RESUMEN
OBJETIVO: Determinar la percepción de los médicos internos residentes (MIR) de cardiología de España sobre el efecto de la pandemia por COVID-19 en su formación y la adaptación realizada por sus servicios. MÉTODOS: Estudio de corte transversal a través de una plataforma de encuesta digital con el objetivo de conocer la opinión individual de los MIR de cardiología sobre la influencia de la pandemia en su formación. Se realiza un análisis estadístico para determinar los factores que influyeron en la percepción de la formación afectada. RESULTADOS: Participó un total de 180 MIR de las 17 comunidades autónomas (CA). Los MIR de tercer año fueron los más afectados, junto con los que rotaban en imagen cardíaca. Los residentes de las CA con una prevalencia >5 casos/1,000 habitantes fueron los que mayor probabilidad tuvieron de ser desplazados de sus servicios. CONCLUSIONES: Según la opinión de los participantes, el efecto de la pandemia por COVID-19 en su formación fue más negativa en los residentes de tercer año y los que rotaban en imagen cardíaca. OBJECTIVE: The objectives were to analyze the perception of the Cardiology Fellows in Training (FIT) of Spain about the impact of the COVID-19 pandemic on their academic training and to know the adaptative changes performed by their department. METHODS: A cross-sectional study performed through a digital survey platform for Cardiology FIT. Chi2 analysis and logistic regression were performed to determine the factors that influenced on the perception of an affected training. RESULTS: A total of 180 FIT from the 17 regions of Spain participated. Third year FIT and those rotating in cardiac imaging were the most affected with statistically significant difference. The residents of the regions with a prevalence of >5 cases/1,000 inhabitants were the most likely to be displaced from their departments. CONCLUSIONS: According to the opinion of the participants, the impact of the COVID-19 pandemic on their academic training was more negative in third year FITs and those rotating in cardiac imaging.
Asunto(s)
COVID-19 , Cardiología , Cardiología/educación , Estudios Transversales , Humanos , Internado y Residencia , Pandemias , Estudios Retrospectivos , EspañaRESUMEN
BACKGROUND: Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR. METHODS: Observational study including 552 patients presenting definite IE post-TAVR. Patients were divided in 2 groups according to the timing of TAVR (historical cohort [HC]: before 2014; contemporary cohort [CC]: after 2014). RESULTS: Overall incidence rates of IE were similar in both cohorts (CC vs HC: 5.45 vs 6.52 per 1000 person-years; P = .12), but the rate of early IE was lower in the CC (2.29 vs 4.89, P < .001). Enterococci were the most frequent microorganism. Most patients presented complicated IE (CC: 67.7%; HC: 69.6%; P = .66), but the rate of surgical treatment remained low (CC: 20.7%; HC: 17.3%; P = .32). The CC exhibited lower rates of in-hospital acute kidney injury (35.1% vs 44.6%; P = .036) and in-hospital (26.6% vs 36.4%; P = .016) and 1-year (37.8% vs 53.5%; P < .001) mortality. Higher logistic EuroScore, Staphylococcus aureus etiology, and complications (stroke, heart failure, and acute renal failure) were associated with in-hospital mortality in multivariable analyses (P < .05 for all). CONCLUSIONS: Although overall IE incidence has remained stable, the incidence of early IE has declined in recent years. The microorganism, high rate of complications, and very low rate of surgical treatment remained similar. In-hospital and 1-year mortality rates were high but progressively decreased over time.