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Papers by Joan Masip

Revista Clinica Espanola, Apr 1, 2019

Resultados: Seleccionamos 3.868 primeros ingresos por IC (56,8% de todos los episodios de IC). En... more Resultados: Seleccionamos 3.868 primeros ingresos por IC (56,8% de todos los episodios de IC). En 1.220 pacientes (31,7%) el diagnóstico de IC fue realizado por el médico de atención primaria. El modelo principal fue el de una mujer (OR = 2,4), con alta prevalencia de hipertensión (OR = 1,7), fibrilación auricular (OR = 1,3), enfermedad renal crónica (OR = 1,6) y tasa de mortalidad del 9,8%. La tasa de muerte intrahospitalaria fue del 5,8%; los principales factores contribuyentes fueron la edad (mayor de 85 años; OR = 5,57), la presencia de enfermedad renal crónica (OR = 1,44) y la duración del ingreso (7 días; OR = 1,90). Conclusiones: Los casos de primer ingreso asociado a IC representan el 56,7% de todos los casos de IC. Aproximadamente un tercio de los pacientes fueron diagnosticados en el momento de su primera hospitalización. El mayor número de casos se dio en el grupo de mujeres ancianas, aunque no solo en ellas. Los principales contribuyentes de muerte intrahospitalaria fueron la edad, la duración del ingreso y la presencia de enfermedad renal crónica.

Medicina Clinica, 2020

Background: Death and unexpected readmission are frequent among heart failure patients. We aimed ... more Background: Death and unexpected readmission are frequent among heart failure patients. We aimed to assess 30-day readmission and mortality rate as well as to identify predictive factors for patients discharged from a first HF related hospital admission. Methods and results: Retrospective, single-center, cohort study, using administrative data from a tertiary care hospital in Barcelona, Spain. Patients discharged alive from a first HF related admission from 2010 to 2014 were assessed for 30-day death, readmission and adverse outcome rate. A Linear Logistic Regression Model was fitted for each outcome. The set accounted for 3642 patients; 50.1% female and 49.9% male. Mean age was 76 years (SD = 12). 30-Days rates were 9.2% for readmission, 5.6% for death and 13.8% for adverse outcome. Admission to an ED within 30 days was strongly linked to readmission (OR = 6.97), death (OR = 2.31) and adverse outcome (OR = 8.55), as well as chronic kidney disease (OR = 1.44/1.61/2.86 respectively). Discharge to a Long Stay Care (LSC) facility was linked to lower readmission and adverse event rates (OR = .57 and OR = .15). Conclusion: Pre and post-index discharge use of health care resources is related to adverse outcome rates. Our findings point out the potential benefit for a more tailored approach in the management of HF patients.

Revista clínica española, Apr 1, 2019

Objectives: We evaluated the patient profile and outcomes of first heart failure (HF) related hos... more Objectives: We evaluated the patient profile and outcomes of first heart failure (HF) related hospital admission patients in the 2010-2014 period. Design: Retrospective, single-center, cohort study. Setting: We used administrative data from a tertiary care hospital (

Archives of Internal Medicine, 2010

Background: Life expectancy of people with human immunodeficiency virus (HIV) is now estimated to... more Background: Life expectancy of people with human immunodeficiency virus (HIV) is now estimated to approach that of the general population in some successfully treated subgroups. However, to attain these life expectancies, viral suppression must be maintained for decades. Methods: We studied the rate of triple-class virologic failure (TCVF) in patients within the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) who started antiretroviral therapy (ART) that included a nonnucleoside reverse-transcriptase inhibitor (NNRTI) or a ritonavir-boosted protease inhibitor (PI/r) from 1998 onwards. We also focused on TCVF in patients who started a PI/r-containing regimen after a firstline NNRTI-containing regimen failed. Results: Of 45 937 patients followed up for a median (interquartile range) of 3.0 (1.5-5.0) years, 980 developed TCVF (2.1%). By 5 and 9 years after starting ART, an estimated 3.4% (95% confidence interval [CI], 3.1%-3.6%) and 8.6% (95% CI, 7.5%-9.8%) of patients, respectively, had developed TCVF. The incidence of TCVF rose during the first 3 to 4 years on ART but plateaued thereafter. There was no significant difference in the risk of TCVF according to whether the initial regimen was NNRTI or PI/r based (P =.11). By 5 years after starting a PI/r regimen as second-line therapy, 46% of patients had developed TCVF. Conclusions: The rate of virologic failure of the 3 original drug classes is low, but not negligible, and does not appear to diminish over time from starting ART. If this trend continues, many patients are likely to need newer drugs to maintain viral suppression. The rate of TCVF from the start of a PI/r regimen after NNRTI failure provides a comparator for studies of response to secondline regimens in resource-limited settings.

