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Laserna-Mendieta EJ, Navarro P, Casabona-Francés S, Savarino EV, Amorena E, Pérez-Martínez I, Guagnozzi D, Blas-Jhon L, Betoré E, Guardiola-Arévalo A, Pellegatta G, Krarup AL, Perello A, Barrio J, Gutiérrez-Junquera C, Teruel Sánchez-Vegazo C, Fernández-Fernández S, Naves JE, Oliva S, Rodríguez-Oballe JA, Carrión S, Espina S, Llorente Barrio M, Masiques-Mas ML, Dainese R, Feo-Ortega S, Martín-Dominguez V, Fernández-Pacheco J, Pérez-Fernández MT, Ghisa M, Maniero D, Nantes-Castillejo Ó, Nicolay-Maneru J, Suárez A, Maray I, Llerena-Castro R, Ortega-Larrodé A, Alcedo J, Granja Navacerrada A, Racca F, Santander C, Arias Á, Lucendo AJ. Swallowed topical corticosteroids for eosinophilic esophagitis: Utilization and real-world efficacy from the EoE CONNECT registry. United European Gastroenterol J 2024. [PMID: 38284792 DOI: 10.1002/ueg2.12533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/25/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Swallowed topical corticosteroids (tC) are common therapy for patients with eosinophilic esophagitis (EoE). Widely heterogeneous results have occurred due to their active ingredients, formulations and doses. OBJECTIVE To assess the effectiveness of topical corticosteroid therapy for EoE in real-world practice. METHODS Cross-sectional study analysis of the multicentre EoE CONNECT registry. Clinical remission was defined as a decrease of ≥50% in dysphagia symptom scores; histological remission was defined as a peak eosinophil count below 15 per high-power field. The effectiveness in achieving clinico-histological remission (CHR) was compared for the main tC formulations. RESULTS Overall, data on 1456 prescriptions of tC in monotherapy used in 866 individual patients were assessed. Of those, 904 prescriptions with data on formulation were employed for the induction of remission; 234 reduced a previously effective dose for maintenance. Fluticasone propionate formulations dominated the first-line treatment, while budesonide was more common in later therapies. A swallowed nasal drop suspension was the most common formulation of fluticasone propionate. Doses ≥0.8 mg/day provided a 65% CHR rate and were superior to lower doses. Oral viscous solution prepared by a pharmacist was the most common prescription of budesonide; 4 mg/day provided no benefit over 2 mg/day (CHR rated being 72% and 80%, respectively). A multivariate analysis revealed budesonide orodispersible tablets as the most effective therapy (OR 18.9, p < 0.001); use of higher doses (OR 4.3, p = 0.03) and lower symptom scores (OR 0.9, p = 0.01) were also determinants of effectiveness. CONCLUSION Reduced symptom severity, use of high doses, and use of budesonide orodispersible tablets particularly were all independent predictors of tC effectiveness.
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Affiliation(s)
- Emilio J Laserna-Mendieta
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Laboratory Medicine Department, Hospital Universitario de La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Navarro
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Casabona-Francés
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Edoardo V Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
- Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | - Edurne Amorena
- Department of Gastroenterology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Isabel Pérez-Martínez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Danila Guagnozzi
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario Valld'Hebrón, Barcelona, Spain
| | | | - Elena Betoré
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Gaia Pellegatta
- Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Anne Lund Krarup
- Department of Emergency Medicine and Trauma Care, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Antonia Perello
- Department of Gastroenterology, Hospital de Viladecans, Viladecans, Spain
| | - Jesús Barrio
- Department of Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Carolina Gutiérrez-Junquera
- Pediatric Gastroenterology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | - Salvatore Oliva
- Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza - University of Rome, Rome, Italy
| | - Juan Armando Rodríguez-Oballe
- Department of Gastroenterology, Hospital Universitario Arnau de Vilanova & Hospital Universitario Santa María, Lérida, Spain
| | - Silvia Carrión
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Gastroenterology, Hospital de Mataró, Mataró, Spain
| | - Silvia Espina
- Department of Gastroenterology, Hospital General de la Defensa, Zaragoza, Spain
| | | | | | - Raffaella Dainese
- Department of Gastroenterology, Centre Hospitalier d'Antibes Juan-les-Pins, Antibes, France
| | - Sara Feo-Ortega
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Pediatrics, Hospital General de Tomelloso, Tomelloso, Spain
| | - Verónica Martín-Dominguez
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Jennifer Fernández-Pacheco
