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Oliveras A, Vázquez S, Vega MV, Camps C, Illana FJ, Armario P, Crespo M, de la Sierra A. Improvement of non-adherence and reduction of BP values in patients with difficult-to-treat hypertension: the ATHAN clinical trial. Hypertens Res 2024:10.1038/s41440-024-01748-x. [PMID: 39085464 DOI: 10.1038/s41440-024-01748-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/21/2024] [Accepted: 05/28/2024] [Indexed: 08/02/2024]
Abstract
Hypertension treatment and blood pressure (BP) control reduce cardiovascular disease burden. However, prevalence of controlled BP is overall insufficient and lack of adherence to treatment is a suggested major contributor. This prospective, randomized clinical trial was designed to evaluate whether a specific 3-month (m) action plan to improve therapeutic adherence results in a decrease in BP. Patients with ambulatory 24 h-BP ≥ 130/80 mmHg despite receiving ≥2 antihypertensive drugs and with therapeutic non-compliance confirmed by antihypertensive drugs analyzed in urine were randomized (1:1) to receive a specific 3 m program to improve adherence (INT = intervention) or routine follow-up (C = control). Antihypertensive treatment was not modified and knowledge of non-adherence was only notified to patients randomized to the intervention group. Before randomization and at 3 m all patients underwent urinary screening for antihypertensive drugs and 24 h-ambulatory-BP monitoring. Forty-five patients (36% women, mean age: 58 ± 13 yr) were randomized. At 3 m, mean (95% CI) BP differences (INT vs. C) were 12.2 mmHg (4.3-20.8), adjusted-p = 0.032 and 8.7 mmHg (2.5-14.8), adjusted-p = 0.018 for 24 h-systolic and 24 h-diastolic BP, respectively. Differences (INT vs. C) for office SBP and DBP were 18.4 mmHg (6.8-30.1), adjusted-p = 0.005 and 15.7 mmHg (7.2-24.2), adjusted-p < 0.001. Non-detected antihypertensive drugs were median [IQR]: 40% [25-100] and 0% [0-20] at baseline and 3 m, respectively, in the INT group, and 33.3% [25-63.7] and 33.3% [23.8-57.9], in the C group (p < 0.001 for the 3-month between-group comparison). A combined action plan of notifying knowledge of non-adherence plus a 3-month specific nursing intervention to improve therapeutic adherence results in BP reduction in patients with inadequate therapeutic compliance.
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Affiliation(s)
- Anna Oliveras
- Hypertension Unit, Nephrology Dpt, Hospital del Mar, Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Universitat Pompeu Fabra, Barcelona, Spain.
| | - Susana Vázquez
- Hypertension Unit, Nephrology Dpt, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Carme Camps
- Hypertension Unit, Nephrology Dpt, Hospital del Mar, Barcelona, Spain
| | - Francisco J Illana
- Biochemistry Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Pedro Armario
- Cardiovascular Risk Area, Complex Hospitalari Universitari Moisès Broggi, University of Barcelona, Barcelona, Spain
| | - Marta Crespo
- IMIM (Hospital del Mar Medical Research Institute), Universitat Pompeu Fabra, Barcelona, Spain
- Nephrology Dpt, Hospital del Mar, Barcelona, Spain
| | - Alejandro de la Sierra
- Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Terrassa, Spain
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García-Carmona JA, Conesa-García E, Vidal-Mena D, González-Morales M, Ramos-Arenas V, Sánchez-Vizcaíno-Buendía C, Soria-Torrecillas JJ, Pérez-Vicente JA, García-de-Guadiana-Romualdo L. Increased plasma levels of N-terminal pro-B-type natriuretic peptide as biomarker for the diagnosis of cardioembolic ischaemic stroke. Neurologia 2024; 39:496-504. [PMID: 38901926 DOI: 10.1016/j.nrleng.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 09/24/2021] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Despite comprehensive study, the aetiology of stroke is not identified in 35% of cases. AIMS We conducted a study to assess the diagnostic capacity of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the identification of ischaemic stroke of cardioembolic origin. The secondary purpose of the study was to evaluate the prognostic value of NT-proBNP for predicting 90-day all-cause mortality. METHODS We designed a prospective observational study including patients hospitalised due to stroke between March 2019 and March 2020. Blood samples were collected on admission to the emergency department and serum NT-proBNP levels were determined. Statistical analysis was performed using a bivariate logistic regression model and receiver operating characteristic (ROC) and Kaplan-Meier curves. Statistical significance was established at p<.05. RESULTS The study included 207 patients with first ischaemic stroke. Plasma NT-proBNP levels were significantly higher (p<.001) in the cardioembolic stroke group (2069pg/mL±488.5). ROC curves showed that NT-proBNP>499pg/mL was the optimum value for diagnosing cardioembolic ischaemic stroke (sensitivity, 82%; specificity, 80%). Moreover, plasma NT-proBNP levels>499pg/mL were independently associated with cardioembolic stroke (OR: 9.881; p=.001). Finally, NT-proBNP>1500pg/mL was useful for predicting 90-day mortality (sensitivity, 70%; specificity, 93%). CONCLUSIONS NT-proBNP was independently associated with cardioembolic stroke and should be quantified in blood tests within 24h of stroke onset. High plasma levels (>499pg/mL) may indicate an underlying cardioembolic cause, which should be further studied, while NT-proBNP >1500pg/mL was associated with increased 90-day mortality.
