Background
Peru is the country with the world’s highest COVID-19 death rate per capita. Characteristics associated with increased mortality among adult patients with COVID-19 pneumonia in this setting are not well described.
Methods
Retrospective, single-center cohort study including 1537 adult patients hospitalized with a diagnosis of SARS-CoV-2 pneumonia between May 2020 and August 2020 at a national hospital in Lima, Peru. The primary outcome measure was in-hospital mortality.
Results
In-hospital mortality was 49.71%. The mean age was 60 ± 14.25 years, and 68.38% were males. We found an association between mortality and inflammatory markers, mainly leukocytes, D-dimer, lactate dehydrogenase, C-reactive protein and ferritin. A multivariate model adjusted for age, hypertension, diabetes mellitus, and corticosteroid use demonstrated that in-hospital mortality was associated with greater age (RR: 2.01, 95%CI: 1.59–2.52) and a higher level of oxygen requirement (RR: 2.77, 95%CI: 2.13–3.62). Conclusions: In-hospital mortality among COVID-19 patients in Peru is high and is associated with greater age and higher oxygen requirements.
La simulación de alta fidelidad ha surgido como un importante método tecnológico de aprendizaje y enseñanza para escenarios clínicos complejos en áreas especializadas, lo que permite enseñar tanto habilidades técnicas como no técnicas. La experiencia descrita se relaciona a la inserción curricular de la simulación de alta fidelidad en alumnos de pregrado de cuarto y quinto año (2018-2019) de la Facultad de Medicina de la Universidad Peruana Cayetano Heredia (UPCH) con el objetivo de establecer diagnósticos, solicitar e interpretar exámenes auxiliares, instaurar y evaluar la respuesta a un tratamiento inicial, así como, establecer comunicación efectiva con otros profesionales de la salud, mediante el empleo de escenarios clínicos con simuladores de alta complejidad, haciendo énfasis en el debriefing con buen juicio inmediato, donde se reflexionó sobre los objetivos de aprendizaje establecidos para cada caso, y concluyendo la sesión con los aprendizajes de cada alumno.
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