los modelos ajustados por riesgo del IAMCEST (OR=1,05; IC95%, 1,03-1,08; p<0,001) y del SCASEST (OR=1,08; IC95%, 1,05-1,12; p <0,001). La tasa de ICP en el IAMCEST fue más de 2 puntos porcentuales mayor en los pacientes ingresados en días laborables durante el periodo 2003-2011 y similar o incluso más baja en 2012-2018, sin cambios significativos para el SCASEST. El IFSF se mostró como factor de riesgo estadísticamente significativo tanto para el IAMCEST como para el SCASEST. Conclusiones El IFSF puede aumentar el riesgo de muerte hospitalaria en un 5% (IAMCEST) y un 8% (SCASEST). La persistencia del riesgo de mayor mortalidad hospitalaria tras ajustar por la realización de ICP y las demás variables explicativas probablemente indique dficiencias en el tratamiento durante el fin de semana respecto de los días laborables.
Increasing Influenza Vaccination in Primary HealthcareWorkers Using Solidary Incentives: Analysis of Efficacy and Costs
(Vaccines, 2023) Bengoa Terrero, Christian; Bas Villalobos, Marian; Pastor Rodríguez-Moñino, Ana; Lasheras Carbajo, María Dolores; Pérez Villacastín Domínguez, Julián; Fernández Pérez, Cristina; García Torrent, María Jesús; Sánchez del Hoyo, Rafael; García Lledó, Alberto
Introduction: Influenza vaccination campaigns have difficulty in reaching the 75% uptake in healthcare workers (HCWs) that public health organizations target. This study runs a campaign across 42 primary care centers (PCCs) where for every HCW vaccinated against influenza, a polio vaccine is donated through UNICEF for children in developing nations. It also analyses the efficacy and cost of the campaign. Method: This observational prospective non-randomized cohort study was conducted across 262 PCCs and 15.812 HCWs. A total of 42 PCCs were delivered the full campaign, 114 were used as the control group, and 106 were excluded. The vaccine uptake in HCWs within each of those PCCs was registered. The cost analysis assumes that campaign costs remain stable year to year, and the only added cost would be the polio vaccines (0.59€). Results: We found statistically significant differences between both groups. A total of 1423 (59.02%) HCWs got vaccinated in the intervention group and 3768 (55.76%) in the control group OR 1.14, CI 95% (1.04–1.26). In this scenario, each additional HCW vaccinated in the intervention group costs 10.67€. Assuming all 262 PCCs had joined the campaign and reached 59.02% uptake, the cost of running this incentive would have been 5506€. The potential cost of increasing uptake in HCWs by 1% across all PCC (n = 8816) would be 1683€, and across all healthcare providers, 8862€ (n = 83.226). Conclusions: This study reveals that influenza vaccination uptake can be innovative by including solidary incentives and be successful in increasing uptake in HCWs. The cost of running a campaign such as this one is low.
