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Factores asociados con la estancia media hospitalaria prolongada en pacientes con neumonía por el virus de la gripe A H1N1
Factor Associated with Prolonged Hospital Stay in Patients with H1N1 Virus Influenza
Enrique Bernal
, A. Ángeles Muñoz, Alfredo Cano
Corresponding author
Sección de Enfermedades Infecciosas, Hospital General Universitario Reina Sofía, Murcia, España
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En los pacientes ingresados, las tasas de prevalencia de neumonía oscilan entre el 39 y el 66%<a class="elsevierStyleCrossRefs" href="#bib1"><span class="elsevierStyleSup">1,3,4</span></a>, diferencias atribuibles a la heterogeneicidad de los criterios de ingresos utilizados y a la sensibilidad del sistema de detección de casos. La evolución desfavorable de los pacientes ingresados se ha relacionado con el retraso en el inicio del tratamiento antiviral, la utilización de corticoides, la edad de los pacientes y la existencia de enfermedad neuromuscular<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a>.</p><p id="p0010" class="elsevierStylePara elsevierViewall">Presentamos un estudio prospectivo, observacional y descriptivo realizado en el Hospital General Universitario Reina Sofía de Murcia, de 250 camas de adultos que atiende a una población de 200.000 habitantes, desde el 25 de abril al 31 de diciembre de 2009. El objetivo fue estimar la frecuencia de neumonía en pacientes ingresados con infección por el virus de la gripe A (H1N1) y determinar los factores relacionados con la estancia media hospitalaria prolongada. Para evaluar la gravedad de los pacientes se utilizó el índice de gravedad de la neumonía (IGN)<a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a>. El virus de la gripe A (H1N1) fue determinado por exudado nasofaríngeo y PCR a tiempo real mediante RealTime ready Influenza A/H1N1 Detection test de Roche. Para ingresar a los pacientes se siguieron las guías internacionales<a class="elsevierStyleCrossRef" href="#bib6"><span class="elsevierStyleSup">6</span></a> y desde septiembre de 2009 las recomendaciones del Ministerio de Sanidad<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>.</p><p id="p0015" class="elsevierStylePara elsevierViewall">Se diagnosticaron 537 pacientes con infección por el virus de la gripe A (H1N1) y se ingresaron a 97 pacientes. La prevalencia de neumonía fue de 37,1% (intervalo de confianza [IC, 95%], 27,4–46,6%) entre los ingresados. En la <a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a> se representan las características principales de los 36 pacientes con neumonía.</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0020" class="elsevierStylePara elsevierViewall">La estancia media fue de 6,43 (desviación estándar [DE], 4,83) días. Considerando la estancia media como variable dependiente, se realizó un análisis multivariante lineal en el que se incluyeron la edad, el sexo, la presencia de factores de riesgo para gripe A complicada<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a> y/o enfermedades de base, hábito tabáquico, afectación neumónica multilobar y bilateral, existencia de coinfección, saturación de oxígeno al ingreso, existencia de leucopenia, concentraciones de LDH, utilización de corticoides, tiempo hasta el inicio de oseltamivir, ingreso en la UCI e IGN. El IGN (coeficiente estandarizado beta [CEB], +0,317), la existencia de coinfección (CEB, +0,276), la saturación de oxígeno al ingreso (CEB, −0,676) y la utilización de corticoides (CEB, −0,368) fueron los mejores predictores (r<span class="elsevierStyleSup">2</span>=0,765; p<=0,001) de estancia media prolongada.</p><p id="p0025" class="elsevierStylePara elsevierViewall">Los hallazgos de nuestro estudio muestran una prevalencia elevada de neumonía en los pacientes ingresados por gripe A (H1N1)<a class="elsevierStyleCrossRefs" href="#bib1"><span class="elsevierStyleSup">1,3,4</span></a>. La gravedad de los pacientes, la insuficiencia respiratoria al ingreso y la existencia de coinfección, son factores de severidad conocidos que pueden influir negativamente en el desenlace de la neumonía y prolongar así la estancia media. Fine et al<a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a> encontraron una estancia media de 5 días en los pacientes de bajo riesgo (clase <span class="elsevierStyleSmallCaps">i</span>), mientras que aquellos con mayor gravedad (clase <span class="elsevierStyleSmallCaps">v</span>) la duración media del ingreso alcanzó los 11 días. En cambio, la administración de corticoides podría actuar como un factor protector al detener la cascada inflamatoria precipitada por la infección viral y evitar el empeoramiento clínico<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a>.</p><p id="p0030" class="elsevierStylePara elsevierViewall">En resumen, el estudio pone de manifiesto que la neumonía es una complicación frecuente en los pacientes ingresados con infección por el virus de la gripe A (H1N1) y que los factores identificados deberían considerarse al evaluar la idoneidad de la duración del ingreso hospitalario en la neumonía en los pacientes con infección por el virus de la gripe A (H1N1).</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-06-04" "fechaAceptado" => "2010-06-19" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "t0005" "etiqueta" => "Tabla 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Variables continuas representadas como media (desviación estándar) y variables categóricas como numero (%).</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">EPOC: enfermedad pulmonar obstructiva crónica; IGN: índice gravedad neumonía; IMC: índice de masa corporal; LDH: lactato deshidrogenasa; UCI: unidad de cuidados intensivos.