array:23 [
  "pii" => "S0210569120301820"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2020.05.014"
  "estado" => "S300"
  "fechaPublicacion" => "2021-08-01"
  "aid" => "1531"
  "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2021;45:383-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S021056911930230X"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2019.09.012"
    "estado" => "S300"
    "fechaPublicacion" => "2021-08-01"
    "aid" => "1396"
    "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Med Intensiva. 2021;45:385"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8
      "formatos" => array:2 [
        "HTML" => 4
        "PDF" => 4
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>"
      "titulo" => "Hamman&#39;s syndrome in a child"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "385"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "S&#237;ndrome de Hamman en un ni&#241;o"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 700
              "Ancho" => 1200
              "Tamanyo" => 116106
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Y&#46;A&#46; Kamal"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Y&#46;A&#46;"
              "apellidos" => "Kamal"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911930230X?idApp=WMIE"
    "url" => "/02105691/0000004500000006/v1_202107200632/S021056911930230X/v1_202107200632/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0210569120302527"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2020.07.001"
    "estado" => "S300"
    "fechaPublicacion" => "2021-08-01"
    "aid" => "1559"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2021;45:382"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA AL EDITOR</span>"
      "titulo" => "Respuesta a &#171;Algunas consideraciones sobre la &#233;tica del triaje en UCI durante la pandemia COVID-19&#187;"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "382"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Reply to &#8220;Considerations on ICU triage ethics during the COVID-19 pandemic&#8221;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "O&#46; Rubio, L&#46; Cabr&#233;, A&#46; Estella, R&#46; Ferrer"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Rubio"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Cabr&#233;"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Estella"
            ]
            3 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Ferrer"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572721000588"
        "doi" => "10.1016/j.medine.2021.04.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572721000588?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120302527?idApp=WMIE"
    "url" => "/02105691/0000004500000006/v1_202107200632/S0210569120302527/v1_202107200632/es/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "COVID-19 mortality and health-care resources&#58; Organization"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "383"
        "paginaFinal" => "384"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; Immovilli, N&#46; Morelli, E&#46; Rota, D&#46; Guidetti"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "P&#46;"
            "apellidos" => "Immovilli"
            "email" => array:1 [
              0 => "paolo.immovilli.md@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "N&#46;"
            "apellidos" => "Morelli"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Rota"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Guidetti"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Neurology Unit&#44; Emergency Department&#44; Guglielmo da Saliceto Hospital&#44; Piacenza&#44; Italy"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Neurology Unit&#44; ASL Alessandria&#44; Italy"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Mortalidad de COVID-19 y recursos sanitarios&#58; organizaci&#243;n"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 715
            "Ancho" => 2174
            "Tamanyo" => 76141
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The correlation between the case fatality rate and the COVID-19 incidence&#59; &#40;b&#41; the inverse correlation between the case fatality rate and the ICU admission rate &#40;number of people admitted to the ICU to total inpatient rate&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Ji and colleagues<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> plotted COVID-19 mortality against incidence and demonstrated a statistically significant correlation&#44; which highlighted a possible link between mortality and health-care burden&#59; we recently found a similar association between case fatality rate &#40;CFR&#41; and intensive care unit to total inpatient admission rate &#40;ICUAR&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Extending our previous analysis over time on the cumulative data from February 21<span class="elsevierStyleSup">st</span> to April 18<span class="elsevierStyleSup">th</span>&#44; and including COVID-19 incidence&#44; we evaluated CFR and ICUAR on 175&#44;925 cases&#44; 27&#44;740 inpatients&#44; 2733 intensive care unit &#40;ICU&#41; inpatients&#44; 23&#44;227 deaths&#58; the CFR was 13&#46;2&#37;&#44; and the number of patients admitted in ICU varied along time&#44; reaching a peak of 4068 on April 3<span class="elsevierStyleSup">rd</span> and reducing to 2733 on April 18<span class="elsevierStyleSup">th</span> &#40;32&#46;8&#37; reduction in 2 weeks&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The COVID-19 incidence and ICU capability varied widely amongst the Italian Regions&#58; the average incidence was 28&#46;6 per 10&#44;000 people &#40;range 5&#46;2&#8211;85&#46;6&#41; and the average ICUAR was 11&#46;8&#37; &#40;range 4&#46;4&#8211;22&#46;7&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">There are some particular issues involved in the estimation of CFR in Italy&#58; the high average age of the Italian population&#44; the definition of COVID-19-related deaths&#44; the pharyngeal swab testing strategy employed and the CFR variation in different epidemic time-frame&#46; It has been postulated that the confirmed diagnosis of milder cases could increase with the number of swabs