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Maria Teresa Pérez-Fernández
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Matteo Ghisa
- Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | - Daria Maniero
- Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | | | - Julia Nicolay-Maneru
- Department of Gastroenterology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Adolfo Suárez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Iván Maray
- Department of Pharmacy, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ronald Llerena-Castro
- Department of Gastroenterology, Hospital Universitario Valld'Hebrón, Barcelona, Spain
| | | | - Javier Alcedo
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Francesca Racca
- Personalized Medicine, Asthma and Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Cecilio Santander
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Ángel Arias
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Research Unit, Hospital General Mancha-Centro, Alcázar de San Juan, Spain
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
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Casas-Rojo JM, Ventura PS, Antón Santos JM, de Latierro AO, Arévalo-Lorido JC, Mauri M, Rubio-Rivas M, González-Vega R, Giner-Galvañ V, Otero Perpiñá B, Fonseca-Aizpuru E, Muiño A, Del Corral-Beamonte E, Gómez-Huelgas R, Arnalich-Fernández F, Llorente Barrio M, Sancha-Lloret A, Rábago Lorite I, Loureiro-Amigo J, Pintos-Martínez S, García-Sardón E, Montaño-Martínez A, Rojano-Rivero MG, Ramos-Rincón JM, López-Escobar A. Improving prediction of COVID-19 mortality using machine learning in the Spanish SEMI-COVID-19 registry. Intern Emerg Med 2023; 18:1711-1722. [PMID: 37349618 DOI: 10.1007/s11739-023-03338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/01/2023] [Indexed: 06/24/2023]
Abstract
COVID-19 is responsible for high mortality, but robust machine learning-based predictors of mortality are lacking. To generate a model for predicting mortality in patients hospitalized with COVID-19 using Gradient Boosting Decision Trees (GBDT). The Spanish SEMI-COVID-19 registry includes 24,514 pseudo-anonymized cases of patients hospitalized with COVID-19 from 1 February 2020 to 5 December 2021. This registry was used as a GBDT machine learning model, employing the CatBoost and BorutaShap classifier to select the most relevant indicators and generate a mortality prediction model by risk level, ranging from 0 to 1. The model was validated by separating patients according to admission date, using the period 1 February to 31 December 2020 (first and second waves, pre-vaccination period) for training, and 1 January to 30 November 2021 (vaccination period) for the test group. An ensemble of ten models with different random seeds was constructed, separating 80% of the patients for training and 20% from the end of the training period for cross-validation. The area under the receiver operating characteristics curve (AUC) was used as a performance metric. Clinical and laboratory data from 23,983 patients were analyzed. CatBoost mortality prediction models achieved an AUC performance of 84.76 (standard deviation 0.45) for patients in the test group (potentially vaccinated patients not included in model training) using 16 features. The performance of the 16-parameter GBDT model for predicting COVID-19 hospital mortality, although requiring a relatively large number of predictors, shows a high predictive capacity.
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Affiliation(s)
- José-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, 28981, Madrid, Spain
| | - Paula Sol Ventura
- Department of Pediatric Endocrinology, Hospital HM Nens, HM Hospitales, 08009, Barcelona, Spain
| | | | | | | | - Marc Mauri
- Data Scientist, Kaizen AI, Barcelona, Spain
| | - Manuel Rubio-Rivas
- Internal Medicine Department, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Rocío González-Vega
- Internal Medicine Department, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - Vicente Giner-Galvañ
- Internal Medicine Department, Hospital Universitario San Juan. San Juan de Alicante, Alicante, Spain
| | | | - Eva Fonseca-Aizpuru
- Internal Medicine Department, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
| | - Antonio Muiño
- Internal Medicine Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Málaga, Spain
| | | | | | | | - Isabel Rábago Lorite
- Internal Medicine Department, Hospital Universitario Infanta Sofía. San Sebastián de los Reyes, Madrid, Spain
| | - José Loureiro-Amigo
- Internal Medicine Department, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | - Santiago Pintos-Martínez
- Internal Medicine Department, Hospital Universitario de Sagunto, Puerto de Sagunto, Valencia, Spain
| | - Eva García-Sardón
- Internal Medicine Department, Hospital Universitario de Cáceres, Cáceres, Spain
| | | | | | | | - Alejandro López-Escobar
- Pediatrics Department, Clinical Research Unit, Hospital Universitario Vithas Madrid La Milagrosa, Fundación Vithas, Madrid, Spain.
