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una de las dificultades para conocer la magnitud de la gripe estacional es la variabilidad en los sistemas de vigilancia&#46; Hasta la temporada 2016-2017&#44; el Sistema de Vigilancia de Gripe en Espa&#241;a &#40;SVGE&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> solo recib&#237;a informaci&#243;n de casos graves hospitalizados&#46; En temporadas posteriores se incorpor&#243; la vigilancia de casos hospitalizados con gripe independientemente de su gravedad&#44; aunque &#250;nicamente con datos agregados y periodicidad semanal&#46; La COVID-19 ha acelerado la transici&#243;n hacia sistemas de vigilancia de infecci&#243;n respiratoria aguda leve y grave&#44; con informaci&#243;n de cualquier virus respiratorio o posible agente etiol&#243;gico emergente en el futuro<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A pesar de esta mejora progresiva&#44; los sistemas de vigilancia actuales todav&#237;a no contemplan algunas de las cuestiones m&#225;s relevantes sobre las complicaciones de la gripe&#44; como su relaci&#243;n con la aparici&#243;n posterior de un evento cardiovascular&#44; destacando el infarto agudo de miocardio<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#44;8</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Por todo lo anterior&#44; nuestro objetivo fue determinar la frecuencia de complicaciones en todos los casos de poblaci&#243;n adulta con infecci&#243;n por virus gripales hospitalizados en un complejo asistencial terciario y&#44; de forma espec&#237;fica&#44; analizar las caracter&#237;sticas de los eventos cardiovasculares tras la gripe&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o del estudio</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio observacional y descriptivo que analiza los episodios de gripe en adultos hospitalizados durante las temporadas 2017-2018 y 2018-2019&#44; independientemente de su gravedad&#46; La temporada 2017-2018 comprendi&#243; desde el 1&#47;10&#47;2017&#44; hasta el 19&#47;05&#47;2018&#44; y la temporada 2018-2019 desde el 30&#47;09&#47;2018&#44; hasta el 18&#47;05&#47;2019&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">&#193;mbito</span><p id="par0030" class="elsevierStylePara elsevierViewall">La investigaci&#243;n tuvo lugar en un hospital terciario en Salamanca &#40;Castilla y Le&#243;n&#44; Espa&#241;a&#41;&#44; con 903 camas de agudos&#44; que atiende a una poblaci&#243;n de 332&#46;234 habitantes&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Las coberturas vacunales en el &#225;rea fueron del 21&#44;80&#37; en la temporada 2017-2018 &#40;62&#44;04&#37; entre los mayores de 65 a&#241;os&#41; y del 22&#44;03&#37; en la temporada 2018-2019 &#40;61&#44;11&#37; entre los mayores de 65 a&#241;os&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Fuente de datos</span><p id="par0040" class="elsevierStylePara elsevierViewall">La fuente de datos fue el sistema de vigilancia de gripe del hospital&#44; que incluy&#243; la realizaci&#243;n de PCR a todos los pacientes con cl&#237;nica compatible y criterios de hospitalizaci&#243;n&#44; y la actualizaci&#243;n diaria de la informaci&#243;n cl&#237;nica y administrativa de los casos&#44; hasta el momento del alta&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se consider&#243; caso a los pacientes con s&#237;ndrome gripal&#44; confirmado a trav&#233;s de la detecci&#243;n de ARN del virus en muestras respiratorias procesadas en el servicio de microbiolog&#237;a mediante detecci&#243;n molecular&#46; Las variables recogidas fueron&#58; sexo&#44; edad&#44; principales comorbilidades&#44; temporada gripal&#44; estado vacunal&#44; virus de la gripe&#44; tipo de infecci&#243;n&#44; ingreso en la UCI&#44; complicaciones &#40;neumon&#237;a&#44; fallo multiorg&#225;nico&#44; <span class="elsevierStyleItalic">shock</span> s&#233;ptico&#44; s&#237;ndrome de distr&#233;s respiratorio agudo &#91;SDRA&#93; y eventos cardiovasculares&#41;&#44; d&#237;as de estancia y situaci&#243;n al alta&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">La informaci&#243;n se almacen&#243; en una base de datos codificada y su tratamiento y an&#225;lisis se realiz&#243; con los fines recogidos en el Real Decreto&#160;2210&#47;1995&#44; de 28 de diciembre&#44; por el que se crea la Red Nacional de Vigilancia Epidemiol&#243;gica<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">An&#225;lisis estad&#237;stico</span><p id="par0055" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis descriptivo de las variables estudiadas&#58; las cuantitativas se expresaron como media &#177; desviaci&#243;n est&#225;ndar y las categ&#243;ricas como n&#250;mero y porcentaje&#46; Para la comparaci&#243;n de medias se emplearon la t de Student y el test de Mann-Whitney&#44; y para las variables cualitativas la prueba de Chi-cuadrado y el test exacto de Fisher&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Con el fin de identificar los factores asociados a la aparici&#243;n de un evento card&#237;aco&#44; se construy&#243; un modelo de regresi&#243;n log&#237;stica&#44; con el evento card&#237;aco