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Edad, años \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42,69 (19,03) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><18 años, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (5,6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>18–49 años, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (66,7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>50–64 años, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (16,7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>≥65 años, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (11,1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sexo varón, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (69,44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tipo de afectación pulmonar</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unilobar, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (38,9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multilobar, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (16,7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intersticial, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (63,9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bilateral, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (55,6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bronconeumonía, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (16,7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Derrame pleural, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (5,5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neumotórax, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infección asociada, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (19,4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clasificación IGN, %</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (36,1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (25) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (22,2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (13,8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio V \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2,8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vacunación gripe estacional, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (13,88) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vacunación gripe A (H1N1), % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2,7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fumador, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (30,55) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Enfermedad de base o factor de riesgo, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (55,5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Embarazo, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Asma, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (11,1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EPOC, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (16,6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Enfermedad neurológica, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (8,33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Enfermedad hepática crónica, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2,77) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neoplasia, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2,77) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiopatía, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2,7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Insuficiencia renal crónica, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (5,5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Esplenectomía, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inmunodepresión, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diabetes, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (16,6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Obesidad (IMC>30–39<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>), % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (25) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Obesidad mórbida (IMC≥40<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>), % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (16,6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sintomatología</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fiebre, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escalofríos, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (83,33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tos, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Expectoración, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (52,77) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disnea, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (63,88) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dolor torácico, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (33,33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cefalea, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (30,55) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Artromialgias, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (75) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diarrea, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (19,4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Malestar general, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (66,66) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Insuficiencia respiratoria, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (36,11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LDH (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">329,23 (164,23) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leucocitos (células/mm<span class="elsevierStyleSup">3</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.655,56 (5.701,7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Plaquetas (células/mm<span class="elsevierStyleSup">3</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">182.166,6 (52.925,5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Utilización de antiobiótico, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Utilización de corticoides, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (36,11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inicio de oseltamivir ≤48<span class="elsevierStyleHsp" style=""></span>h, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (30,55) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ingreso en UCI, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (11,11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Estancia media (días) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6,43 (4,82) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortalidad \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab262538.png" ] ] ] ] "descripcion" => array:1 [ "es" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Características generales de los pacientes 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 3 | 6 |
| 2024 October | 54 | 20 | 74 |
| 2024 September | 51 | 15 | 66 |
| 2024 August | 74 | 35 | 109 |
| 2024 July | 52 | 23 | 75 |
| 2024 June | 69 | 19 | 88 |
| 2024 May | 80 | 28 | 108 |
| 2024 April | 59 | 26 | 85 |
| 2024 March | 44 | 26 | 70 |
| 2024 February | 38 | 35 | 73 |
| 2024 January | 0 | 1 | 1 |
| 2023 December | 0 | 1 | 1 |
| 2023 October | 0 | 4 | 4 |
| 2023 September | 0 | 1 | 1 |
| 2023 July | 0 | 6 | 6 |
| 2023 June | 0 | 16 | 16 |
| 2023 March | 7 | 6 | 13 |
| 2023 February | 47 | 21 | 68 |
| 2023 January | 40 | 23 | 63 |
| 2022 December | 53 | 22 | 75 |
| 2022 November | 61 | 33 | 94 |
| 2022 October | 53 | 20 | 73 |
| 2022 September | 39 | 28 | 67 |
| 2022 August | 33 | 37 | 70 |
| 2022 July | 40 | 52 | 92 |
| 2022 June | 28 | 27 | 55 |
| 2022 May | 72 | 30 | 102 |
| 2022 April | 77 | 37 | 114 |
| 2022 March | 73 | 38 | 111 |
| 2022 February | 66 | 22 | 88 |
| 2022 January | 90 | 29 | 119 |
| 2021 December | 63 | 40 | 103 |
| 2021 November | 52 | 49 | 101 |
| 2021 October | 77 | 47 | 124 |
| 2021 September | 47 | 50 | 97 |
| 2021 August | 36 | 41 | 77 |
| 2021 July | 41 | 22 | 63 |
| 2021 June | 41 | 34 | 75 |
| 2021 May | 44 | 33 | 77 |
| 2021 April | 114 | 72 | 186 |
| 2021 March | 67 | 19 | 86 |
| 2021 February | 108 | 25 | 133 |
| 2021 January | 89 | 21 | 110 |
| 2020 December | 43 | 17 | 60 |
| 2020 November | 59 | 30 | 89 |
| 2020 October | 35 | 14 | 49 |
| 2020 September | 40 | 16 | 56 |
| 2020 August | 33 | 16 | 49 |
| 2020 July | 31 | 22 | 53 |
| 2020 June | 24 | 12 | 36 |
| 2020 May | 34 | 20 | 54 |
| 2020 April | 35 | 18 | 53 |
| 2020 March | 38 | 22 | 60 |
| 2020 February | 34 | 27 | 61 |
| 2020 January | 40 | 33 | 73 |
| 2019 December | 47 | 25 | 72 |
| 2019 November | 25 | 21 | 46 |
| 2019 October | 27 | 18 | 45 |
| 2019 September | 26 | 16 | 42 |
| 2019 August | 28 | 31 | 59 |
| 2019 July | 23 | 31 | 54 |
| 2019 June | 23 | 19 | 42 |
| 2019 May | 37 | 39 | 76 |
| 2019 April | 24 | 33 | 57 |
| 2019 March | 27 | 28 | 55 |
| 2019 February | 26 | 22 | 48 |
| 2019 January | 33 | 24 | 57 |
| 2018 December | 23 | 13 | 36 |
| 2018 November | 56 | 27 | 83 |
| 2018 October | 63 | 21 | 84 |
| 2018 September | 22 | 8 | 30 |
| 2018 June | 1 | 0 | 1 |
| 2018 May | 18 | 1 | 19 |
| 2018 April | 35 | 7 | 42 |
| 2018 March | 27 | 7 | 34 |
| 2018 February | 49 | 8 | 57 |
| 2018 January | 35 | 7 | 42 |
| 2017 December | 38 | 9 | 47 |
| 2017 November | 32 | 9 | 41 |
| 2017 October | 35 | 8 | 43 |
| 2017 September | 48 | 8 | 56 |
| 2017 August | 56 | 6 | 62 |
| 2017 July | 45 | 6 | 51 |
| 2017 June | 60 | 11 | 71 |
| 2017 May | 56 | 5 | 61 |
| 2017 April | 50 | 5 | 55 |
| 2017 March | 61 | 26 | 87 |
| 2017 February | 33 | 5 | 38 |
| 2017 January | 22 | 7 | 29 |
| 2016 December | 32 | 6 | 38 |
| 2016 November | 43 | 8 | 51 |
| 2016 October | 42 | 15 | 57 |
| 2016 September | 39 | 11 | 50 |
| 2016 August | 43 | 13 | 56 |
| 2016 July | 45 | 11 | 56 |
| 2016 June | 61 | 22 | 83 |
| 2016 May | 62 | 9 | 71 |
| 2016 April | 46 | 2 | 48 |
| 2016 March | 57 | 2 | 59 |
| 2016 February | 49 | 3 | 52 |
| 2016 January | 46 | 17 | 63 |
| 2015 December | 54 | 24 | 78 |
| 2015 November | 90 | 16 | 106 |
| 2015 October | 81 | 3 | 84 |
| 2015 September | 52 | 0 | 52 |
| 2015 August | 54 | 0 | 54 |
| 2015 July | 64 | 0 | 64 |
| 2015 June | 54 | 0 | 54 |
| 2015 May | 71 | 0 | 71 |
| 2015 April | 55 | 0 | 55 |
| 2015 March | 63 | 0 | 63 |
| 2015 February | 75 | 0 | 75 |
| 2015 January | 56 | 0 | 56 |
| 2014 December | 58 | 0 | 58 |
| 2014 November | 62 | 0 | 62 |
| 2014 October | 86 | 0 | 86 |
| 2014 September | 70 | 0 | 70 |
| 2014 August | 68 | 0 | 68 |
| 2014 July | 68 | 0 | 68 |
| 2014 June | 94 | 0 | 94 |
| 2014 May | 95 | 0 | 95 |
| 2014 April | 96 | 0 | 96 |
| 2014 March | 108 | 0 | 108 |
| 2014 February | 111 | 0 | 111 |
| 2014 January | 80 | 0 | 80 |
| 2013 December | 75 | 0 | 75 |
| 2013 November | 66 | 0 | 66 |
| 2013 October | 65 | 0 | 65 |
| 2013 September | 69 | 0 | 69 |
| 2013 August | 79 | 0 | 79 |
| 2013 July | 95 | 0 | 95 |
| 2013 June | 69 | 0 | 69 |
| 2013 May | 68 | 0 | 68 |
| 2013 April | 26 | 0 | 26 |
| 2013 March | 12 | 0 | 12 |
| 2000 January | 1044 | 0 | 1044 |
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