Heart Failure Is a Poor Prognosis Risk Factor in Patients Undergoing Cholecystectomy: Results from a Spanish Data-Based Analysis
(Journal of Clinical Medicine, 2021) Marco Martínez, Javier; Elola Somoza, Francisco Javier; Fernández Pérez, Cristina; Bernal Sobrino, José Luis; Azaña Gómez, Francisco Javier; García Klepizg, José Luis; Andrès, Emmanuel; Zapatero Gaviria, Antonio; Barba Martín, Raquel; Calvo Manuel, Elpidio; Canora Lebrato, Jesus; Lorenzo Villalba, Noel; Méndez Bailón, Manuel
Background: The incidence of cholecystectomy is increasing as the result of the aging worldwide. Our aim was to determine the influence of heart failure on in-hospital outcomes in patients undergoing cholecystectomy in the Spanish National Health System (SNHS). Methods: We conducted a retrospective study using the Spanish National Hospital Discharge Database. Patients older than 17 years undergoing cholecystectomy in the period 2007–2015 were included. Demographic and administrative variables related to patients’ diseases as well as procedures were collected. Results: 478,111 episodes of cholecystectomy were identified according to the data from SNHS hospitals in the period evaluated. From all the episodes, 3357 (0.7%) were excluded, as the result the sample was represented by 474,754 episodes. Mean age was 58.3 (+16.5) years, and 287,734 (60.5%) were women (p < 0.001). A primary or secondary diagnosis of HF was identified in 4244 (0.89%) (p < 0.001) and mean age was 76.5 (+9.6) years. A higher incidence of all main complications studied was observed in the HF group (p < 0.001), except stroke (p = 0.753). Unadjusted in-hospital mortality was 1.1%, 12.9% in the group with HF versus 1% in the non HF group (p < 0.001). Average length of hospital stay was 5.4 (+8.9) days, and was higher in patients with HF (16.2 + 17.7 vs. 5.3 + 8.8; p < 0.001). Risk-adjusted in-hospital mortality models’ discrimination was high in both cases, with AUROC values = 0.963 (0.960–0.965) in the APRG-DRG model and AUROC = 0.965 (0.962–0.968) in the CMS adapted model. Median odds ratio (MOR) was high (1.538 and 1.533, respectively), stating an important variability of risk-adjusted outcomes among hospitals. Conclusions: The presence of HF during admission increases in hospital mortality and lengthens the hospital stay in patients undergoing cholecystectomy. However, mortality and hospital stay have significantly decreased during the study period in both groups (HF and non HF patients).
Increasing Influenza Vaccination in Primary Healthcare Workers Using Solidary Incentives: Analysis of Efficacy and Costs
(Vaccines, 2023) Bengoa Terrero, Christian; Bas Villalobos, Marian; Pastor Rodríguez-Moñino, Ana; Lasheras Carbajo, María Dolores; Pérez-Villacastín Domínguez, Julián; Fernández Pérez, Cristina; García Torrent, María Jesús; Sánchez del Hoyo, Rafael; García Lledó, Alberto
Introduction: Influenza vaccination campaigns have difficulty in reaching the 75% uptake in healthcare workers (HCWs) that public health organizations target. This study runs a campaign across 42 primary care centers (PCCs) where for every HCW vaccinated against influenza, a polio vaccine is donated through UNICEF for children in developing nations. It also analyses the efficacy and cost of the campaign. Method: This observational prospective non-randomized cohort study was conducted across 262 PCCs and 15.812 HCWs. A total of 42 PCCs were delivered the full campaign, 114 were used as the control group, and 106 were excluded. The vaccine uptake in HCWs within each of those PCCs was registered. The cost analysis assumes that campaign costs remain stable year to year, and the only added cost would be the polio vaccines (0.59€). Results: We found statistically significant differences between both groups. A total of 1423 (59.02%) HCWs got vaccinated in the intervention group and 3768 (55.76%) in the control group OR 1.14, CI 95% (1.04–1.26). In this scenario, each additional HCW vaccinated in the intervention group costs 10.67€. Assuming all 262 PCCs had joined the campaign and reached 59.02% uptake, the cost of running this incentive would have been 5506€. The potential cost of increasing uptake in HCWs by 1% across all PCC (n = 8816) would be 1683€, and across all healthcare providers, 8862€ (n = 83.226). Conclusions: This study reveals that influenza vaccination uptake can be innovative by including solidary incentives and be successful in increasing uptake in HCWs. The cost of running a campaign such as this one is low.