posgripe como variable dependiente y los posibles factores pron&#243;sticos como variables independientes&#46; En los an&#225;lisis se estableci&#243; un riesgo &#945; de 0&#44;05 como l&#237;mite de significaci&#243;n estad&#237;stica&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">En el per&#237;odo de estudio&#44; precisaron hospitalizaci&#243;n 928 adultos con gripe&#59; 515 durante la temporada 2017-2018 y 413 en la temporada 2018-2019&#46; La cobertura vacunal global fue del 52&#44;7&#37;&#44; con un 59&#44;3&#37; de vacunados entre los mayores de 65 a&#241;os&#46; El tiempo medio desde la vacunaci&#243;n hasta la infecci&#243;n fue de 92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>29 d&#237;as&#46; La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> y la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> muestran&#44; respectivamente&#44; las caracter&#237;sticas de los casos y su curva epidemiol&#243;gica&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Un total de 303 pacientes &#40;32&#44;7&#37;&#41; presentaron&#44; al menos&#44; una complicaci&#243;n de la gripe&#44; con una mortalidad del 26&#44;74&#37;&#46; La complicaci&#243;n m&#225;s frecuente fue la neumon&#237;a &#40;27&#37; del total de adultos hospitalizados con gripe&#41;&#44; seguida del fallo multiorg&#225;nico &#40;9&#44;5&#37;&#41;&#44; <span class="elsevierStyleItalic">shock</span> s&#233;ptico &#40;3&#44;7&#37;&#41;&#44; SDRA &#40;3&#44;6&#37;&#41; y eventos card&#237;acos &#40;2&#44;5&#37;&#41;&#46; Entre estos 23 eventos card&#237;acos&#44; 13 fueron en la temporada 2017-2018 y 10 en la 2018-2019&#59; el diagn&#243;stico mayoritario fue s&#237;ndrome coronario agudo sin elevaci&#243;n del segmento ST &#40;SCASEST&#41; con 11 pacientes &#40;5 Killip I&#44; 4 Killip II&#44; 1 Killip III y 1 Killip IV&#41;&#44; seguido de fibrilaci&#243;n auricular parox&#237;stica &#40;9 pacientes&#41;&#44; SCACEST &#40;2&#41; y fibrilaci&#243;n ventricular &#40;1&#41;&#46; Siete pacientes ingresaron en la unidad coronaria&#44; precisando 3 casos una coronariograf&#237;a terap&#233;utica&#44; 2 oxigenaci&#243;n por membrana extracorp&#243;rea &#40;ECMO&#41; y una ventilaci&#243;n mec&#225;nica no invasiva &#40;VMNI&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">El tiempo medio desde el diagn&#243;stico de gripe hasta el infarto agudo de miocardio fue de 2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3 d&#237;as&#44; coincidiendo ambos diagn&#243;sticos en 10 pacientes&#46; La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> muestra la comparaci&#243;n entre los casos con complicaci&#243;n cardiovascular y el resto de los hospitalizados con gripe&#46; La <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> muestra la distribuci&#243;n temporal de los eventos card&#237;acos en ambas temporadas&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">En el modelo de regresi&#243;n log&#237;stica &#40;Pseudo-R2&#58; 0&#44;19&#41;&#44; mostraron una asociaci&#243;n estad&#237;sticamente significativa con la aparici&#243;n de evento card&#237;aco posgripe&#44; la vacunaci&#243;n &#40;OR&#58; 0&#44;32&#59; IC 95&#37;&#58; 0&#44;13-0&#44;83&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; el ingreso en la UCI &#40;OR&#58; 6&#44;9&#59; IC 95&#37;&#58; 1&#44;64-29&#44;1&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41; y el fallo multiorg&#225;nico &#40;OR&#58; 4&#44;84&#59; IC 95&#37;&#58; 1&#44;73-13&#44;53&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46; El resto de variables incluidas en el modelo &#40;edad&#44; hipertensi&#243;n arterial&#44; dislipemia&#44; insuficiencia renal&#44; enfermedad cardiovascular previa&#44; estancia hospitalaria&#44; estancia tras PCR positiva&#44; neumon&#237;a con criterio cl&#237;nico&#44; neumon&#237;a con cultivo positivo y SDRA&#41; carecieron de significaci&#243;n estad&#237;stica&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">Este estudio tuvo como objetivo conocer las complicaciones de la gripe&#44; analizando en detalle los eventos card&#237;acos posinfecci&#243;n&#44; a trav&#233;s de la vigilancia de todos los adultos hospitalizados con esta enfermedad durante 2 temporadas&#46; Los resultados muestran que&#44; aproximadamente&#44; un tercio de los pacientes presentaron una o m&#225;s complicaciones durante el ingreso&#44; y un 2&#44;5&#37; del total sufrieron un evento card&#237;aco&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">En poblaci&#243;n general la gripe cursa mayoritariamente de forma leve<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a>&#44; con diferencias interanuales en funci&#243;n de las cepas circulantes y la composici&#243;n de las vacunas<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a>&#46; No obstante&#44; existe evidencia sobre las importantes complicaciones que puede producir esta infecci&#243;n&#44; tanto a nivel pulmonar &#40;neumon&#237;a&#44; reagudizaci&#243;n de enfermedades pulmonares cr&#243;nicas&#41;&#44; como extrapulmonar&#44; destacando la afectaci&#243;n card&#237;aca&#44; muscular y neurol&#243;gica<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a>&#46; Respecto