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Affiliation(s)
- J A García-Carmona
- Department of Neurology, Santa Lucia University Hospital, Cartagena, Spain.
| | - E Conesa-García
- Department of Neurology, Santa Lucia University Hospital, Cartagena, Spain
| | - D Vidal-Mena
- Department of Neurology, Santa Lucia University Hospital, Cartagena, Spain
| | - M González-Morales
- Laboratory Medicine Department, Santa Lucia University Hospital, Cartagena, Spain
| | - V Ramos-Arenas
- Laboratory Medicine Department, Santa Lucia University Hospital, Cartagena, Spain
| | - C Sánchez-Vizcaíno-Buendía
- Department of Neurology, Santa Lucia University Hospital, Cartagena, Spain; Unit of Neurovascular, Department of Neurology, Santa Lucia University Hospital, Cartagena, Spain
| | | | - J A Pérez-Vicente
- Department of Neurology, Santa Lucia University Hospital, Cartagena, Spain; Head of Department of Neurology, Santa Lucia University Hospital, Cartagena, Spain
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Santos S, Manito N, Sánchez-Covisa J, Hernández I, Corregidor C, Escudero L, Rhodes K, Nordon C. Risk of severe cardiovascular events following COPD exacerbations: results from the EXACOS-CV study in Spain. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024:S1885-5857(24)00194-4. [PMID: 38936468 DOI: 10.1016/j.rec.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/11/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION AND OBJECTIVES This real-world study-the first of its kind in a Spanish population-aimed to explore severe risk for cardiovascular events and all-cause death following exacerbations in a large cohort of patients with chronic obstructive pulmonary disease (COPD). METHODS We included individuals with a COPD diagnosis code between 2014 and 2018 from the BIG-PAC health care claims database. The primary outcome was a composite of a first severe cardiovascular event (acute coronary syndrome, heart failure decompensation, cerebral ischemia, arrhythmia) or all-cause death following inclusion in the cohort. Time-dependent Cox proportional hazards models estimated HRs for associations between exposed time periods (1-7, 8-14, 15-30, 31-180, 181-365, and >365 days) following an exacerbation of any severity, and following moderate or severe exacerbations separately (vs unexposed time before a first exacerbation following cohort inclusion). RESULTS During a median follow-up of 3.03 years, 18 901 of 24 393 patients (77.5%) experienced ≥ 1 moderate/severe exacerbation, and 8741 (35.8%) experienced the primary outcome. The risk of a severe cardiovascular event increased following moderate/severe COPD exacerbation onset vs the unexposed period, with rates being most increased during the first 1 to 7 days following exacerbation onset (HR, 10.10; 95%CI, 9.29-10.97) and remaining increased >365 days after exacerbation onset (HR, 1.65; 95%CI, 1.49-1.82). CONCLUSIONS The risk of severe cardiovascular events or death increased following moderate/severe exacerbation onset, illustrating the need for proactive multidisciplinary care of patients with COPD to prevent exacerbations and address other cardiovascular risk factors.