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Ramos-Rincón JM, Ventura PS, Casas-Rojo JM, Mauri M, Bermejo CL, de Latierro AO, Rubio-Rivas M, Mérida-Rodrigo L, Pérez-Casado L, Barrientos-Guerrero M, Giner-Galvañ V, Gallego-Lezaun C, Milián AH, Manzano L, Blázquez-Encinar JC, Solís-Marquínez MN, García MG, Lobo-García J, Valente VAR, Roig-Martí C, León-Téllez M, Tellería-Gómez P, González-Juárez MJ, Gómez-Huelgas R, López-Escobar A, Bermejo CL, Núñez-Cortés JM, Santos JMA, Huelgas RG, Corbella X, Pérez FF, Homs N, Montero A, Mora-Luján JM, Rubio-Rivas M, Bandera VA, Alegría JG, Jiménez-García N, del Pino JL, Escalante MDM, Romero FN, Rodriguez VN, Sierra JO, de Blas PA, Cañas CA, Ayuso B, Morejón JB, Escudero SC, Frías MC, Tejido SC, de Miguel Campo B, Pedroche CD, Simon RD, Reyne AG, Veganzones LI, Huerta LJ, Blanco AL, Gonzalo JL, Lora-Tamayo J, Bermejo CL, de la Calle GM, Godoy RM, Perpiña BO, Ruiz DP, Fernández MS, Montes JT, Suárez AMÁ, Vergés CD, Martínez RFM, Aizpuru EMF, Carrasco AG, Amezua CH, Caleya JFL, Martínez DL, del Mar Martínez López M, Zapico AM, Iscar CO, Casado LP, Martínez MLT, Chamorro LMT, Casas LA, de Oña ÁA, Beato RA, Gonzalo LA, Muñoz JA, Oblitas CMA, García CA, Cebrián MB, Corral JB, Guerrero MB, Estrada ADB, Moreno MC, Fernández PC, Carrillo R, Pérez SC, Muñoz EC, Moreno ADC, Carvajal MCC, de Santos S, Gómez AE, Carracedo EF, Jenaro MMFM, Valle FG, Garcia A, Fernandez-Bravo IG, Leoni MEG, Antúnez MG, Narciso CGS, Gurjian AA, Ibáñez LJ, Olleros CL, Mendo CL, García SL, Jimeno VM, Nohales CM, Núñez-Cortés JM, Ledesma SM, Míguez AM, Delgado CM, Ortega LO, Sánchez SP, Virto AP, Sanz MTP, Llorente BP, Ruiz SP, Fernández-Llamazares GS, Macías MT, Samaniego NT, do Rego AT, Garcia MVV, Villarreal G, Etayo MZ, Lara RA, Fernandez IC, García JCC, García García GM, Granados JG, Sánchez BG, Periáñez FJM, Perez MJP, Pérez JLB, Méndez MLS, Rivera NA, Vieitez AC, del Corral Beamonte E, Manglano JD, Mera IF, del Mar Garcia Andreu M, Aseguinolaza MG, Lezaun CG, Laorden CJ, Murgui RM, Sanz MTM, Ayala-Gutiérrez MM, López RB, Fonseca JB, Buonaiuto VA, Martínez LFC, Palacios LC, Muriel CC, de Windt F, Christophel ATFT, Ocaña PG, Huelgas RG, García JG, Oliver JAH, Jansen-Chaparro S, López-Carmona MD, Quirantes PL, Sampalo AL, Lorenzo-Hernández E, Sevilla JJM, Carmona JM, Pérez-Belmonte LM, de Pedro IP, Pineda-Cantero A, Gómez CR, Ricci M, Cánovas JS, Troncoso JÁ, Fernández FA, Quintana FB, Arenzana CB, Molina SC, Candalija AC, Bengoa GD, de Gea Grela A, de Lorenzo Hernández A, Vidal AD, Capitán CF, Iglesias MFG, Muñoz BG, Gil CRH, Martínez JMH, Hontañón V, Hernández MJJ, Lahoz C, Calvo CM, Gutiérrez JCM, Prieto MM, Robles EM, Saldaña AM, Fernández AM, Prieto JMM, Mozo AN, López CMO, Peláez EP, Pampyn MP, Simón MAQ, Ramos Ramos JC, Ruperto LR, Purificación AS, Bueso TS, Torre RS, Abanedes CIS, Tabares YU, Mayoral MV, Manau JV, del Carmen Beceiro Abad M, Romero MAF, Castro SM, Guillan EMP, Nuñez MP, Fontan PMP, de Larriva APA, Espinal PC, Lista JD, Fuentes-Jiménez F, del Carmen Guerrero Martínez M, Vázquez MJG, Torres JJ, Pérez LL, López-Miranda