Revista de Calidad Asistencial, 2006

Preventive Medicine, 2006

Background. Factors associated with compliance with smoke-free policies among hospitalized smoker... more Background. Factors associated with compliance with smoke-free policies among hospitalized smokers are poorly described. A better understanding of these factors may improve smoking cessation during admission and in the long-term. Methods. Two cross-sectional studies were conducted in an urban teaching hospital in Spain during 2002 and 2004. We interviewed 229 admitted smokers gathering data on smoking history, admission diagnosis, belief that hospitalization is related to smoking, policy's awareness, and smoking during admission and place of smoking. Results. Among hospitalized patients, approximately a third were current smokers. The compliance with the nonsmoking policy in 2002 and 2004 was respectively 71.9% (IC95%: 63.9-79.9) and 60.1% (IC95%: 50.9-69.3). In the multivariate regression model, factors significantly associated with compliance were: contemplation stage, confidence in quitting after discharge, belief that current symptoms or illness were related to smoking, and mild withdrawal symptoms. Conclusions. Admission in a smoke-free hospital does not guarantee that patients will refrain from smoking. Factors associated with compliance identified may be modified by tailored smoking cessation interventions. Our results might help physicians to understand inpatients' difficulties to abstain from cigarettes and enhance their efforts to take advantage of the hospitalization as a window opportunity to quit.

Medicina Clínica

BACKGROUND Death and unexpected readmission are frequent among heart failure patients. We aimed t... more BACKGROUND Death and unexpected readmission are frequent among heart failure patients. We aimed to assess 30-day readmission and mortality rate as well as to identify predictive factors for patients discharged from a first HF related hospital admission. METHODS AND RESULTS Retrospective, single-center, cohort study, using administrative data from a tertiary care hospital in Barcelona, Spain. Patients discharged alive from a first HF related admission from 2010 to 2014 were assessed for 30-day death, readmission and adverse outcome rate. A Linear Logistic Regression Model was fitted for each outcome. The set accounted for 3642 patients; 50.1% female and 49.9% male. Mean age was 76 years (SD=12). 30-Days rates were 9.2% for readmission, 5.6% for death and 13.8% for adverse outcome. Admission to an ED within 30 days was strongly linked to readmission (OR=6.97), death (OR=2.31) and adverse outcome (OR=8.55), as well as chronic kidney disease (OR=1.44/1.61/2.86 respectively). Discharge to a Long Stay Care (LSC) facility was linked to lower readmission and adverse event rates (OR=.57 and OR=.15). CONCLUSION Pre and post-index discharge use of health care resources is related to adverse outcome rates. Our findings point out the potential benefit for a more tailored approach in the management of HF patients.

Revista Clínica Española (English Edition)

Abstract Objectives We evaluated the patient profile and outcomes of first heart failure (HF) rel... more Abstract Objectives We evaluated the patient profile and outcomes of first heart failure (HF) related hospital admission patients in the 2010–2014 period. Design Retrospective, single-center, cohort study. Setting We used administrative data from a tertiary care hospital (Hospital Universitari de Bellvitge, Barcelona, Spain). Participants All patients with primary diagnosis of HF registered at the hospital discharge database from 2010 to 2014 were included, ruling out that HF was present 10 years prior to the current episode. Intervention Primary care HF diagnosis status was assessed in order to distinguish new onset from no-new onset patients. Main measures Descriptive, bivariate and multivariate analysis were performed using age, previous primary care HF diagnosis and in-hospital death as grouping variables. Significant variables were fitted into a Linear logistic regression model for each outcome. Results We selected 3868 first HF-related admissions (56.8% of all HF episodes). In 1220 patients (31.7%) HF was diagnosed by their primary care physician. Main pattern was a woman (OR = 2.4), with higher prevalence of hypertension (OR = 1.7), atrial fibrillation (OR = 1.3), chronic kidney disease (OR = 1.6) and mortality rate (9.8%). In-hospital death rate was 5.8%, age over 85 (OR = 5.57), chronic kidney disease (OR = 1.44) and length of stay over 7 days (OR = 1.90) being the main contributors. Conclusions First HF related admissions account for 56.7% of all HF episodes. Roughly one third of patients were already diagnosed by the time of their first hospital admission. Elderly women were the most frequent, but not the only, group of patients. Age, hospital stay and chronic kidney disease were the main contributors for in-hospital death.

