An Assessment of Mortality among Elderly Brazilians from Alcohol Abuse Diseases: A Longitudinal Study from 1996 to 2019

Alcohol use disorder (AUD) is a worldwide public health problem, being an important aggravating factor of comorbidities found in the elderly, with the potential to increase mortality indicators for this age group.

OBJECTIVE

To analyze alcohol-induced deaths in elderly people with alcohol-related disorder in Brazil between 1996 and 2019.

METHODS

An ecological study was conducted with secondary data obtained from the Brazilian Unified Health System (SIM) Mortality Information System from 1996 to 2019. TabNet/DATASUS, Excel^® 2016 and SPSS 21^® were used to prepare the results.

RESULTS

Between 1996 and 2019, 85,928 alcohol-induced deaths were recorded among the elderly (>60 years); in 1996, the lowest number of deaths was recorded (n = 1396), and in 2018, there were the highest number of deaths (n = 5667). In the profile of the elderly, there was a predominance of men (88%). Mortality from AUD was due to alcoholic liver disease (62.2%), followed by mental disorders due to alcohol use (37.3%).

CONCLUSIONS

Coping with AUD is a public health problem that aims to reduce the number of deaths from diseases, conditions and injuries in which alcohol consumption is the causative agent, in addition to preventing deaths to which alcohol contributes.

Cost of antimicrobial treatment of patients infected with multidrug-resistant organisms in the Intensive Care Unit

This study aims to compare the costs of antimicrobial drugs used in the treatment of patients infected with multidrug-resistant organisms (MDRO) or those not infected with this type of organisms in an intensive care unit (ICU). It is a retrospective comparative case-control study, performed in a public hospital in the capital city of Brazil, comprising the years 2007, 2008 and 2009. Information on age, sex, length of hospitalization, clinical outcome, antimicrobial drugs, microorganisms and microbial sensitivity to antibiotics was collected. Spearman and Mann-Whitney tests were used for statistical analysis. The level of significance was set at p < 0.05. The sample consisted of 401 patients with a mean age of 51.36 years (± 19.68) being 226 (56.4%) male. As for the length of stay, 32.9% of the patients remained more than 20 days, with 195 discharged and 206 deaths. Global cost of antimicrobial treatment was US$ 1113 221.55 during the three year period. Treatment cost for patients with MDRO was higher than for those without (p = 0.010). At least one MDR strain was isolated in 54.6% of the patients. According to these results, nosocomial infections due to MDRO and the high costs involved may endanger the effectiveness of antimicrobial therapy in ICU and Health Centers.

[Albumin and drug therapy in the prognosis of hospitalized elderly]

OBJECTIVE

This study aimed to investigate the relationship between serum albumin levels, drugs used, length of hospitalization and number of diseases with the prognosis of hospitalized elderly.

METHODS

A descriptive cross-sectional and retrospective study was carried out using a review of medical charts. Variables collected were disease motivating admission, albumin, drugs used and their affinity for albumin and length of stay in an elderly population of a Brazilian public hospital. We used multiple regression to assess whether age, length of stay, medication with or without affinity to albumin and number of drugs motivating admission were causes of death. The relation between dependent and independent variables was analyzed by two-way ANOVA.

RESULTS

The sample consisted of 277 elderly, 151 with hypoalbuminemia and those using an average of 6.6 +/- 3.80 different prescription drugs most of which had affinity for albumin (4.96 +/- 2.64). Results showed that the number of drugs with affinity for albumin and hospital stay were predictors of death (r = 0.47, R2 = 0.224), (F(8.170) = 6.13; p=0.001). The relation between dependent and independent variables resulted in the mathematical equation: (death= 0.545 - 0.374 (albumin) - 0.195 (days of hospitalization) + 0.175 (number of drugs with affinity for albumin)).

CONCLUSION

The mathematical equation obtained by this study demonstrated that albumin and days of hospitalization were inversely correlated with death and directly correlated with the number of drugs bound to albumin.