J, Piedra LM, Orge MM, Vinagre JP, Pérez-Martinez P, Vílchez MER, Martínez AR, Cabrera JLR, Torres-Peña JD, Tomás MA, Balaz D, Tur DB, Navarro RC, Pérez PC, Redondo JC, White ED, Espínola ME, Del Barrio LE, Atiénzar PJE, Cervera CG, Núñez DFG, Navarro FG, Galvañ VG, Uranga AG, Martínez JG, Isasi IH, Villar LL, Sempere VM, Cruz JMN, Fernández SP, García JJP, Pleguezuelos RP, Pérez AR, Ripoll JMS, Mira AS, Wikman-Jorgensen P, Ayllón JAA, Artero A, del Mar Carmona Martín M, Valls MJF, de Mar Fernández Garcés M, Belda ABG, Cruz IL, López MM, Sanchis EM, Gandia JM, Roger LP, Belmonte AMP, García AV, Eisenhofer AA, Milla AA, Pérez IB, Gutiérrez LB, Garay JB, Parra JC, Díaz AC, Da Silva EC, Hernández MC, Díaz RC, Sánchez MJC, Gozalo CC, Martínez VCM, Doblado LD, de la Fuente Moral S, de Santiago AD, Yagüe ID, Velasco ID, Duca AM, del Campo PD, López GE, Palomo EE, Cruz AF, Gómez AG, Prieto SG, Revilla BG, Viejo MÁG, Irusta JG, Merino PG, Abreu EVG, Martín IG, Rojas ÁG, Villanueva AG, Jiménez JH, Estéllez FI, del Estal PL, Sáiz MCM, de Mendoza Fernández C, Urbistondo MM, Vera FM, Seirul-lo MM, Pita SM, Sánchez PAM, Hernández EM, Vargas AM, Concha VMT, De La Torre IM, Rubio EM, de Benito RM, Serrano AM, Palomo PN, Pascual IP, Martín-Vegue AJR, Martínez AR, Olleros CR, Montaud AR, Pizarro YR, García SR, de Domingo DR, Ortiz DS, Chica ES, Almena IS, Martin ES, Chen YT, de Ureta PT, Alijo ÁV, Comendador JMV, Núñez JAV, Yeguas IA, Gómez JA, Cuchillo JB, López IB, Clotet NC, Elías AEC, Manuel EC, de Luque CMC, Benbunan CC, Vilan LD, Hernández CD, Peralta EED, Pérez VE, Fernandez-Castelao S, Saavedra MOF, Klepzig JLG, del Rosario Iguarán Bermúdez M, Ferrer EJ, Rodríguez AM, de Pedro AM, Sánchez RÁM, Bailón MM, Álvarez SM, Orantos MJN, Mata CO, García EO, Mata DO, González CO, Perez-Somarriba J, Mateos PP, Muñoz MER, Regaira XR, Gallardo LMR, Fornie IS, Botrán AS, Robles MS, Urbano ME, González AMV, Martínez MV, Monge Monge D, Pasos EMF, García AV, Comet LS, Giménez LL, Samper UA, Repiso GA, Bruñén JMG, Barrio ML, Martínez MAC, Igual JJG, Fenoll RG, García MA, Monge EA, Rodríguez JÁ, Varela CA, Gòdia MB, Molina MB, Vega MB, Curbelo J, de las Heras Moreno A, Godoy ID, Alvarez ACE, Martín-Caro IF, López-Mosteiro AF, Marquez GG, Blanco MJG, del Álamo Hernández YG, Encina CGR, González NG, Rodríguez CG, Martín NLS, Báez MM, Delgado CM, Caballero PP, Serrano JP, Rodríguez LR, Cortés PR, Franco CR, Roy-Vallejo E, Vega MR, Lloret AS, Moreno BS, Alba MS, Ballesteros JS, Somovilla A, Fernández CS, Tirado MV, Marti AV, Pareja JFP, Fraile IP, Blanco AM, del Castillo Cantero R, López JLV, Lorite IR, Martínez RF, García IS, Rangel LS, Álvarez AA, Juarros OA, López AA, Castiñeira CC, Calviño AC, Sánchez MC, Varela RF, Castro SJF, Trigo AP, Jarel RP, Varea FR, Freán IR, Alonso LR, Pensado FJS, Porto DV, Saavedra CC, Gómez JF, López BG, Garrido MSH, Amorós AIL, Gil SL, de los Reyes Pascual Pérez M, Perea NR, García AT, Lobo JA, Casanovas LF, Amigo JL, Fernández MM, Bermúdez IO, Fernández MP, Rhyman N, Piqueras NV, Pedrajas JNA, García AM, Vargas I, Jiménez IA, González