Revista Clínica Española

Resumen Objetivos Evaluamos el perfil de paciente y los resultados del primer ingreso hospitalari... more Resumen Objetivos Evaluamos el perfil de paciente y los resultados del primer ingreso hospitalario asociado a un acontecimiento de insuficiencia cardiaca (IC) en el periodo de tiempo comprendido entre 2010-2014. Diseno Estudio de cohorte retrospectivo de centro unico. Contexto Utilizamos los datos de un hospital de atencion terciaria (Hospital Universitari de Bellvitge, Barcelona, Espana). Participantes Se incluyeron todos los pacientes con diagnostico primario de IC registrados en la base de datos de altas hospitalarias entre los anos 2010 y 2014, excluyendo los casos en los que la IC se presento 10 anos antes del episodio objeto de estudio. Intervencion El diagnostico de IC en atencion primaria fue evaluado para diferenciar entre pacientes con IC de inicio y aquellos sin ella. Principales medidas Los analisis descriptivo, bivariado y multivariado se realizaron usando como variables de agrupamiento la edad, el diagnostico previo de IC en atencion primaria y la muerte hospitalaria. Se ajustaron variables significativas en un modelo de regresion logistica lineal para cada resultado. Resultados Seleccionamos 3.868 primeros ingresos por IC (56,8% de todos los episodios de IC). En 1.220 pacientes (31,7%) el diagnostico de IC fue realizado por el medico de atencion primaria. El modelo principal fue el de una mujer (OR = 2,4), con alta prevalencia de hipertension (OR = 1,7), fibrilacion auricular (OR = 1,3), enfermedad renal cronica (OR = 1,6) y tasa de mortalidad del 9,8%. La tasa de muerte intrahospitalaria fue del 5,8%; los principales factores contribuyentes fueron la edad (mayor de 85 anos; OR = 5,57), la presencia de enfermedad renal cronica (OR = 1,44) y la duracion del ingreso (7 dias; OR = 1,90). Conclusiones Los casos de primer ingreso asociado a IC representan el 56,7% de todos los casos de IC. Aproximadamente un tercio de los pacientes fueron diagnosticados en el momento de su primera hospitalizacion. El mayor numero de casos se dio en el grupo de mujeres ancianas, aunque no solo en ellas. Los principales contribuyentes de muerte intrahospitalaria fueron la edad, la duracion del ingreso y la presencia de enfermedad renal cronica.

International journal of cardiology, 2017

The Readmission Risk score (RR score) has been considered useful to predict Medicare/Medicaid pat... more The Readmission Risk score (RR score) has been considered useful to predict Medicare/Medicaid patients' likelihood of 30-day hospital readmission for heart failure (HF). To our knowledge, the accuracy of this prediction model has not been independently validated in other clinical circumstances in Europe. From July 2013 to December 2014, all patients who survived to a first admission due to decompensated HF at our tertiary care teaching hospital were retrospectively included in the study. The RR score was calculated in all patients to predict future 30 and 90-day unplanned all-cause readmissions. A total of 679 patients were included, of them, 52 patients (7.6%) were readmitted by any cause within 30days after discharge, and 98 (14.4%) within 90days. When compared, the average RR scores for patients readmitted was significantly higher to those who did not, either within 30days (22.7 vs. 20.1) or 90days (22.7 vs. 20.1) of discharge. The 30-day C-statistic was 0.649 (95% CI 0.574-0...

Annals of Emergency Medicine, 2005

However, retinal hemorrhage was significantly more common in cases of NAHT [NAHT, 5/9 (56%); non-... more However, retinal hemorrhage was significantly more common in cases of NAHT [NAHT, 5/9 (56%); non-birth related AHI, 1/9 (5%); p=.0005]. Conclusion: Mixed-density subdural hematoma may be found on NCCT performed within 24 hours of accidental head injury. Neither mixed-density SDH nor perifalcine hemorrhage is a specific indicator of NAHT. Although retinal hemorrhage can occur after accidental head injury, it is significantly more common after nonaccidental head trauma.