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Affiliation(s)
- Salud Santos
- Servicio de Neumología, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Nicolás Manito
- Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | | | - Kirsty Rhodes
- Real World Science & Analytics, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
| | - Clementine Nordon
- Epidemiology Medical Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
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Rivas Sucari HC, Rodríguez Eguizabal JL. [Smoking, dependence and possibilities]. Aten Primaria 2024; 56:102894. [PMID: 38412779 PMCID: PMC10907524 DOI: 10.1016/j.aprim.2024.102894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/29/2024] Open
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Suárez‐González P, Suárez‐Elosegui A, Arias‐Fernández L, Pérez‐Regueiro I, Jimeno‐Demuth FJ, Lana A. Nursing diagnoses and hospital readmission of patients with respiratory diseases: Findings from a case-control study. Nurs Open 2024; 11:e2182. [PMID: 38783599 PMCID: PMC11116758 DOI: 10.1002/nop2.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/18/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
AIM The rate of readmission after hospitalisation for respiratory diseases has become a common and challenging clinical problem. Social and functional patient variables could help identify cases at high risk of readmission. The aim was to identify the nursing diagnoses that were associated with readmission after hospitalisation for respiratory disease in Spain. DESIGN Case-control study within the cohort of patients admitted for respiratory disease during 2016-19 in a tertiary public hospital in Spain (n = 3781). METHODS Cases were patients who were readmitted within the first 30 days of discharge, and their controls were the remaining patients. All nursing diagnoses (n = 130) were collected from the electronic health record. They were then grouped into 29 informative diagnostic categories. Clinical confounder-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression models. RESULTS The readmission rate was 13.1%. The nursing diagnoses categories 'knowledge deficit' (OR: 1.61; 95%CI: 1.13-2.31), 'impaired skin integrity and risk of ulcer infection' (OR: 1.45; 95%CI: 1.06-1.97) and 'activity intolerance associated with fatigue' (OR: 1.56; 95%CI: 1.21-2.01) were associated with an increased risk of suffering an episode of hospital readmission rate at 30% after hospital discharge, and this was independent of sociodemographic background, care variables and comorbidity. PATIENT OR PUBLIC CONTRIBUTION The nursing diagnoses assigned as part of the care plan of patients during hospital admission may be useful for predicting readmissions.
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Affiliation(s)
- Paloma Suárez‐González
- Department of Preventive Medicine and Public Health, School of Medicine and Health SciencesUniversity of OviedoOviedoSpain
| | - Ane Suárez‐Elosegui
- Department of Preventive Medicine and Public Health, School of Medicine and Health SciencesUniversity of OviedoOviedoSpain
| | - Lucía Arias‐Fernández
- Department of Preventive Medicine and Public Health, School of Medicine and Health SciencesUniversity of OviedoOviedoSpain
| | - Irene Pérez‐Regueiro
- Emergency Medical Care Service (SAMU‐Asturias)OviedoSpain
- Healthcare Research AreaHealth Research Institute of Asturias (ISPA)OviedoSpain
| | - Francisco J. Jimeno‐Demuth
- Healthcare Research AreaHealth Research Institute of Asturias (ISPA)OviedoSpain
- Central University Hospital of AsturiasHealth Care Service of AsturiasOviedoSpain
| | - Alberto Lana
- Department of Preventive Medicine and Public Health, School of Medicine and Health SciencesUniversity of OviedoOviedoSpain
- Healthcare Research AreaHealth Research Institute of Asturias (ISPA)OviedoSpain
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Lopez-Pineda A, Cordero A, Nouni-García R, Quesada JA, Castellano-Vazquez JM, Orozco-Beltrán D, Nolasco A, Carratalá-Munuera C, Gil Guillén VF. Design and validation of a new questionnaire with a gender perspective to measure medication adherence for secondary prevention of ischaemic heart disease: study protocol. BMJ Open 2024; 14:e077982. [PMID: 38553079 PMCID: PMC10982786 DOI: 10.1136/bmjopen-2023-077982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION AND OBJECTIVES Only about 50% of chronic patients in high-income countries adhere to their treatment. There are methods to measure medication adherence but none of them can be considered optimal. This study will aim to design and validate a questionnaire to measure medication adherence in patients with ischaemic heart disease using a direct method as a gold-standard adherence measure and taking into account the gender perspective. Moreover, the profile of low adherence in these patients will be determined. METHODS AND ANALYSIS First study phase consists on the questionnaire design following the next steps: identification of the dimensions, definition of the target population, questionnaire items and order, response coding, questionnaire instructions, content validity by experts and understandability. In the second phase, a cross-sectional study will be performed to end the questionnaire development and validate it. Four hundred and forty patients (50% female) with acute coronary syndrome receiving treatment within the previous 12 months will be included. Patient will answer the initial questionnaire and adherence to aspirin and statin will be measured using a direct method (drug concentration analysis in blood) and other questionnaires. From the set of preselected questionnaire items, those most closely associated with the gold standard measure will be selected using multivariate statistics. ETHICS AND DISSEMINATION All participants gave their written informed consent before participating in the study. The study protocol follows the recommendations of the Declaration of Helsinki and was approved by the ethics committees of the three participating centres. The results of this study will be displayed at national and international conferences and in peer-reviewed scientific journals.