a la neumon&#237;a&#44; investigaciones previas se&#241;alaron que est&#225; presente en el 40&#37; de los pacientes hospitalizados y que&#44; de entre los que precisan ingreso en la UCI&#44; el 49&#37; desarrollan neumon&#237;a viral y el 20&#37;&#44; neumon&#237;a bacteriana secundaria<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; la neumon&#237;a fue la complicaci&#243;n m&#225;s frecuente&#44; observ&#225;ndose en el 27&#37; de los hospitalizados&#44; lo que se sit&#250;a en el punto medio entre los an&#225;lisis de cohortes comunitarias y los estudios centrados en casos graves&#44; en los que se reporta una frecuencia de ingreso en la UCI de alrededor del 21&#37; y una letalidad mayor del 17&#37;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">La vigilancia epidemiol&#243;gica de los pacientes hospitalizados con gripe permite tambi&#233;n estudiar su papel como factor de riesgo de eventos cardiovasculares<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; Nuestros resultados&#44; tras el seguimiento hasta el alta&#44; coinciden con otros estudios situando el per&#237;odo de riesgo en la semana posterior a la infecci&#243;n<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a>&#46; La gravedad de estos eventos resulta evidente&#44; con una mortalidad alrededor del 40&#37; y una prevalencia cercana a complicaciones cl&#225;sicamente estudiadas&#44; como el <span class="elsevierStyleItalic">shock</span> s&#233;ptico o el SDRA&#46; Estas cifras son similares en otros centros y se ha acelerado la adopci&#243;n de medidas cl&#237;nicas y organizativas&#44; como la implementaci&#243;n de programas de cribado de gripe<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a>&#44; identificando una incidencia de infecci&#243;n de un 8&#37; en 227 ingresados en la UCI card&#237;aca&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Finalmente&#44; destacamos el papel protector de la vacunaci&#243;n antigripal en las complicaciones cardiovasculares&#46; Los datos de nuestro estudio&#44; que&#44; a diferencia de experiencias similares&#44; s&#237; logran mostrar una asociaci&#243;n estad&#237;sticamente significativa<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a>&#44; se alinean con investigaciones internacionales<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a> corroborando que nos encontramos ante una estrategia preventiva efectiva&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Entre las limitaciones del estudio debemos se&#241;alar que&#44; al tratarse de un registro de casos de gripe&#44; no se pudo comparar con otros pacientes de caracter&#237;sticas similares&#44; pero sin esta infecci&#243;n&#46; Dado el car&#225;cter descriptivo del estudio&#44; no fue posible establecer causalidad&#46; Adem&#225;s&#44; ampliar las temporadas estudiadas hubiera permitido explorar nuevas hip&#243;tesis&#44; pero no fue posible porque no se dispon&#237;a de un sistema de vigilancia similar en temporadas previas<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> y por impacto de la pandemia de COVID-19 en temporadas posteriores<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusiones</span><p id="par0115" class="elsevierStylePara elsevierViewall">Las complicaciones de la gripe son frecuentes en los adultos hospitalizados con esta enfermedad&#44; destacando la neumon&#237;a&#46; Los eventos card&#237;acos posinfecci&#243;n tienen una prevalencia cercana a alguna de las complicaciones cl&#225;sicamente estudiadas y una elevada mortalidad&#46; La vacunaci&#243;n se ha asociado a menor frecuencia de eventos card&#237;acos&#46; Por ello&#44; deben incrementarse las medidas de prevenci&#243;n y control&#44; destacando la vacunaci&#243;n antigripal anual&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Financiaci&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">La presente investigaci&#243;n no ha recibido ayudas espec&#237;ficas provenientes de agencias del sector p&#250;blico&#44; sector comercial o entidades sin &#225;nimo de lucro&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicto de intereses</span><p id="par0125" class="elsevierStylePara elsevierViewall">Todos los autores declaran que no tienen conflictos de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio fue determinar las complicaciones de la gripe en todos los adultos hospitalizados con esta enfermedad y&#44; de forma espec&#237;fica&#44; analizar las caracter&#237;sticas de los eventos cardiovasculares posinfecci&#243;n&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Metodolog&#237;a</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional y descriptivo de los episodios de gripe en adultos hospitalizados durante las temporadas 2017-2018 y 2018-2019&#44; utilizando el registro espec&#237;fico de un hospital terciario&#46; Las complicaciones analizadas fueron&#58; neumon&#237;a&#44; fallo multiorg&#225;nico&#44; <span class="elsevierStyleItalic">shock</span> s&#233;ptico&#44; s&#237;ndrome de distr&#233;s respiratorio agudo y eventos card&#237;acos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Un total de 928 