Bioanalytical Detection of Steroid Abuse in Sports Based on the Androgenic Activity Measurement
(Chemosensors, 2021) Martín Escudero, M. Del Pilar; Muñoz Guerra, Jesus A.; García Tenorio, Soledad Vargas; Serrano Garde, Ester; Soldevilla Navarro, Ana Belén; Cortes Carrillo, Nuria; Galindo Canales, Mercedes; del Prado, Nayade; Fuentes Ferrer, Manuel; Fernández Pérez, Cristina; Behnisch, Peter Alexander; Brouwer, Abraham
The anabolic androgenic steroids (AAS) are the most frequently consumed performance enhancing drugs (PED) in sports. In the anti-doping field, the detection of AAS is carried out by the analysis of the athlete’s urine using methodologies based on liquid/gas chromatography-mass spectrometry. Unfortunately, the detection of unknown compounds is not possible. BDS’s AR CALUX® bio detection technology was studied as an indirect method to detect the administration of a single dose of testosterone (T). Twelve T and placebo single dose administered men volunteers underwent a triple-blind crossover clinical trial. The UGT2B17 deletion was present among the volunteers and evenly distributed in heterozygous (ins/del), wild-type homozygous (ins/ins), and mutated homozygous (del/del) groups. A significant statistical difference in terms of bioluminescence was observed after the testosterone (T) administration for the three types of polymorphic groups. The ratio of means between the pre- and post-T administration periods, depending on the type of polymorphism, was in group ins/ins 3.31 (CI. 95%: 2.07–5.29), group ins/del 4.15 (CI 95%: 3.05–5.67), and group del/del 2.89 (CI 95%: 2.42–3.46). The results of the study are very promising, as they may offer us the possibility of designing a detection approach that, based on intra-individual monitoring of androgenic values, in the UGT2B17 deletion type.
Trends in cardiogenic shock management and prognostic impact of type of treating center
(Revista Española de Cardiología, 2020) Sánchez Salado, José C.; Bernal, José Luis; Fernández Pérez, Cristina; Martínez-Sellés D Oliveira Soares, Manuel; Viana Tejedor, Ana Teresa; Bueno Zamora, Héctor José; Elola, Javier
Las guías de práctica clínica actuales recomiendan centralizar la atención de los pacientes con shock cardiogénico en centros de alto volumen. El objetivo de este estudio era evaluar la asociación entre las características hospitalarias, incluida la disponibilidad de una unidad de cuidados intensivos cardiológicos y los resultados en los pacientes con shock cardiogénico relacionado con infarto de miocardio con elevación del segmento ST (IAMCEST). Métodos: Los episodios de alta con diagnóstico de SC relacionado con IAMCEST entre 2003 y 2015 fueron seleccionados del Conjunto Mínimo de Datos del Sistema Nacional de Salud español. Los centros se clasificaron en función de la disponibilidad de servicio de cardiología, laboratorio de hemodinámica, servicio de cirugía cardiaca y unidad de cuidados intensivos cardiológicos. El resultado principal medido fue la mortalidad intrahospitalaria. Resultados: Se identificaron un total de 19.963 episodios. La edad media era de 73,4 años. La proporción de pacientes con SC tratados en hospitales con laboratorio de hemodinámica y servicio de cirugía cardíaca aumentó del 38,4% en 2005 al 52,9% en 2015 (p < 0,005). Las tasas de mortalidad bruta y ajustada por riesgo disminuyeron con el tiempo, del 82% al 67,1%, y del 82,7% al 66,8%, respectivamente (ambas P < 0,001). La revascularización coronaria, ya fuera percutánea o mediante bypass coronario, se asoció de forma independiente a un menor riesgo de mortalidad (OR 0,29 y 0,25; ambas p < 0,001, respectivamente). La disponibilidad de cuidados intensivos cardiológicos se asoció a tasas de mortalidad ajustadas más bajas (65,3% frente a 72%; P < 0.001). Conclusiones: La proporción de pacientes con SC relacionada con IAMCEST tratados en centros altamente especializados aumentó mientras que la mortalidad disminuyó durante el período de estudio. Los mejores resultados se asociaron a la mayor realización de procedimientos de revascularización y al acceso a unidades de cuidados intensivos cardiológicos a lo largo del tiempo.