Person:
Fernández Pérez, Cristina

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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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2017 - 201912020 - 20232
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    The Effect of Frailty on 30-day Mortality Risk in Older Patients With Acute Heart Failure Attended in the Emergency Department
    (Academic Emergency Medicine, 2017) Martín Sánchez, Francisco Javier; Rodríguez Adrada, Esther; Vidán Astiz, María Teresa; Fernández Pérez, Cristina; Miró, Oscar; Cuadrado Cenzual, María Ángeles
    Objective: The objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs). Methodology: The Frailty-AHF Study is a retrospective analysis of a multicenter, observational, prospective, cohort study (Older-AHF Register). This study included consecutive patients ≥ 65 years of age without severe functional dependence or dementia attended for AHF in three Spanish EDs for 4 months. Frailty was defined by frailty phenotype as the presence of three or more domains. Baseline and episode characteristics and 30-day mortality were collected in all the patients. Results: A total of 465 patients with a mean (±SD) age of 82 (±7) years were included, 283 (61.0%) being female and 225 (51.3%) with severe comorbidity (Charlson index ≥ 3). Frailty was present in 169 (36.3%). The rate of 30-day mortality was 7.3%. Frailty adjusted for potential confounding factors was an independent factor associated with 30-day mortality (adjusted hazard ratio = 2.5; 95% confidence interval = 1.0 to 6.0; p = 0.047). Conclusion: The presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.
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    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.
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    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.