adultos con gripe precisaron hospitalizaci&#243;n&#44; de los que 303 &#40;32&#44;7&#37;&#41; presentaron una o m&#225;s complicaciones&#46; El 2&#44;5&#37; de los pacientes sufrieron un evento card&#237;aco posgripe&#44; con mayor probabilidad de ingreso en la UCI y mayor mortalidad&#46; La vacunaci&#243;n antigripal fue un factor protector del evento card&#237;aco &#40;OR&#58; 0&#44;32&#59; IC 95&#37;&#58; 0&#44;13-0&#44;83&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La gripe presenta importantes complicaciones en los pacientes hospitalizados&#46; La elevada mortalidad de los eventos card&#237;acos posinfecci&#243;n implica acentuar las medidas preventivas&#44; destacando la vacunaci&#243;n antigripal anual&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Antecedentes y objetivo"
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            "titulo" => "Metodolog&#237;a"
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            "identificador" => "abst0015"
            "titulo" => "Resultados"
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            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and aims</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to determine the complications of influenza in all adults hospitalized with this disease and&#44; specifically&#44; to analyze the characteristics of post-infection cardiovascular events&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Observational and descriptive study of adults hospitalized with influenza during the 2017-2018 and 2018-2019 seasons using the specific registry of a tertiary hospital&#46; The complications analyzed were pneumonia&#44; multiple organ dysfunction syndrome&#44; septic shock&#44; acute respiratory distress syndrome&#44; and cardiac events&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 928 adults with influenza required hospitalization and 303 &#40;32&#46;7&#37;&#41; presented with one or more complications&#46; A post-influenza cardiac event occurred in 2&#46;5&#37; of patients&#59; they had a higher probability of ICU admission and higher mortality&#46; Influenza vaccination was a protective factor for cardiac events &#40;OR 0&#46;32&#59; 95&#37;CI 0&#46;13-0&#46;83&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Influenza can lead to important complications in hospitalized patients&#46; The high mortality rate associated with post-infection cardiac events means that preventive measures&#44; including annual influenza vaccination&#44; need to be emphasized&#46;</p></span>"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curva epidemiol&#243;gica de detecciones positivas de virus gripales y eventos card&#237;acos posgripe en un hospital de tercer nivel&#46;</p>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; HTA&#58; hipertensi&#243;n arterial&#59; PCR&#58; reacci&#243;n en cadena de la polimerasa&#59; SDRA&#58; s&#237;ndrome de distr&#233;s respiratorio agudo&#59; UCI&#58; unidad de cuidados intensivos&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">En negrita se destacan los valores estad&#237;sticamente significativos &#40;p&#60;0&#44;05&#41;&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mujeres&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#177;12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#177;16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " colspan="8" align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Domicilio particular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">725&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">78&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">87&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">705&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">77&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Institucionalizado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">203&nbsp;\t\t\t\t\t\t\n
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        0 => array:2 [
          "identificador" => "bibs0015"
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                    0 => array:2 [
                      "titulo" => "Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong&#58; An observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;J&#46; Cowling"
                            1 => "S&#46;T&#46; Ali"
                            2 => "T&#46;W&#46;Y&#46; Ng"
                            3 => "T&#46;K&#46; Tsang"
                            4 => "J&#46;C&#46;M&#46; Li"
                            5 => "M&#46;W&#46; Fong"
                          ]
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Vol. 222. Núm. 9.
Páginas 523-528 (noviembre 2022)
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Vol. 222. Núm. 9.
Páginas 523-528 (noviembre 2022)
Original Breve
Complicaciones de la gripe: información sobre eventos cardíacos a través de un sistema de vigilancia hospitalario
Influenza complications: Reporting cardiac events through a hospital surveillance system
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52
V. Quirós-Gonzáleza,
Autor para correspondencia
victor.quiros@salud.madrid.org

