Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

[EN] Introduction: Candidemia in critically ill patients is usually a severe and life-threatening condition with a high crude mortality. Very few studies have focused on the impact of candidemia on ICU patient outcome and attributable mortality still remains controversial. This study was carried out to determine the attributable mortality of ICU-acquired candidemia in critically ill patients using propensity score matching analysis. Methods: A prospective observational study was conducted of all consecutive non-neutropenic adult patients admitted for at least seven days to 36 ICUs in Spain, France, and Argentina between April 2006 and June 2007. The probability of developing candidemia was estimated using a multivariate logistic regression model. Each patient with ICU-acquired candidemia was matched with two control patients with the nearest available Mahalanobis metric matching within the calipers defined by the propensity score. Standardized differences tests (SDT) for each variable before and after matching were calculated. Attributable mortality was determined by a modified Poisson regression model adjusted by those variables that still presented certain misalignments defined as a SDT > 10%. Results: Thirty-eight candidemias were diagnosed in 1,107 patients (34.3 episodes/1,000 ICU patients). Patients with and without candidemia had an ICU crude mortality of 52.6% versus 20.6% (P < 0.001) and a crude hospital mortality of 55.3% versus 29.6% (P = 0.01), respectively. In the propensity matched analysis, the corresponding figures were 51.4% versus 37.1% (P = 0.222) and 54.3% versus 50% (P = 0.680). After controlling residual confusion by the Poisson regression model, the relative risk (RR) of ICU- and hospital-attributable mortality from candidemia was RR 1.298 (95% confidence interval (CI) 0.88 to 1.98) and RR 1.096 (95% CI 0.68 to 1.69), respectively. Conclusions: ICU-acquired candidemia in critically ill patients is not associated with an increase in either ICU or hospital mortality.

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Índice h de las revistas españolas de Historia según Google Scholar Metrics (2007-2011)

[ES] La aparición de Google Scholar Metrics en abril de 2012 como nuevo sistema de evaluación bibliométrica de revistas científicas a partir del recuento de las citas bibliográficas que estas han recibido en Google Scholar, abre nuevas posibilidades para la medición del impacto de las revistas de humanidades. El objetivo de este trabajo es comprobar el alcance de este producto, a partir del análisis de la cobertura que muestra de las revistas españolas de Historia. Las búsquedas bibliográficas se efectuaron entre el 5 y 6 de diciembre de 2012. Se han identificado 69 revistas, cifra que representa tan solo un 24% de las revistas españolas de Historia. Los valores del índice h alcanzados por las revistas son minúsculos lo que hace que el ranking carezca de poder discriminatorio. Se propone un cambio en el diseño de Google Scholar Metrics para adaptarse a los patrones de producción y citación de la Historia, en particular, y las Humanidades, en general.