NAIRA HOSSEPIAN SALLES DE LIMA HOJAIJ
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/66, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
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bookPart A Importância das Doenças Crônicas no Envelhecimento(2016) HOJAIJ, Naira Hossepian Salles de LimabookPart Multimorbidade(2019) HOJAIJ, Naira Hossepian Salles de Lima; RANGEL, Luis Fernando; LEONEL, Fabio Campos; MARTINELLI, Marcos Oliveira- COVID-19 is not over and age is not enough: Using frailty for prognostication in hospitalized patients(2021) ALIBERTI, Marlon Juliano Romero; SZLEJF, Claudia; AVELINO-SILVA, Vivian I.; SUEMOTO, Claudia Kimie; APOLINARIO, Daniel; DIAS, Murilo Bacchini; GARCEZ, Flavia Barreto; TRINDADE, Carolina B.; AMARAL, Jose Renato das Gracas; MELO, Leonardo Rabelo de; AGUIAR, Renata Cunha de; COELHO, Paulo Henrique Lazzaris; HOJAIJ, Naira Hossepian Salles de Lima; SARAIVA, Marcos Daniel; SILVA, Natalia Oliveira Trajano da; JACOB-FILHO, Wilson; AVELINO-SILVA, Thiago J.Background Frailty screening using the Clinical Frailty Scale (CFS) has been proposed to guide resource allocation in acute care settings during the pandemic. However, the association between frailty and coronavirus disease 2019 (COVID-19) prognosis remains unclear. Objectives To investigate the association between frailty and mortality over 6 months in middle-aged and older patients hospitalized with COVID-19 and the association between acute morbidity severity and mortality across frailty strata. Design Observational cohort study. Setting Large academic medical center in Brazil. Participants A total of 1830 patients aged >= 50 years hospitalized with COVID-19 (March-July 2020). Measurements We screened baseline frailty using the CFS (1-9) and classified patients as fit to managing well (1-3), vulnerable (4), mildly (5), moderately (6), or severely frail to terminally ill (7-9). We also computed a frailty index (0-1; frail >0.25), a well-known frailty measure. We used Cox proportional hazards models to estimate the association between frailty and time to death within 30 days and 6 months of admission. We also examined whether frailty identified different mortality risk levels within strata of similar age and acute morbidity as measured by the Sequential Organ Failure Assessment (SOFA) score. Results Median age was 66 years, 58% were male, and 27% were frail to some degree. Compared with fit-to-managing-well patients, the adjusted hazard ratios (95% confidence interval [CI]) for 30-day and 6-month mortality were, respectively, 1.4 (1.1-1.7) and 1.4 (1.1-1.7) for vulnerable patients; 1.5 (1.1-1.9) and 1.5 (1.1-1.8) for mild frailty; 1.8 (1.4-2.3) and 1.9 (1.5-2.4) for moderate frailty; and 2.1 (1.6-2.7) and 2.3 (1.8-2.9) for severe frailty to terminally ill. The CFS achieved outstanding accuracy to identify frailty compared with the Frailty Index (area under the curve = 0.94; 95% CI = 0.93-0.95) and predicted different mortality risks within age and acute morbidity groups. Conclusions Our results encourage the use of frailty, alongside measures of acute morbidity, to guide clinicians in prognostication and resource allocation in hospitalized patients with COVID-19.
bookPart Introdução(2022) MOSCA NETO, Mario; UEHARA, Carlos André; ARECO, Flavia; CAçãO, João de Castilho; VELHO, José Carlos Aquino de Campos; MORIGUTI, Julio Cesar; MORILLO, Lilian Schafirovits; KAIRALLA, Maisa Carla; VENTURA, Mauricio de Miranda; GORZONI, Milton Luiz; HOJAIJ, Naira Hossepian Salles de Lima; BôAS, Paulo Jose Fortes Villas; MIRANDA, Roberto Dischinger- COLONOSCOPY COMPLICATIONS IN THE ELDERLY: the impact of age and multimorbidity(2013) STEIN, Francine de Cristo; HOJAIJ, Naira Hossepian Salles de Lima; SILVA, Jose Guilherme Nogueira da; BORGES, Luana Vilarinho; JACOB-FILHO, Wilson; HASHIMOTO, Claudio LyoitiContext Age has been considered an independent risk factor for colonoscopy complications, especially when associated with multimorbidity. Objectives The primary objective was to verify the relationships between age, multimorbidity and colonoscopy complications in the elderly. Methods A retrospective cohort including patients of 60 years or older who had undergone a colonoscopy. Data relating to age, multimorbidities according to the cumulative illness scale for geriatrics and the Charlson index and complications related to bowel preparation and procedure (sedation and exam) were collected. Results Of the 207 patients (mean age 70.47 ± 7.04) with appropriate indication for colonoscopy according to the American Society for Gastrointestinal Endoscopy, 43 (20.77%) patients had some colonoscopy complications: 1 (0.48%) with the sedation (apnea), 4 (1.93%) with the procedure (abdominal pain and bacteremia) and 38 (18.35%) with the bowel preparation (acute renal failure, hypotension). Individuals ≥80 years had an RR = 3.4 (1.2-10.1), P = 0.025, and those with a Charlson index 3 had an RR = 5.2 (1.6-16.8), P = 0.006, for complications. The cumulative illness rating scale for geriatrics was not associated with complications (P = 0.45). Conclusion There was a significant risk of complications in ≥80 years and in the group with a Charlson index 3. The cumulative illness rating scale for geriatrics was not a good predictor of risk in this sample.
bookPart Autonomia reduzida(2022) KAIRALLA, Maisa Carla; HOJAIJ, Naira Hossepian Salles de Lima; MIRANDA, Roberto DischingerbookPart A bioética no envelhecimento(2015) HOJAIJ, Naira Hossepian S. L.; OLIVEIRA, Reinaldo Ayer debookPart Manutenção do envelhecimento saudável(2022) ALMEIDA, Anna Elisa Marcus; HOJAIJ, Naira Hossepian Salles de Lima