taken&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">A univariate analysis of Italian regional data showed a strong correlation between CFR and COVID-19 incidence &#40;<span class="elsevierStyleItalic">R</span> 0&#46;715&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> 0&#46;511&#44; <span class="elsevierStyleItalic">p</span>-value 0&#46;000&#41;&#44; an inverse correlation between CFR and ICUAR &#40;<span class="elsevierStyleItalic">R</span> &#8722;0&#46;466&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> 0&#46;217&#44; <span class="elsevierStyleItalic">p</span>-value 0&#46;033&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The pharyngeal swab per 10&#44;000 people did not correlate with the CFR &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;368&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The multivariate analysis showed that CFR was only associated with COVID-19 incidence &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;001&#41;&#44; but neither with ICUAR &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;172&#41;&#44; nor with pharyngeal swab per 10&#44;000 people &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;221&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The different COVID-19 incidence and ICU capability in the Italian Regions showed that mortality was linked to high incidence and ICU capability&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Our previous analysis was done during the continuous everyday increasing of ICU patients&#44; which peaked on April 3<span class="elsevierStyleSup">rd</span>&#44; whether now we included two weeks of decreasing pressure on ICU&#58; the association between CFR and ICAR is still present&#44; but in the multivariate regression model only the incidence had a significant effect&#46; Lombardy was the epicenter of the out-break and the region with higher CFR&#58; it was an outlier&#44; probably contributing to reduce the coefficient of determination &#40;<span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span>&#41; in the correlation between CFR and ICUAR&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">During different time-frame of such a huge outbreak the key factors associated with CFR may play different roles&#58; the incidence seems to be strongly associated with CFR&#44; but the ICUAR could be associated especially during the increasing of out-break when the ICU capability could be overwhelmed&#46; According to this hypothesis different health-care resources should be implemented in different out-break time-frame&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">On behalf of all authors&#44; the corresponding author states that there is no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflict of interest"
        ]
        1 => array:2 [
          "identificador" => "xack546459"
          "titulo" => "Acknowledgments"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 715
            "Ancho" => 2174
            "Tamanyo" => 76141
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The correlation between the case fatality rate and the COVID-19 incidence&#59; &#40;b&#41; the inverse correlation between the case fatality rate and the ICU admission rate &#40;number of people admitted to the ICU to total inpatient rate&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:4 [
            0 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Potential association between COVID-19 mortality and healthcare resource availability"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Ji"
                            1 => "Z&#46; Ma"
                            2 => "M&#46;P&#46; Peppelenbosch"
                            3 => "Q&#46; Pan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Lancet Glob Health"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "CVID-19 mortality and ICU admission&#58; the Italian experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Immovilli"
                            1 => "N&#46; Morelli"
                            2 => "E&#46; Antonucci"
                            3 => "G&#46; Radaelli"
                            4 => "M&#46; Barbera"
                            5 => "D&#46; Guidetti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-020-02957-9"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2020"
                        "volumen" => "24"
                        "paginaInicial" => "228"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32414403"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "<a target="_blank" href="http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe%2038d4138b1">http&#58;&#47;&#47;opendatadpc&#46;maps&#46;arcgis&#46;com&#47;apps&#47;opsdashboard&#47;index&#46;html&#35;&#47;b0c68bce2cce478eaac82fe 38d4138b1</a> &#40;accessed 18&#46;04&#46;20&#41;"
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Onder"
                            1 => "G&#46; Rezza"
                            2 => "S&#46; Brusaferro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2020.4683. Published online: March 23"
                      "Revista" => array:3 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2020"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9676687"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack546459"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0055" class="elsevierStylePara elsevierViewall">The author thanks The Italian Civil Protection Department for sharing the data on line and Mrs Barbara Ward for her linguistic advice&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02105691/0000004500000006/v1_202107200632/S0210569120301820/v1_202107200632/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "57221"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas al Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004500000006/v1_202107200632/S0210569120301820/v1_202107200632/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120301820?idApp=WMIE"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Letter to the Editor
COVID-19 mortality and health-care resources: Organization
Mortalidad de COVID-19 y recursos sanitarios: organización
P. Immovillia,
Autor para correspondencia
paolo.immovilli.md@gmail.com

Corresponding author.