MC, Cobos-Siles M, Corral-Gudino L, Cubero-Morais P, Fernández MG, González JPM, Dehesa MP, Espinosa PS, Blanco SC, Gamboa JOM, Mosteiro CS, Asiain AS, Santos JMA, Barrera ABB, Vela BB, Muiño CB, Fernández CB, Hernáiz RC, López IC, Rojo JMC, Troncoso AC, Romano PC, Deodati F, Santiago AE, Sánchez GGC, Guijarro EG, Sánchez FJG, de la Torre PG, de Guzmán García-Monge M, Luordo D, González MM, Bermejo JAM, Valverde CP, Quero JLP, Rojas FR, García LR, Gonzalo ES, Muñoz FJT, de la Sota JV, Martínez JV, Gómez MG, Sánchez PR, Gonzalez GA, Iraurgi AL, Arostegui AA, Martínez PA, Fernández IMP, Becerro EM, Jiménez AI, Núñez CV, López MA, López EG, Losada MSA, Estévez BR, Muñoz AMA, Fernández MB, Cano V, Moreno RC, Garcia-Tenorio FC, Nájera BDT, González RE, Butenegro MPG, Díez AG, Caverzaschi VG, Pedraza PMG, Moraleja JG, Carvajal RH, Aranda PJ, González RL, Caparachini ÁL, Castañeyra PL, Ancin AL, Garcia JDM, Romero CM, Saiz MJM, Moríñigo HM, Nicolás GM, Platon EM, Oliveri F, Ortiz Ortiz E, Rafael RP, Galán PR, Berrocal MAS, de Ávila VSR, Sierra PT, Aranda YU, Clemente JV, Bergua CY, de la Peña Fernández A, Milián AH, Manrique MA, Erdozain AC, Ruiz ALI, Luque FJB, Carrasco-Sánchez FJ, de-Sousa-Baena M, Leal JD, Rubio AE, Huertas MF, Bravo JAG, Macías AG, Jiménez EG, Jiménez AH, Quintero CL, Reguera CM, Marcos FJM, Beamud FM, Pérez-Aguilar M, Jiménez AP, Castaño VR, dedel AlcazarRío AS, Ruiz LT, González DA, de Zabalza IAP, Hernández SA, Sáenz JC, Dendariena B, del Mazo MG, de Narvajas Urra IM, Hernández SM, Fernández EM, Somovilla JLP, Pejenaute ER, Rodríguez-Solís JB, Osorio LC, del Pilar Fidalgo Montero M, Soriano MIF, Rincón EEL, Hermida AM, Carrilero JM, Santiago JÁP, Robledo MS, Rojas PS, Yebes NJT, Vento V, Vaca LFA, Arnanz AA, García OA, González MB, Sanz PB, Llisto AC, de Pedro Baena S, Del Hoyo Cuenda B, Fabregate-Fuente M, Osorio MAG, Sánchez IG, García AG, Cisneros OAL, Manzano L, Martínez-Lacalzada M, Ortiz BM, Rey-García J, González ER, Díaz CS, Fajardo GS, Carantoña CS, Viteri-Noël A, Zhilina Zhilina S, Claudio GMA, Rodríguez VB, Muñoz CC, Pérez AC, Orbes MVC, Sánchez DE, Revuelta SI, Martín MM, González JIM, Oterino JÁM, Alonso LM, Balbuena SP, García MLP, Prados AR, Rodríguez-Alonso B, Alegría ÁR, Ledesma MS, Pérez RJT, Encinar JCB, Cilleros CM, Martínez IJ, Delange TG, González RF, Noya AG, Ceron CH, Avanzini II, Diez AL, Mato PL, Vizcaya AML, Benítez DP, Zemsch MMP, Expósito LP, Bar MP, González LR, Lara LR, Cabañero D, Ballester MC, Fernández PC, Sánchez RG, Escrig MJ, Amela CM, Gómez LP, Navarro CP, Parra JAT, de Almeida CT, Villarejo MEF, Calvo VP, Otero SP, López BG, Frías CA, Romero VM, Pérez LA, Velado EM, González RA, Boixeda R, Fernández Fernández J, Mármol CL, Navarro MP, Guzmán AR, Fustier AS, Castro JL, Reboiro MLL, González CS, Sala ER, Izuel JMP, Zamrani ZK, Diaz HA, Lopez TD, Pego EM, Pérez CM, Ferro AP, Trigo SS, Sambade DS, Ferrin MT, del Carmen Vázquez Friol M, Maneiro LV, Rodríguez BC, Espartero MEG, Rivas LM, de la Sierra Navas Alcántara M, Tirado-Miranda R, Marquínez MNS, García VA, Suárez DB, Arenas NG, García PM, Copa