Publications by authors named "Nuria Albacar"

5 Publications

  • Page 1 of 1

Community-acquired pneumonia severity assessment tools in patients hospitalized with COVID-19: a validation and clinical applicability study.

Clin Microbiol Infect 2021 Jul 2;27(7):1037.e1-1037.e8. Epub 2021 Apr 2.

Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain; Pulmonary Division, Heart Institute (InCor), Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Objective: To externally validate community-acquired pneumonia (CAP) tools on patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia from two distinct countries, and compare their performance with recently developed COVID-19 mortality risk stratification tools.

Methods: We evaluated 11 risk stratification scores in a binational retrospective cohort of patients hospitalized with COVID-19 pneumonia in São Paulo and Barcelona: Pneumonia Severity Index (PSI), CURB, CURB-65, qSOFA, Infectious Disease Society of America and American Thoracic Society Minor Criteria, REA-ICU, SCAP, SMART-COP, CALL, COVID GRAM and 4C. The primary and secondary outcomes were 30-day in-hospital mortality and 7-day intensive care unit (ICU) admission, respectively. We compared their predictive performance using the area under the receiver operating characteristics curve (AUC), sensitivity, specificity, likelihood ratios, calibration plots and decision curve analysis.

Results: Of 1363 patients, the mean (SD) age was 61 (16) years. The 30-day in-hospital mortality rate was 24.6% (228/925) in São Paulo and 21.0% (92/438) in Barcelona. For in-hospital mortality, we found higher AUCs for PSI (0.79, 95% CI 0.77-0.82), 4C (0.78, 95% CI 0.75-0.81), COVID GRAM (0.77, 95% CI 0.75-0.80) and CURB-65 (0.74, 95% CI 0.72-0.77). Results were similar for both countries. For the 1%-20% threshold range in decision curve analysis, PSI would avoid a higher number of unnecessary interventions, followed by the 4C score. All scores had poor performance (AUC <0.65) for 7-day ICU admission.

Conclusions: Recent clinical COVID-19 assessment scores had comparable performance to standard pneumonia prognostic tools. Because it is expected that new scores outperform older ones during development, external validation studies are needed before recommending their use.
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http://dx.doi.org/10.1016/j.cmi.2021.03.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016546PMC
July 2021

Lung Function sequelae in COVID-19 Patients 3 Months After Hospital Discharge.

Arch Bronconeumol 2021 Apr 24;57 Suppl 2:59-61. Epub 2021 Feb 24.

Respiratory Institute, Hospital Clinic, University of Barcelona, C/Villaroel 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/Roselló 149, 08036 Barcelona, Spain.

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http://dx.doi.org/10.1016/j.arbres.2021.01.036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903150PMC
April 2021

Improving home oxygen therapy in patients with interstitial lung diseases: application of a noninvasive ventilation device.

Ther Adv Respir Dis 2020 Jan-Dec;14:1753466620963027

Servei de Pneumologia, Respiratory Institute, Hospital Clínic, C/Villarroel 170, Barcelona, 08036, Spain.

Background: Proper adjustment of arterial oxygen saturation (SaO) during daily activities in patients with interstitial lung disease (ILD) requiring long-term oxygen therapy is challenging. Given the multifactorial nature of the limited exercise tolerance in patients with ILDs, the isolated use of oxygen therapy may not be enough. As demonstrated previously in patients with chronic obstructive pulmonary disease, the use of a noninvasive ventilation (NIV) device combined with oxygen therapy may prevent the falling of oxygen saturation during exercise, due to an improvement of the ventilation-perfusion ratio and a reduction of the respiratory work, thus enhancing exercise tolerance. We sought to assess in patients diagnosed with ILD who are in need of oxygen therapy, the effect of associating an NIV to improve oxygen parameters and the distance covered during the 6 min walking test (6MWT).

Methods: We conducted a prospective observational study in patients with ILDs. After a clinical characterization, we performed a 6MWT in two different situations: using a portable oxygen concentrator with the regular flow used by the patient during their daily life activities and afterwards adding the additional support of a NIV. The oxygen saturation parameters were registered with a portable oximeter.

Results: We included 16 patients with different ILDs who have oxygen therapy prescribed. The use of NIV associated with oxygen therapy in comparison with the use of oxygen therapy alone showed an increase of the average SaO [91% (88-93) 88% (86-90%);  = 0.0005] and a decrease in the percentage of time with oxygen saturation <90%: 36% (6-56%) 58% (36-77%);  < 0.0001. There were no changes in the 6MWT distance: 307 m (222-419 m) 316 m (228-425 m);  = 0.10.

Conclusions: In our study the use of a NIV system associated with long-term oxygen therapy during exercise showed beneficial effects, especially improvement of oxygen saturation.The reviews of this paper are available via the supplemental material section.
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http://dx.doi.org/10.1177/1753466620963027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7586034PMC
October 2020

Smoking and Interstitial lung damage/effects: A Plausible Association?

Arch Bronconeumol (Engl Ed) 2020 Jul 18;56(7):422-423. Epub 2019 Nov 18.

Servei de Pneumologia, Respiratory Institute, Hospital Clínic, Universitat de Barcelona, Barcelona, España; Centro de Investigación Biomedica en Red-Enfermedades Respiratorias (CIBERES); Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España. Electronic address:

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http://dx.doi.org/10.1016/j.arbres.2019.09.006DOI Listing
July 2020
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