, N. Morellia, E. Rotab, D. Guidettia
a Neurology Unit, Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
b Neurology Unit, ASL Alessandria, Italy
Leído
7545
Veces
se ha leído el artículo
2402
Total PDF
5143
Total HTML
Compartir estadísticas
 array:23 [
  "pii" => "S0210569120301820"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2020.05.014"
  "estado" => "S300"
  "fechaPublicacion" => "2021-08-01"
  "aid" => "1531"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2021;45:383-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S021056911930230X"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2019.09.012"
    "estado" => "S300"
    "fechaPublicacion" => "2021-08-01"
    "aid" => "1396"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Med Intensiva. 2021;45:385"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8
      "formatos" => array:2 [
        "HTML" => 4
        "PDF" => 4
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>"
      "titulo" => "Hamman&#39;s syndrome in a child"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "385"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "S&#237;ndrome de Hamman en un ni&#241;o"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 700
              "Ancho" => 1200
              "Tamanyo" => 116106
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Y&#46;A&#46; Kamal"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Y&#46;A&#46;"
              "apellidos" => "Kamal"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911930230X?idApp=WMIE"
    "url" => "/02105691/0000004500000006/v1_202107200632/S021056911930230X/v1_202107200632/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0210569120302527"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2020.07.001"
    "estado" => "S300"
    "fechaPublicacion" => "2021-08-01"
    "aid" => "1559"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2021;45:382"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA AL EDITOR</span>"
      "titulo" => "Respuesta a &#171;Algunas consideraciones sobre la &#233;tica del triaje en UCI durante la pandemia COVID-19&#187;"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "382"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Reply to &#8220;Considerations on ICU triage ethics during the COVID-19 pandemic&#8221;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "O&#46; Rubio, L&#46; Cabr&#233;, A&#46; Estella, R&#46; Ferrer"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Rubio"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Cabr&#233;"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Estella"
            ]
            3 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Ferrer"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572721000588"
        "doi" => "10.1016/j.medine.2021.04.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572721000588?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120302527?idApp=WMIE"
    "url" => "/02105691/0000004500000006/v1_202107200632/S0210569120302527/v1_202107200632/es/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "COVID-19 mortality and health-care resources&#58; Organization"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "383"
        "paginaFinal" => "384"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; Immovilli, N&#46; Morelli, E&#46; Rota, D&#46; Guidetti"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "P&#46;"
            "apellidos" => "Immovilli"
            "email" => array:1 [
              0 => "paolo.immovilli.md@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "N&#46;"
            "apellidos" => "Morelli"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Rota"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Guidetti"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Neurology Unit&#44; Emergency Department&#44; Guglielmo da Saliceto Hospital&#44; Piacenza&#44; Italy"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Neurology Unit&#44; ASL Alessandria&#44; Italy"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Mortalidad de COVID-19 y recursos sanitarios&#58; organizaci&#243;n"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 715
            "Ancho" => 2174
            "Tamanyo" => 76141
