Institution
Hospital General Universitario Gregorio Marañón
Healthcare•Madrid, Spain•
About: Hospital General Universitario Gregorio Marañón is a healthcare organization based out in Madrid, Spain. It is known for research contribution in the topics: Population & Transplantation. The organization has 11975 authors who have published 12386 publications receiving 244847 citations.
Topics: Population, Transplantation, Myocardial infarction, Intensive care, COPD
Papers published on a yearly basis
Papers
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TL;DR: In this paper, the authors assess the effect of surgical delay on hospital outcomes according to the cause of delay and find that longer delays are associated with higher mortality rates and rates of medical complications.
Abstract: Background The clinical effect of surgical delay in older patients with hip fracture is controversial. Discrepancies among study findings may be due to confounding that is caused by the reason for the delay or a differential effect on patient risk subgroups. Objective To assess the effect of surgical delay on hospital outcomes according to the cause of delay. Design Prospective cohort study. Setting A hip fracture unit in a university hospital in Spain. Patients 2250 consecutive elderly patients with hip fracture. Measurements Time to surgery, reasons for surgical delay, adjusted in-hospital death, and risk for complications. Results Median time to surgery was 72 hours. Lack of operating room availability (60.7%) and acute medical problems (33.1%) were the main reasons for delays longer than 48 hours. Overall, rates of hospital death and complications were 4.35% and 45.9%, respectively, but were 13.7% and 74.2% in clinically unstable patients. Longer delays were associated with higher mortality rates and rates of medical complications. After adjustment for age, dementia, chronic comorbid conditions, and functionality, this association did not persist for delays of 120 hours or less but did persist for delays longer than 120 hours (P = 0.002 for overall time effect on death and 0.002 for complications). The risks were attenuated after adjustment for the presence of acute medical conditions as the cause of the delay (P = 0.06 for time effect on mortality and 0.31 on medical complications). Risk for urinary tract infection remained elevated (odds ratio, 1.54 [95% CI, 0.99 to 2.44]). No interaction between delay and age, dementia, or functional status was found. Limitation This was a single-center study without postdischarge follow-up. Conclusion The reported association between late surgery and higher morbidity and mortality in patients with hip fracture is mostly explained by medical reasons for surgical delay, although some association between very delayed surgery and worse outcomes persists. Primary funding source None.
196 citations
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TL;DR: Several studies have shown that ICU patients with mucosal Candida colonization, particularly if multifocal, are at a higher risk for invasive candidiasis, and that colonization selects a population amenable to antifungal prophylaxis or empirical therapy.
195 citations
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TL;DR: NIV and CPAP were more effective than lifestyle modification in improving clinical symptoms and polysomnographic parameters, although NIV yielded better respiratory functional improvements than did CPAP.
Abstract: Rationale: The incidence of obesity hypoventilation syndrome (OHS) may be increasing in parallel with the present obesity epidemic. Despite extensive noninvasive ventilation (NIV) and continuous positive airway pressure (CPAP) use in patients with OHS, information regarding efficacy is limited.Objectives: We performed a large, multicenter randomized controlled study to determine the comparative efficacy of NIV, CPAP, and lifestyle modification (control group) using daytime PaCO2 as the main outcome measure.Methods: Sequentially screened patients with OHS with severe sleep apnea were randomized into the above-mentioned groups for a 2-month follow up. Arterial blood gas parameters, clinical symptoms, health-related quality-of-life assessments, polysomnography, spirometry, 6-minute-walk distance, dropouts, compliance, and side effects were evaluated. Statistical analysis was performed using intention-to-treat analysis, although adjustments for CPAP and NIV compliance were also analyzed.Measurements and Main ...
195 citations
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University of Barcelona1, University of Bonn2, University of Bern3, Derriford Hospital4, University of Hamburg5, University of Debrecen6, University of Bologna7, Hospital General Universitario Gregorio Marañón8, University of Padua9, University of Pavol Jozef Šafárik10, Katholieke Universiteit Leuven11, Ludwig Maximilian University of Munich12, Sapienza University of Rome13, Leiden University14, University College London15
TL;DR: MDR bacterial infections constitute a prevalent, growing and complex healthcare problem in patients with decompensated cirrhosis and acute-on-chronic liver failure across Europe, negatively impacting on prognosis and strategies aimed at preventing the spread of antibiotic resistance should be urgently evaluated.
195 citations
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TL;DR: The lack of differences between these two treatment alternatives, despite the more advanced age and greater prevalence of heart disease in the embolotherapy group, provides support for future prospective randomized studies aimed to evaluate the role of embol therapy in the management of refractory peptic ulcer bleeding.
193 citations
Authors
Showing all 12014 results
Name | H-index | Papers | Citations |
---|---|---|---|
David H. Adams | 155 | 1613 | 117783 |
Stefanie Dimmeler | 147 | 574 | 81658 |
Stuart J. Pocock | 145 | 684 | 143547 |
M. I. Martínez | 134 | 1251 | 79885 |
Guy A. Rouleau | 129 | 884 | 65892 |
Jose L. Jimenez | 124 | 654 | 64226 |
Antoni Torres | 120 | 1238 | 65049 |
Paul P. Tak | 112 | 591 | 57689 |
Luis A. Diaz | 111 | 596 | 75036 |
Frans Van de Werf | 109 | 747 | 63537 |
José Luis Zamorano | 105 | 695 | 133396 |
Francisco Sánchez-Madrid | 102 | 527 | 43418 |
Francesco Locatelli | 99 | 820 | 42454 |
Roberto M. Lang | 96 | 823 | 56638 |
Carlos Simón | 95 | 589 | 31147 |