En Chile, entre un 20% y un 38% de los usuarios que sufren un ataque cerebro-vascular (ACV) presentan afasia. Pese a su alta prevalencia no existen herramientas validadas que permitan realizar una caracterización lingüística temprana de la afasia. Por lo anterior, el objetivo del presente trabajo es analizar la sensibilidad y especificidad de la versión en español del ScreeLing en una muestra de usuarios afásicos después de producido un ACV. Se trata de un estudio transversal analítico en el cual se aplicó el test ScreeLing a 13 usuarios afásicos tras primer evento de ACV en etapa aguda (< 6 semanas tras ACV) y a 56 adultos neurológicamente sanos. Adicionalmente, se evaluó el nivel comprensivo y el lenguaje espontáneo de usuarios con afasia, con la versión abreviada del Token Test y Escala de Severidad de la Afasia (ASRS). Se construyeron modelos mediante regresiones logísticas, obteniendo sus respectivas áreas bajo la curva ROC. Los resultados muestran que el equilibrio entre sensibilidad y especificidad para el puntaje global del test ScreeLing se estableció en 67 puntos, obteniendo una sensibilidad del 94,6% y especificidad del 100%. El área bajo la curva ROC alcanzó 0,99 (IC 95%: 0,97-1,00). En las subpruebas sintáctica y fonológica se alcanzó un puntaje de corte de 21 puntos, mientras que en la subprueba semántica se lograron 22 puntos. Se concluye que el ScreeLing en español posee una alta sensibilidad y especificidad para la detección de déficits lingüísticos post ACV similar a los resultados encontrados en la versión original del test en holandés. Esfuerzos futuros deben concentrarse en ampliar la muestra de usuarios afásicos con distintos perfiles de severidad.
Evolution and prognostic factors associated with mortality in older adults hospitalized for COVID-19Background: SARS-CoV-2 affects all age groups, but higher mortality rates are recorded in older people, men and with comorbidities, mainly hypertension, diabetes and obesity. Aim: To describe the main clinical characteristics, evolution and prognostic factors for death in older patients hospitalized for COVID-19. Materials and Methods: Retrospective analysis of 128 patients aged 73 years, 66% men, hospitalized at a clinical hospital, with a diagnosis of COVID-19, admitted from May 1 to August 1, 2020. Data were collected from the clinical records, a description of the study population was made, and a univariate analysis and logistic regression were performed. Results: Seventy-two percent of patients had two or more comorbidities, mainly arterial hypertension in 66%, diabetes mellitus in 34% and cardiovascular disease in 19%. Forty-one percent were admitted to intensive care and 31% were connected to mechanical ventilation. In-hospital mortality was 26.6%. A multivariate analysis was performed in two blocks, finding in the first that arterial hypertension and older age significantly predict mortality. However, when previous institutionalization and immunosuppression were included as variables in the second block, age ceased to be a significant predictor. Conclusions: Prognostic factors associated with death in this age group are arterial hypertension and previous institutionalization.
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