DC, García AÁ, Álvarez JC, Calderón MJM, Noriega RG, Rubia MC, García JL, Martínez LT, Celeiro JF, Aguilar DEO, Riesco IM, Bécares JV, Mateos AB, García AAT, Casamayor JD, Silvera DG, Díaz AA, Carballo CH, Tejera A, Prieto MJM, Muñoz MBM, Del Arco Delgado JM, Díaz DR, Feria MB, Herrera Herrera FJ, de la Luz Padilla Salazar M, Luis RH, Ledezma EMC, del Mar López Gámez M, Hernández LT, Pérez SC, García SGA, Gainett GC, Hidalgo AG, Daza JM, Peraza MH, Santos RA, Bernabeu-Wittel M, Suárez SR, Nieto M, Miranda LG, Mancera RMG, Torre FE, Quiles CH, Guzmán CC, de la Cuesta JD, Vega JET, del Carmen López Ríos M, Jiménez PD, Franco BB, de Juan CJ, Rivero SG, Tenllado JL, Lara VA, Estrada AG, Ena J, Segado JEG, Ferrer RG, Lorenzo VG, Arroyo RM, García MG, Hernández FJV, González ÁLM, Montes BV, Die RMG, Molinero AM, Regidor MM, Díez RR, Sierra BH, García LFD, Acedo IEA, Cano CMS, García VH, Bernal BR, Jiménez JC, Bazán EC, Reniu AC, Grabalosa JR, Solà JF, De Boulle IC, Xancó CG, Núñez OR, Ripper CJ, Gutiérrez AG, Trallero LER, Novo MFA, Lecumberri JJN, Ruiz NP, Riancho J, García IS, Baena PC, Sevilla JE, Padilla LG, Ronquillo PG, Bustos PG, Botías MN, Taboada JR, Rodríguez MR, Alvarez VA, Suárez NM, Suárez SR, Díaz SS, Pérez LS, Gómez MF, Castaño CM, Rodríguez LM, Vázquez C, Estévanez IC, Gutiérrez CY, Sela MM, Cosío SF, Álvaro CMG, García JL, Piñeiro AP, Viera YC, Rodríguez LC, de Juan Alvarez C, Benitez GF, Escudero LG, Torres JM, Escriche PM, Canteli SP, Pérez MCR, Soler JA, Remolar MB, Álvarez AC, Carlotti DD, Gimeno MJE, Juana SF, López PG, Soler MTG, de la Sota DP, Castellanos GP, Catalán IP, Martí CR, Monzó PR, Padilla JR, Gaya NT, Blasco JU, Pascual MAM, Vidal LJ, Conesa AA, Rivas MCA, Alsina MH, Romero JM, Diez-Canseco AMU, Martínez FA, Vásquez EA, Stablé JCE, Belmonte AH, Peiró AM, Goñi RM, Castellanos MCP, Belda BS, Navarro DV, Lombraña AS, Ugartondo JC, Plaza ABM, Asensio AN, Alves BP, López NV, Téllez ML, Epelde F, Torrente I, Vasco PG, Santacruz AR, Muñoz AV, Giner MJE, Calvo-Sotelo AE, Sardón EG, González JG, Salazar LG, Garcia AA, Días IM, Gomez AS, Matos MC, Gaspar SN, Nieto AG, Méndez RG, Álvarez AR, Hernández OP, Ramírez AP, González MCM, Lorite MNN, Navarrete LG, Negrin JCA, González JFA, Jiménez I, Toledo PO, Ponce EM, Torres XTE, González SG, Fernández CN, Gómez PT, Gisbert OA, Llistosella MB, Casanova PC, Flores AG, Hinojo AG, Martínez AIM, del Carmen Nogales Nieves M, Austrui AR, Cervantes AZ, Castro VA, Lomba AMB, Aparicio RB, Morales MF, Villar JMF, Monteagudo MTL, García CP, Ferreira LR, Llovo DS, Feijoo MBV, Romero JAM, de Albornoz JLSC, Pérez MJS, Martín ES, Astrua TC, Giraldo PTG, Juárez MJG, Fernandez VM, Echevarry AVR, Arche JFV, Rivero MGR, Martínez AM, Bernad RV, Limia C, Fernández CA, Fernández AT, Fajardo LP, de Vega Santos T, Ruiz AL, Míguez HM. Validation of the RIM Score-COVID in the Spanish SEMI-COVID-19 Registry. Intern Emerg Med 2023; 18:907-915. [PMID: 36680737 PMCID: PMC9862219 DOI: 10.1007/s11739-023-03200-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
