{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:50:48Z","timestamp":1750143048834},"reference-count":0,"publisher":"SEMES (Sociedad Espanola de Medicina de Urgencias y Emergencias)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emergencias"],"abstract":"<jats:p>Objetivo. Determinar si el nivel econ\u00f3mico durante la primera ola pand\u00e9mica tuvo una influencia diferente a la esperable en la mortalidad intrahospitalaria de los pacientes mayores atendidos en los servicios de urgencias (SU) de los hospitales p\u00fablicos espa\u00f1oles. M\u00e9todo. Cincuenta y un SU p\u00fablicos espa\u00f1oles que participaron voluntariamente y que dan cobertura al 25% de la poblaci\u00f3n incluyeron todos los registros de pacientes de edad $ 65 a\u00f1os atendidos durante una semana del periodo preCOVID (1-4-2019 a 7-4-2019) y una semana del periodo COVID (30-3-2020 a 5-4-2020). Se identific\u00f3 la renta bruta (RB) asignada al c\u00f3digo postal de residencia de cada paciente y se calcul\u00f3 la RB normalizada (RBN) dividiendo aquella por la RB media de su comunidad aut\u00f3noma. La existencia y fuerza de la relaci\u00f3n entre RBN y mortalidad intrahospitalaria se determin\u00f3 mediante curvas spline c\u00fabicas restringidas (SCR) ajustadas por 10 caracter\u00edsticas basales del paciente. Las OR para cada situaci\u00f3n econ\u00f3mica se expres\u00f3 en relaci\u00f3n con una RBN de 1 (referencia, renta correspondiente a la media de la comunidad aut\u00f3noma). La comparaci\u00f3n entre periodo COVID y no COVID se realiz\u00f3 mediante el estudio de interacci\u00f3n de primer grado. Resultados. De los 35.280 registros de pacientes atendidos en ambos periodos, se dispon\u00eda de la RB en 21.180 (60%): 15.437 del periodo preCOVID y 5.746 del periodo COVID. La RBN de los pacientes incluidos fue discretamente superior en el periodo preCOVID (1,006 versus 0,994; p = 0,012). La mortalidad intrahospitalaria fue del 5,6%, y fue superior durante el periodo COVID (2,8% versus 13,1%; p &lt; 0,001). Las curvas SCR ajustadas mostraron una asociaci\u00f3n entre nivel econ\u00f3mico y mortalidad diferente entre ambos periodos (p interacci\u00f3n = 0,004): en el periodo preCOVID no hubo diferencias significativas de mortalidad en funci\u00f3n de la RBN, mientras que en el periodo COVID la mortalidad se increment\u00f3 en rentas bajas (OR = 1,82, IC 95% = 1,32-3,37 para RBN de 0,5) y en rentas altas (OR = 1,32, IC 95% = 1,04-1,68 y OR = 1,92, IC 95% = 1,14-3,23 para RBN de 1,5 y 2, respectivamente), sin diferencias significativas entre pacientes con COVID y con otros diagn\u00f3sticos (p interacci\u00f3n = 0,667). Conclusiones. Durante la primera ola de la pandemia COVID, la RB asignada al c\u00f3digo postal de residencia de los pacientes atendidos en los SU p\u00fablicos espa\u00f1oles se asoci\u00f3 con la mortalidad intrahospitalaria, que aument\u00f3 en pacientes de rentas bajas y altas. Las razones de estas asociaciones pueden ser distintas para cada segmento econ\u00f3mico y deben ser investigadas en el fututo.<\/jats:p>","DOI":"10.55633\/s3me\/e06.2023","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T06:52:31Z","timestamp":1715928751000},"source":"Crossref","is-referenced-by-count":1,"title":["Influence of income on in-hospital mortality in older adults during the first wave of the COVID-19 pandemic: results from the EDEN-33 study"],"prefix":"10.55633","author":[{"given":"Lourdes","family":"Artajona","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Garc\u00eda-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sira","family":"Aguil\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillermo","family":"Burillo-Putze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aitor","family":"Alqu\u00e9zar-Arb\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ces\u00e1reo","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amparo","family":"Fern\u00e1ndez-Sim\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Fern\u00e1ndez 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Cubillas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Hern\u00e1ndez Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesc Xavier","family":"Alemany Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"S\u00e1nchez Ram\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bego\u00f1a","family":"Espinosa Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Gonz\u00e1lez del Castillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d2scar","family":"Mir\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"33356","published-online":{"date-parts":[[2024,5,17]]},"container-title":["Emergencias"],"original-title":["Influencia de la renta econ\u00f3mica en la mortalidad intrahospitalaria de las personas mayores durante la primera ola de la pandemia por COVID-19: resultados del estudio EDEN-33"],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T06:52:33Z","timestamp":1715928753000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistaemergencias.org\/numeros-anteriores\/volumen-35\/numero-6\/influencia-de-la-renta-economica-en-la-mortalidad-intrahospitalaria-de-las-personas-mayores-durante-la-primera-ola-de-la-pandemia-por-covid-19resultados-del-estudio-eden-33\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,17]]},"references-count":0,"URL":"https:\/\/doi.org\/10.55633\/s3me\/e06.2023","relation":{},"ISSN":["1137-6821","2386-5857"],"issn-type":[{"value":"1137-6821","type":"print"},{"value":"2386-5857","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,17]]}}}