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Ameneiros-Lago, C. Carballada-Rico, I. Gómez-Buela" "autores" => array:3 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Ameneiros-Lago" "email" => array:1 [ 0 => "eugenia.ameneiros.lago@sergas.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Carballada-Rico" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "I." "apellidos" => "Gómez-Buela" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Complejo Hospitalario Universitario de Ferrol, Ferrol, La Coruña, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Hospitalización a Domicilio, Complejo Hospitalario Universitario de Ferrol, Ferrol, La Coruña, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Comité de Ética Asistencial, Complejo Hospitalario Universitario de Ferrol, Ferrol, La Coruña, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cuidados en los últimos días de vida en los pacientes hospitalizados en medicina interna" ] ] "textoCompleto" => "We read the article by Díez-Manglano et al.<a class="elsevierStyleCrossRef" href="#bib0030">1</a> on the end-of-life care of patients hospitalized in internal medicine (IM) and would like to make a few comments.As indicated by the authors, 10% of patients hospitalized in IM die during the hospitalization; end-of-life care is therefore a critical part of our activities, and we should be experts in this process.In the article, the researchers recognized that 51.9% of the patients were terminal, a figure far from the 87% recorded by Vilá Santasuana et al.<a class="elsevierStyleCrossRef" href="#bib0035">2</a> in a similar study. One of the study's limitations is that the authors used subjective criteria for this identification. Terminal status, defined as a vital prognosis shorter than 6 months, is extremely difficult to define in nononcologic patients, which can result in an underestimate of its recording in the study, both by the clinicians and researchers. Due to these difficulties, we prefer referring to such patients as having complex advanced disease with a limited life prognosis, for which there are defined objective criteria.Once these patients have been identified, a comprehensive approach needs to be conducted that establishes an appropriateness of diagnostic and therapeutic procedures to prevent therapeutic obstinacy.<a class="elsevierStyleCrossRef" href="#bib0040">3</a>In this respect, another of the study limitations is the scarce information regarding the decisions to limit the therapeutic effort (LTE), given that only the do-not-resuscitate orders are recorded. It would be of interest to record whether other LTE decisions were taken and when they were taken, given that if they were close to the end of life, they would lose some of their value.<a class="elsevierStyleCrossRef" href="#bib0045">4</a>Although we should be experts in end-of-life care, the results of this and other studies<a class="elsevierStyleCrossRef" href="#bib0050">5</a> reflect the need to improve this aspect." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Ameneiros-Lago E, Carballada-Rico C, Gómez-Buela I. Cuidados en los últimos días de vida en los pacientes hospitalizados en medicina interna. Rev Clin Esp. 2020;220:75–75." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cuidados en los últimos días de vida en los pacientes hospitalizados en medicina interna" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Díez-Manglano" 1 => "S.I. Isasmendi-Pérez" 2 => "M. Rubio-Gómez" 3 => "F. Formiga" 4 => "L.A. Sánchez-Muñoz" 5 => "J. Castiella-Herrero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2018.06.010" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2019" "volumen" => "219" "paginaInicial" => "107" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30077385" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Última semana de vida en un hospital de agudos: revisión de 401 pacientes consecutivos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Vilá Santasuana" 1 => "N. Celorrio Jiménez" 2 => "X. Sanz Salvador" 3 => "J. Martínez Montautí" 4 => "E. Díez-Cascón Menéndez" 5 => "C. Puig Rossel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0211-139x(08)73570-4" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Geriatr Gerontol" "fecha" => "2008" "volumen" => "43" "paginaInicial" => "284" "paginaFinal" => "290" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18842202" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adecuación de las intervenciones clínicas en pacientes con enfermedad avanzada y compleja. Propuesta de algoritmo para la toma de decisiones" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Ameneiros-Lago" 1 => "C. Carballada-Rico" 2 => "J.A. Garrido-Sanjuan" 3 => "A. García-Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cali.2014.12.010" "Revista" => array:6 [ "tituloSerie" => "Rev Calid Asist" "fecha" => "2015" "volumen" => "30" "paginaInicial" => "38" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25666087" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Limitación del esfuerzo terapéutico en pacientes hospitalizados en servicios de medicina interna" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. García Caballero" 1 => "B. Herreros" 2 => "D. Real de Asúa" 3 => "S. Gámez" 4 => "G. Vega" 5 => "L. García Olmos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2017.10.001" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2018" "volumen" => "218" "paginaInicial" => "1" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29137700" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mortalidad esperable en medicina interna: ¿cómo son los últimos días de vida en los pacientes en los que la muerte es previsible?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Ameneiros-Lago" 1 => "C. Carballada Rico" 2 => "J.A. Garrido-Sanjuan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Paliat" "fecha" => "2017" "volumen" => "24" "paginaInicial" => "63" "paginaFinal" => "71" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022000000001/v1_202002130124/S2254887419302139/v1_202002130124/en/main.assets" "Apartado" => array:4 [ "identificador" => "71813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Correspondence" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000001/v1_202002130124/S2254887419302139/v1_202002130124/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419302139?idApp=WRCEE"]

Revista Clínica Española (English Edition)

ISSN: 2254-8874

Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI).
The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Ten issues are published each year, including mostly originals, reviews and consensus documents.

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