The significant impact of COVID-19 worldwide has made it necessary to develop tools to identify patients at high risk of severe disease and death. This work aims to validate the RIM Score-COVID in the SEMI-COVID-19 Registry. The RIM Score-COVID is a simple nomogram with high predictive capacity for in-hospital death due to COVID-19 designed using clinical and analytical parameters of patients diagnosed in the first wave of the pandemic. The nomogram uses five variables measured on arrival to the emergency department (ED): age, sex, oxygen saturation, C-reactive protein level, and neutrophil-to-platelet ratio. Validation was performed in the Spanish SEMI-COVID-19 Registry, which included consecutive patients hospitalized with confirmed COVID-19 in Spain. The cohort was divided into three time periods: T1 from February 1 to June 10, 2020 (first wave), T2 from June 11 to December 31, 2020 (second wave, pre-vaccination period), and T3 from January 1 to December 5, 2021 (vaccination period). The model's accuracy in predicting in-hospital COVID-19 mortality was assessed using the area under the receiver operating characteristics curve (AUROC). Clinical and laboratory data from 22,566 patients were analyzed: 15,976 (70.7%) from T1, 4,233 (18.7%) from T2, and 2,357 from T3 (10.4%). AUROC of the RIM Score-COVID in the entire SEMI-COVID-19 Registry was 0.823 (95%CI 0.819-0.827) and was 0.834 (95%CI 0.830-0.839) in T1, 0.792 (95%CI 0.781-0.803) in T2, and 0.799 (95%CI 0.785-0.813) in T3. The RIM Score-COVID is a simple, easy-to-use method for predicting in-hospital COVID-19 mortality that uses parameters measured in most EDs. This tool showed good predictive ability in successive disease waves.
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Affiliation(s)
| | - Paula Sol Ventura
- Fundacio Institut d’Investigacio en Ciències de La Salut Germans Trias I Pujol (IGTP), 08916 Badalona, Spain
| | - José-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, 28981 Madrid, Spain
| | - Marc Mauri
- Data Scientist, Kaizen AI, Barcelona, Spain
| | | | | | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | - Vicente Giner-Galvañ
- Internal Medicine Department. Hospital, Clínico Universitario de Sant Joan d’Alacant, Alicante, Spain
| | | | | | - Luis Manzano
- Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Málaga, Spain
| | - Alejandro López-Escobar
- Pediatrics Department, Clinical Research Unit, Hospital Universitario Vithas Madrid La Milagrosa, Fundación Vithas. Madrid, Madrid, Spain
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Sierra Gabarda O, Espinosa Pérez M, Casas Deza D, Lamuela Calvo LJ, Llorente Barrio M, Monzón Báez RM, Sierra Moros E, Alcedo González J. NSAID-induced ischemic colitis. Rev Esp Enferm Dig 2022; 114:307. [PMID: 35067065 DOI: 10.17235/reed.2022.8605/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We present the case of a 38-year-old man with no previous medical history who went to the emergency department due to abdominal pain and diarrheal stools with blood of 24 hours of evolution. The patient reports consumption of anti-inflammatories the previous days due to back pain.
