OBJECTIVES: To evaluate mortality in adolescents and young adult patients with chronic diseases followed in a Latin American tertiary hospital. METHODS: A cross-sectional retrospective study was performed in a tertiary/academic hospital in the state of São Paulo, Brazil. Death occurred in 529/2850 (18.5%) adolescents and young adult patients with chronic diseases, and 25/529 (4.7%) were excluded due to incomplete medical charts. Therefore, 504 deaths were evaluated. RESULTS: Deaths occurred in 316/504 (63%) of early adolescent patients and in 188/504 (37%) of late adolescent/young adult patients. Further comparisons between early adolescents (n=316) and late adolescent/young adult patients (n=188) with pediatric chronic diseases at the last hospitalization showed that the median disease duration (22.0 [0-173] vs. 43.0 [0-227] months, p<0.001) was significantly lower in early adolescents vs. late adolescent/young adult patients. The median number of previous hospitalizations was significantly lower in the former group (4.0 [1-45] vs. 6.0 [1-52], p<0.001), whereas the last hospitalization in intensive care unit was significantly higher (60% vs. 47%, p=0.003). Regarding supportive measures, palliative care was significantly lower in the younger group compared to the older group (33% vs. 43%, p=0.02). The frequencies of renal replacement therapy (22% vs. 13%, p=0.02), vasoactive agents (65% vs. 54%, p=0.01), and transfusion of blood products (75% vs. 66%, p=0.03) were significantly higher in the younger group. The five most important etiologies of pediatric chronic diseases were: neoplasias (54.2%), hepatic diseases/transplantation (10%), human immunodeficiency virus (5.9%), and childhood-onset systemic lupus erythematosus and juvenile idiopathic arthritis (4.9%). Autopsy was performed in 58/504 (11%), and discordance between clinical and postmortem diagnoses was evidenced in 24/58 (41.3%). CONCLUSIONS: Almost 20% of deaths occurred in adolescents and young adults with distinct supportive care and severe disease patterns. Discordance between clinical diagnosis and autopsy was frequently observed.
OBJECTIVES: To evaluate mortality in adolescents and young adult patients with chronic diseases followed in a Latin American tertiary hospital. METHODS: A cross-sectional retrospective study was performed in a tertiary/academic hospital in the state of São Paulo, Brazil. Death occurred in 529/2850 (18.5%) adolescents and young adult patients with chronic diseases, and 25/529 (4.7%) were excluded due to incomplete medical charts. Therefore, 504 deaths were evaluated. RESULTS:Deaths occurred in 316/504 (63%) of early adolescent patients and in 188/504 (37%) of late adolescent/young adult patients. Further comparisons between early adolescents (n=316) and late adolescent/young adult patients (n=188) with pediatric chronic diseases at the last hospitalization showed that the median disease duration (22.0 [0-173] vs. 43.0 [0-227] months, p<0.001) was significantly lower in early adolescents vs. late adolescent/young adult patients. The median number of previous hospitalizations was significantly lower in the former group (4.0 [1-45] vs. 6.0 [1-52], p<0.001), whereas the last hospitalization in intensive care unit was significantly higher (60% vs. 47%, p=0.003). Regarding supportive measures, palliative care was significantly lower in the younger group compared to the older group (33% vs. 43%, p=0.02). The frequencies of renal replacement therapy (22% vs. 13%, p=0.02), vasoactive agents (65% vs. 54%, p=0.01), and transfusion of blood products (75% vs. 66%, p=0.03) were significantly higher in the younger group. The five most important etiologies of pediatric chronic diseases were: neoplasias (54.2%), hepatic diseases/transplantation (10%), human immunodeficiency virus (5.9%), and childhood-onset systemic lupus erythematosus and juvenile idiopathic arthritis (4.9%). Autopsy was performed in 58/504 (11%), and discordance between clinical and postmortem diagnoses was evidenced in 24/58 (41.3%). CONCLUSIONS: Almost 20% of deaths occurred in adolescents and young adults with distinct supportive care and severe disease patterns. Discordance between clinical diagnosis and autopsy was frequently observed.