Autor para correspondencia.
, J.Á. Maderuelo-Fernándezb, A.M. Haro-Pérezc, D. González-Called, V. Barreales-Rodrígueze, J.M. Eirosf
a Dirección de Planificación, Hospital Universitario 12 de Octubre, Madrid, España
b Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), España
c Servicio de Medicina Preventiva, Complejo Asistencial Universitario de Salamanca, Salamanca, España
d Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Salamanca, España
e Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca, Salamanca, España
f Servicio de Microbiología, Hospital Universitario Río Hortega, Valladolid, España
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Antecedentes y objetivo

El objetivo de este estudio fue determinar las complicaciones de la gripe en todos los adultos hospitalizados con esta enfermedad y, de forma específica, analizar las características de los eventos cardiovasculares posinfección.

Metodología

Estudio observacional y descriptivo de los episodios de gripe en adultos hospitalizados durante las temporadas 2017-2018 y 2018-2019, utilizando el registro específico de un hospital terciario. Las complicaciones analizadas fueron: neumonía, fallo multiorgánico, shock séptico, síndrome de distrés respiratorio agudo y eventos cardíacos.

Resultados

Un total de 928 adultos con gripe precisaron hospitalización, de los que 303 (32,7%) presentaron una o más complicaciones. El 2,5% de los pacientes sufrieron un evento cardíaco posgripe, con mayor probabilidad de ingreso en la UCI y mayor mortalidad. La vacunación antigripal fue un factor protector del evento cardíaco (OR: 0,32; IC 95%: 0,13-0,83).

Conclusiones

La gripe presenta importantes complicaciones en los pacientes hospitalizados. La elevada mortalidad de los eventos cardíacos posinfección implica acentuar las medidas preventivas, destacando la vacunación antigripal anual.

Palabras clave:
Gripe
Eventos cardíacos
Sistemas de vigilancia
Vacunación
Control de la infección
Abstract
Background and aims

The aim of this study was to determine the complications of influenza in all adults hospitalized with this disease and, specifically, to analyze the characteristics of post-infection cardiovascular events.

Methods

Observational and descriptive study of adults hospitalized with influenza during the 2017-2018 and 2018-2019 seasons using the specific registry of a tertiary hospital. The complications analyzed were pneumonia, multiple organ dysfunction syndrome, septic shock, acute respiratory distress syndrome, and cardiac events.

Results

A total of 928 adults with influenza required hospitalization and 303 (32.7%) presented with one or more complications. A post-influenza cardiac event occurred in 2.5% of patients; they had a higher probability of ICU admission and higher mortality. Influenza vaccination was a protective factor for cardiac events (OR 0.32; 95%CI 0.13-0.83).

Conclusions

Influenza can lead to important complications in hospitalized patients. The high mortality rate associated with post-infection cardiac events means that preventive measures, including annual influenza vaccination, need to be emphasized.

Keywords:
Influenza
Cardiac events
Surveillance systems
Vaccination
Infection control

Artículo

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