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Lora-Tamayo J, Maestro G, Lalueza A, Rubio-Rivas M, Villarreal Paul G, Arnalich Fernández F, Beato Pérez JL, Vargas Núñez JA, Llorente Barrio M, Lumbreras Bermejo C. Early Lopinavir/ritonavir does not reduce mortality in COVID-19 patients: Results of a large multicenter study. J Infect 2021; 82:276-316. [PMID: 33582204 PMCID: PMC7877892 DOI: 10.1016/j.jinf.2021.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Jaime Lora-Tamayo
- Internal Medicine Department, 12 de Octubre University Hospital, Research Institute Hospital 12 de Octubre "i+12 Institute", Madrid, Spain.
| | - Guillermo Maestro
- Internal Medicine Department, 12 de Octubre University Hospital, Research Institute Hospital 12 de Octubre "i+12 Institute", Madrid, Spain
| | - Antonio Lalueza
- Internal Medicine Department, 12 de Octubre University Hospital, Research Institute Hospital 12 de Octubre "i+12 Institute", Madrid, Spain
| | - Manuel Rubio-Rivas
- Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat (Barcelona), Spain
| | | | | | | | | | | | - Carlos Lumbreras Bermejo
- Internal Medicine Department, 12 de Octubre University Hospital, Research Institute Hospital 12 de Octubre "i+12 Institute", Madrid, Spain
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Casas Deza D, Llorente Barrio M, Monzón Baez RM, Lamuela Calvo LJ, Gascón Ruiz M, Ramos Lisbona AI, García López S. It is not always Crohn's disease: Amebiasis as a differential diagnosis of inflammatory bowel disease. Gastroenterol Hepatol 2019; 42:548-549. [PMID: 31122655 DOI: 10.1016/j.gastrohep.2019.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/08/2019] [Accepted: 03/23/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Diego Casas Deza
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
| | | | | | | | - Marta Gascón Ruiz
- Servicio de Oncología Médica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - Santiago García López
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
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Gotor Delso J, Espina Cadena S, García Cámara P, Sanz Segura P, Llorente Barrio M, Monzon Baez R, Casas Deza D, Lamuela Calvo LJ, Bernal Monterde V. Zieve's syndrome, an underdiagnosed entity. Gastroenterol Hepatol 2019; 42:431-432. [PMID: 30459059 DOI: 10.1016/j.gastrohep.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/07/2018] [Accepted: 10/10/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Jesús Gotor Delso
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - Silvia Espina Cadena
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Paula García Cámara
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Patricia Sanz Segura
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | - Rosmery Monzon Baez
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Diego Casas Deza
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
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Sanz Segura P, García Cámara P, Gotor Delso J, Monzón Báez RM, Llorente Barrio M, Fernández Bonilla E, Bernal Monterde V. Upper gastrointestinal bleeding due to overdose of selective serotonin reuptake inhibitors and nonsteroidal anti-inflammatory drugs. Gastroenterol Hepatol 2019; 42:622-623. [PMID: 31324464 DOI: 10.1016/j.gastrohep.2019.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 03/12/2019] [Accepted: 03/31/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Patricia Sanz Segura
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - Paula García Cámara
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Jesús Gotor Delso
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | | | - Eva Fernández Bonilla
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
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Llorente Barrio M, García López S, Gilaberte Calzada Y, Monzón Báez RM, Casas Deza D, Lamuela Calvo LJ. Bilateral pyoderma gangrenosum associated with ulcerative colitis and restorative proctocolectomy. Gastroenterol Hepatol 2018; 42:441-442. [PMID: 30470567 DOI: 10.1016/j.gastrohep.2018.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/17/2018] [Accepted: 10/07/2018] [Indexed: 11/18/2022]
Affiliation(s)
| | - Santiago García López
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | | | - Diego Casas Deza
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
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