El objetivo del presente estudio fue analizar las causas y los costos directos de hospitalización de pacientes con artritis reumatoidea, establecer la morbilidad asociada y evaluar su impacto sobre los costos de la hospitalización. Para tal fin, se revisaron las historias clínicas y los registros del Departamento de Estadística y Contabilidad de todos los pacientes con artritis reumatoidea admitidos a la Clínica Universitaria Bolivariana en Medellín, en el periodo comprendido entre enero de 1999 y junio de 2003. Se hospitalizaron 41 pacientes en 62 oportunidades (0,34 hospitalizaciones por paciente por año). La principal causa de hospitalización fue la actividad de la enfermedad (60%), seguida de cirugía (18%) e infección (10%). En 30 casos hospitalizados (48,4%) se observó, al menos, una morbilidad asociada; la más frecuente fue la enfermedad cardiovascular (32%). El promedio de estancia fue de 5±6 días. El promedio de los costos totales fue de US$1.277, y el costo promedio del día de hospitalización fue de US$235. Los medicamentos representaron el 54% de los costos totales, mientras que los de asistencia médica representaron apenas el 3%. La enfermedad cardiovascular fue el determinante más importante de altos costos de hospitalización (p<0,01). En conclusión, los costos directos de hospitalización de pacientes con artritis reumatoidea son considerables y surgen principalmente del compromiso orgánico de la enfermedad. La prevención y el tratamiento de la enfermedad cardiovascular son indispensables no sólo para reducir el impacto económico de la artritis reumatoidea, sino también para disminuir el riesgo de mortalidad que la misma acarrea. Estos resultados pueden ser útiles en la definición de las políticas de salud en nuestra población.Palabras clave: artritis reumatoidea, morbilidad asociada, enfermedad cardiovascular, costos directos, hospitalización, infección, mortalidad. Impact of cardiovascular illness on hospitalization costs in patients with rheumatoid arthritisThe causes of admission and the distribution of direct medical costs were examined to establish the clinical predictors of high hospitalization costs in patients with rheumatoid arthritis. This retrospective study included all rheumatoid arthritis patients who were hospitalized in the Clínica Universitaria Bolivariana in Medellín, Colombia, between January 1999 and June 2003. Data were obtained from the medical records and from the hospital statistical section using a cost-analysis spreadsheet. A total of 41 patients were hospitalized 62 times (0.34 hospitalization per patient per year). Disease activity was the most important cause of admission (60%), followed by surgery (18%), and infection (10%). In 30 (48%) hospitalizations, at least one comorbidity was recorded, with cardiovascular disease being the most frequent (32%). The mean length of stay per patient was 5±6 days. The mean total cost was US$1,277, and the mean cost per day of hospitalization was US$235. Medications represented 54% of the total cost, whereas that representing medical c...

e19604 Background: The etiology of FN is well established in the US and the EU. Less is known about it in Colombia. This cohort attempts to fill this void. Methods: We collected prospectively the information on all FN cases with an established etiology that were admitted to the Clínica SOMA (A 160 bed-facility in Medellín, Colombia) from September 2010 to October 2011. FN was defined as the coexistence of an absolute neutrophile count (ANC) <500 and a temperature >38.3 degrees Celsius following cytotoxic chemotherapy for cancer. Results: Fifty four cases of FN with known etiology were found. Twenty four in males and 30 in females. Age range from 16 to 73 years-old (median: 42). Acute lymphoblastic leukemia was the underlying diagnosis in 16 (30%), acute myelogenous leukemia in 13 (24% ), and non-Hodgkin’s lymphoma in 11 (20%). HyperCVAD (with o without rituximab), IdaFlag, bortezomib and HiDAC account for 17 (31%), 12 (22%), 7 (13%), and 5 (9%) cases, respectively. FN occurred 2 to 32 days after chemotherapy (average of 10 days). In 20 (37%) cases ANC on admission was 0, and the average ANC on admission was 120. In 51 cases germs were isolated in the blood (94%). Gram-negative bacilli were isolated in 38 cases (76%), S. aureus in 4 (7%), Candidemia was established in 4 patients (2 with C. krusei and 2 with C. parapsilosis). Pulmonary aspergillosis was established in one case. Of note, two cases of hospital-acquired Legionella pneumophila were found (Table). All patients recovered to non-neutropenic ANC with resolution of the infections. No deaths due to FN occurred in this group of patients. Conclusions: In this cohort from Colombia we found a large predominance of gram-negative bacilli and the isolation of L. Pneumophilla, an unusual pathogen in FN. This pattern differs from the usual germ mix reported in other series. [Table: see text]