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The correlation between the case fatality rate and the COVID-19 incidence&#59; &#40;b&#41; the inverse correlation between the case fatality rate and the ICU admission rate &#40;number of people admitted to the ICU to total inpatient rate&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Ji and colleagues<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> plotted COVID-19 mortality against incidence and demonstrated a statistically significant correlation&#44; which highlighted a possible link between mortality and health-care burden&#59; we recently found a similar association between case fatality rate &#40;CFR&#41; and intensive care unit to total inpatient admission rate &#40;ICUAR&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Extending our previous analysis over time on the cumulative data from February 21<span class="elsevierStyleSup">st</span> to April 18<span class="elsevierStyleSup">th</span>&#44; and including COVID-19 incidence&#44; we evaluated CFR and ICUAR on 175&#44;925 cases&#44; 27&#44;740 inpatients&#44; 2733 intensive care unit &#40;ICU&#41; inpatients&#44; 23&#44;227 deaths&#58; the CFR was 13&#46;2&#37;&#44; and the number of patients admitted in ICU varied along time&#44; reaching a peak of 4068 on April 3<span class="elsevierStyleSup">rd</span> and reducing to 2733 on April 18<span class="elsevierStyleSup">th</span> &#40;32&#46;8&#37; reduction in 2 weeks&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The COVID-19 incidence and ICU capability varied widely amongst the Italian Regions&#58; the average incidence was 28&#46;6 per 10&#44;000 people &#40;range 5&#46;2&#8211;85&#46;6&#41; and the average ICUAR was 11&#46;8&#37; &#40;range 4&#46;4&#8211;22&#46;7&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">There are some particular issues involved in the estimation of CFR in Italy&#58; the high average age of the Italian population&#44; the definition of COVID-19-related deaths&#44; the pharyngeal swab testing strategy employed and the CFR variation in different epidemic time-frame&#46; It has been postulated that the confirmed diagnosis of milder cases could increase with the number of swabs taken&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">A univariate analysis of Italian regional data showed a strong correlation between CFR and COVID-19 incidence &#40;<span class="elsevierStyleItalic">R</span> 0&#46;715&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> 0&#46;511&#44; <span class="elsevierStyleItalic">p</span>-value 0&#46;000&#41;&#44; an inverse correlation between CFR and ICUAR &#40;<span class="elsevierStyleItalic">R</span> &#8722;0&#46;466&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> 0&#46;217&#44; <span class="elsevierStyleItalic">p</span>-value 0&#46;033&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The pharyngeal swab per 10&#44;000 people did not correlate with the CFR &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;368&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The multivariate analysis showed that CFR was only associated with COVID-19 incidence &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;001&#41;&#44; but neither with ICUAR &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;172&#41;&#44; nor with pharyngeal swab per 10&#44;000 people &#40;<span class="elsevierStyleItalic">p</span>-value 0&#46;221&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The different COVID-19 incidence and ICU capability in the Italian Regions showed that mortality was linked to high incidence and ICU capability&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Our previous analysis was done during the continuous everyday increasing of ICU patients&#44; which peaked on April 3<span class="elsevierStyleSup">rd</span>&#44; whether now we included two weeks of decreasing pressure on ICU&#58; the association between CFR and ICAR is still present&#44; but in the multivariate regression model only the incidence had a significant effect&#46; Lombardy was the epicenter of the out-break and the region with higher CFR&#58; it was an outlier&#44; probably contributing to reduce the coefficient of determination &#40;<span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span>&#41; in the correlation between CFR and ICUAR&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">During different time-frame of such a huge outbreak the key factors associated with CFR may play different roles&#58; the incidence seems to be strongly associated with CFR&#44; but the ICUAR could be associated especially during the increasing of out-break when the ICU capability could be overwhelmed&#46; According to this hypothesis different health-care resources should be implemented in different out-break time-frame&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">On behalf of all authors&#44; the corresponding author states that there is no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflict of interest"