Authors: Braian L A Sousa; Magda Sampaio-Carneiro; Werther B de Carvalho; Clovis A Silva; Alexandre A Ferraro Journal: Clinics (Sao Paulo) Date: 2020-11-30 Impact factor: 2.365
Authors: Alberto C Helito; Livia Lindoso; Sofia M Sieczkowska; Camilla Astley; Ligia B Queiroz; Natalia Rose; Claudia Renata P Santos; Thalis Bolzan; Rita María I A Peralta; Ruth R Franco; Louise Cominato; Rosa Maria R Pereira; Uenis Tannuri; Lucia Maria A Campos; Benito Lourenço; Ricardo K Toma; Karina Medeiros; Andréia Watanabe; Patricia Moreno Grangeiro; Sylvia C Farhat; Caio B Casella; Guilherme V Polanczyk; Bruno Gualano; Clovis A Silva; Adriana M E Sallum; Amanda Y Iraha; Bianca P Ihara; Bruna C Mazzolani; Claudia A Martinez; Claudia A A Strabelli; Claudia B Fonseca; Dandara C C Lima; Debora N D Setoue; Deborah F P Roz; Fabiana I Smaira; Hamilton Roschel; Helena T Miyatani; Isabela G Marques; Jane Oba; Juliana C O Ferreira; Juliana R Simon; Katia Kozu; Ligia P Saccani; Lorena V M Martiniano; Luana C A Miranda; Luiz E V Silva; Moisés F Laurentino; Nadia E Aikawa; Neusa K Sakita; Nicolas Y Tanigava; Paulo R A Pereira; Patrícia Palmeira; Simone S Angelo; Sofia S M Lavorato; Tamires M Bernardes; Tathiane C Franco; Vivianne S L Viana; Vera P M F R Barros; Yingying Zheng Journal: Clinics (Sao Paulo) Date: 2021-11-19 Impact factor: 2.365
Authors: Heloisa Helena de Sousa Marques; Maria Fernanda Badue Pereira; Angélica Carreira Dos Santos; Thais Toledo Fink; Camila Sanson Yoshino de Paula; Nadia Litvinov; Claudio Schvartsman; Artur Figueiredo Delgado; Maria Augusta Bento Cicaroni Gibelli; Werther Brunow de Carvalho; Vicente Odone Filho; Uenis Tannuri; Magda Carneiro-Sampaio; Sandra Grisi; Alberto José da Silva Duarte; Leila Antonangelo; Rossana Pucineli Vieira Francisco; Thelma Suely Okay; Linamara Rizzo Batisttella; Carlos Roberto Ribeiro de Carvalho; Alexandra Valéria Maria Brentani; Clovis Artur Silva; Adriana Pasmanik Eisencraft; Alfio Rossi Junior; Alice Lima Fante; Aline Pivetta Cora; Amelia Gorete A de Costa Reis; Ana Paula Scoleze Ferrer; Anarella Penha Meirelles de Andrade; Andreia Watanabe; Angelina Maria Freire Gonçalves; Aurora Rosaria Pagliara Waetge; Camila Altenfelder Silva; Carina Ceneviva; Carolina Dos Santos Lazari; Deipara Monteiro Abellan; Emilly Henrique Dos Santos; Ester Cerdeira Sabino; Fabíola Roberta Marim Bianchini; Flávio Ferraz de Paes Alcantara; Gabriel Frizzo Ramos; Gabriela Nunes Leal; Isadora Souza Rodriguez; João Renato Rebello Pinho; Jorge David Avaizoglou Carneiro; Jose Albino Paz; Juliana Carvalho Ferreira; Juliana Ferreira Ferranti; Juliana de Oliveira Achili Ferreira; Juliana Valéria de Souza Framil; Katia Regina da Silva; Kelly Aparecida Kanunfre; Karina Lucio de Medeiros Bastos; Karine Vusberg Galleti; Lilian Maria Cristofani; Lisa Suzuki; Lucia Maria Arruda Campos; Maria Beatriz de Moliterno Perondi; Maria de Fatima Rodrigues Diniz; Maria Fernanda Mota Fonseca; Mariana Nutti de Almeida Cordon; Mariana Pissolato; Marina Silva Peres; Marlene Pereira Garanito; Marta Imamura; Mayra de Barros Dorna; Michele Luglio; Mussya Cisotto Rocha; Nadia Emi Aikawa; Natalia Viu Degaspare; Neusa Keico Sakita; Nicole Lee Udsen; Paula Gobi Scudeller; Paula Vieira de Vincenzi Gaiolla; Rafael da Silva Giannasi Severini; Regina Maria Rodrigues; Ricardo Katsuya Toma; Ricardo Iunis Citrangulo de Paula; Patricia Palmeira; Silvana Forsait; Sylvia Costa Lima Farhat; Tânia Miyuki Shimoda Sakano; Vera Hermina Kalika Koch; Vilson Cobello Junior Journal: Clinics (Sao Paulo) Date: 2021-11-26 Impact factor: 2.365
Authors: Thais T Fink; Heloisa H S Marques; Bruno Gualano; Livia Lindoso; Vera Bain; Camilla Astley; Fernanda Martins; Denise Matheus; Olivia M Matsuo; Priscila Suguita; Vitor Trindade; Camila S Y Paula; Sylvia C L Farhat; Patricia Palmeira; Gabriela N Leal; Lisa Suzuki; Vicente Odone Filho; Magda Carneiro-Sampaio; Alberto José S Duarte; Leila Antonangelo; Linamara R Batisttella; Guilherme V Polanczyk; Rosa Maria R Pereira; Carlos Roberto R Carvalho; Carlos A Buchpiguel; Ana Claudia L Xavier; Marilia Seelaender; Clovis Artur Silva; Maria Fernanda B Pereira; Adriana M E Sallum; Alexandra V M Brentani; Álvaro José S Neto; Amanda Ihara; Andrea R Santos; Ana Pinheiro M Canton; Andreia Watanabe; Angélica C Dos Santos; Antonio C Pastorino; Bernadette D G M Franco; Bruna Caruzo; Carina Ceneviva; Carolina C M F Martins; Danilo Prado; Deipara M Abellan; Fabiana B Benatti; Fabiana Smaria; Fernanda T Gonçalves; Fernando D Penteado; Gabriela S F de Castro; Guilherme S Gonçalves; Hamilton Roschel; Ilana R Disi; Isabela G Marques; Inar A Castro; Izabel M Buscatti; Jaline Z Faiad; Jarlei Fiamoncini; Joaquim C Rodrigues; Jorge D A Carneiro; Jose A Paz; Juliana C Ferreira; Juliana C O Ferreira; Katia R Silva; Karina L M Bastos; Katia Kozu; Lilian M Cristofani; Lucas V B Souza; Lucia M A Campos; Luiz Vicente R F Silva Filho; Marcelo T Sapienza; Marcos S Lima; Marlene P Garanito; Márcia F A Santos; Mayra B Dorna; Nadia E Aikawa; Nadia Litvinov; Neusa K Sakita; Paula V V Gaiolla; Paula Pasqualucci; Ricardo K Toma; Simone Correa-Silva; Sofia M Sieczkowska; Marta Imamura; Silvana Forsait; Vera A Santos; Yingying Zheng Journal: Clinics (Sao Paulo) Date: 2021-11-26 Impact factor: 2.898