        ]
        1 => array:2 [
          "identificador" => "xack546459"
          "titulo" => "Acknowledgments"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 715
            "Ancho" => 2174
            "Tamanyo" => 76141
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; The correlation between the case fatality rate and the COVID-19 incidence&#59; &#40;b&#41; the inverse correlation between the case fatality rate and the ICU admission rate &#40;number of people admitted to the ICU to total inpatient rate&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:4 [
            0 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Potential association between COVID-19 mortality and healthcare resource availability"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Ji"
                            1 => "Z&#46; Ma"
                            2 => "M&#46;P&#46; Peppelenbosch"
                            3 => "Q&#46; Pan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Lancet Glob Health"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "CVID-19 mortality and ICU admission&#58; the Italian experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Immovilli"
                            1 => "N&#46; Morelli"
                            2 => "E&#46; Antonucci"
                            3 => "G&#46; Radaelli"
                            4 => "M&#46; Barbera"
                            5 => "D&#46; Guidetti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-020-02957-9"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2020"
                        "volumen" => "24"
                        "paginaInicial" => "228"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32414403"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "<a target="_blank" href="http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe%2038d4138b1">http&#58;&#47;&#47;opendatadpc&#46;maps&#46;arcgis&#46;com&#47;apps&#47;opsdashboard&#47;index&#46;html&#35;&#47;b0c68bce2cce478eaac82fe 38d4138b1</a> &#40;accessed 18&#46;04&#46;20&#41;"
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Onder"
                            1 => "G&#46; Rezza"
                            2 => "S&#46; Brusaferro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2020.4683. Published online: March 23"
                      "Revista" => array:3 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2020"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9676687"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack546459"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0055" class="elsevierStylePara elsevierViewall">The author thanks The Italian Civil Protection Department for sharing the data on line and Mrs Barbara Ward for her linguistic advice&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02105691/0000004500000006/v1_202107200632/S0210569120301820/v1_202107200632/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "57221"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas al Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004500000006/v1_202107200632/S0210569120301820/v1_202107200632/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120301820?idApp=WMIE"
]
Información del artículo
ISSN: 02105691
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 1 9 10
2024 Octubre 66 39 105
2024 Septiembre 61 25 86
2024 Agosto 81 35 116
2024 Julio 52 31 83
2024 Junio 63 48 111
2024 Mayo 80 41 121
2024 Abril 62 39 101
2024 Marzo 62 28 90
2024 Febrero 53 280 333
2024 Enero 62 40 102
2023 Diciembre 46 39 85
2023 Noviembre 85 53 138
2023 Octubre 56 32 88
2023 Septiembre 52 30 82
2023 Agosto 48 24 72
2023 Julio 56 38 94
2023 Junio 56 20 76
2023 Mayo 53 30 83
2023 Abril 63 29 92
2023 Marzo 74 34 108
2023 Febrero 60 34 94
2023 Enero 58 23 81
2022 Diciembre 82 43 125
2022 Noviembre 67 41 108
2022 Octubre 67 41 108
2022 Septiembre 74 42 116
2022 Agosto 86 46 132
2022 Julio 78 39 117
2022 Junio 75 31 106
2022 Mayo 86 41 127
2022 Abril 138 55 193
2022 Marzo 129 57 186
2022 Febrero 183 41 224
2022 Enero 150 41 191
2021 Diciembre 131 59 190
2021 Noviembre 154 63 217
2021 Octubre 156 49 205
2021 Septiembre 116 41 157
2021 Agosto 135 38 173
2021 Julio 129 32 161
2021 Junio 106 31 137
2021 Mayo 98 31 129
2021 Abril 395 109 504
2021 Marzo 166 42 208
2021 Febrero 95 30 125
2021 Enero 118 55 173
2020 Diciembre 119 46 165
2020 Noviembre 100 29 129
2020 Octubre 65 36 101
2020 Septiembre 69 37 106
2020 Agosto 65 43 108
2020 Julio 361 112 473
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Medicina Intensiva
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?