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Affiliation(s)
- Adriana Lopez-Pineda
- Department of Clinical Medicine, University of Miguel Hernandez Elche, Sant Joan d'Alacant, Comunidad Valenciana, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
- Primary Care Research Center, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Alberto Cordero
- Biomedical Network Research Center for Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology, Hospital San Juan de Alicante, San Juan de Alicante, Spain
| | - Rauf Nouni-García
- Department of Clinical Medicine, University of Miguel Hernandez Elche, Sant Joan d'Alacant, Comunidad Valenciana, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
| | - Jose A Quesada
- Department of Clinical Medicine, University of Miguel Hernandez Elche, Sant Joan d'Alacant, Comunidad Valenciana, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
- Primary Care Research Center, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Jose Maria Castellano-Vazquez
- Comprehensive Center for Cardiovascular Diseases, Montepríncipe University Hospital, HM Hospitales Group, Madrid, Spain
| | - Domingo Orozco-Beltrán
- Department of Clinical Medicine, University of Miguel Hernandez Elche, Sant Joan d'Alacant, Comunidad Valenciana, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
- Primary Care Research Center, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Andreu Nolasco
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicant, San Vicente del Raspeig, Alicante, Spain
| | - Concepción Carratalá-Munuera
- Department of Clinical Medicine, University of Miguel Hernandez Elche, Sant Joan d'Alacant, Comunidad Valenciana, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
- Primary Care Research Center, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Vicente F Gil Guillén
- Department of Clinical Medicine, University of Miguel Hernandez Elche, Sant Joan d'Alacant, Comunidad Valenciana, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
- Primary Care Research Center, Miguel Hernandez University, San Juan de Alicante, Spain
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7
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Soriano JB. Tuberculosis, AIDS and opera: An analytical and lyrical analysis on languid beauty. Med Clin (Barc) 2024; 162:291-296. [PMID: 37923606 DOI: 10.1016/j.medcli.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Joan B Soriano
- Faculty of Medicine, University of the Balearic Islands, Hospital Universitari de Son Espases, Palma, Illes Balears, Spain.
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Gámez JM, Pedreira Pérez M, Fernández Olmo MR, Fasero Laiz M, Inaraja V, Pallarés Carratalá V. Multidisciplinary management of cardiovascular disease in women: Delphi consensus. Front Cardiovasc Med 2024; 11:1315503. [PMID: 38450371 PMCID: PMC10914989 DOI: 10.3389/fcvm.2024.1315503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Background Current clinical guidelines on cardiovascular disease (CVD) do not specifically address the female population. The aim of this consensus is to know the opinion of a group of experts on the management of CVD in women. Methods Through a Delphi consensus, 31 experts in cardiology, 9 in gynecology and obstetrics, and 14 primary care physicians, showed their degree of agreement on 44 items on CVD in women divided into the following groups: (1) risk factors and prevention strategies; (2) diagnosis and clinical manifestations; and (3) treatment and follow-up. Results After two rounds, consensus in agreement was reached on 27 items (61.4%). Most of the non-consensus items (31.8%) belonged to group 3. The lack of consensus in this group was mainly among gynecologists and primary care physicians. The panelists agreed on periodic blood pressure control during pregnancy and delivery to detect hypertensive disorders, especially in women with a history of preeclampsia and/or gestational hypertension, and diabetes mellitus control in those with gestational diabetes. Also, the panelists agreed that women receive statins at a lower intensity than men, although there was no consensus as to whether the efficacy of drug treatments differs between women and men. Conclusions The high degree of consensus shows that the panelists are aware of the differences that exist between men and women in the management of CVD and the need to propose interventions to reduce this inequality. The low level of consensus reveals the lack of knowledge, and the need for information and training on this topic.
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Affiliation(s)
- José M. Gámez
- Servicio de Cardiología, Hospital Universitario Son Llatzer, Departamento de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Spain
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
| | - Milagros Pedreira Pérez
- Coordinadora de la Unidad de Cardio-Oncología y de la Unidad de Enfermedad Cardiovascular en la Mujer, Hospital Clínico Universitario Santiago de Compostela, A Coruña, Spain
| | - María Rosa Fernández Olmo
- Especialista en Cardiología en la Unidad de Rehabilitación Cardiaca, Hospital Universitario de Jaén, Jaén, Spain
| | - María Fasero Laiz
- Coordinadora de la Unidad de Menopausia Saludable, Hospital Universitario La Zarzuela, Madrid, Spain
- Unidad de Menopausia Saludable, Clínica Corofas, Madrid, Spain
- Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Vicente Pallarés Carratalá
- Unidad de Vigilancia de la Salud, Unión de Mutuas de Castellón, Castellón, Spain
- Departamento de Medicina, Universitat Jaume I, Castellón, Spain
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Ramírez-Rodríguez G, Menéndez-Lobo A, Romero-Linares A, Bernabéu-Fernández de Liencres M, Romero-Palacios PJ, Alcázar-Navarrete B. Chronic obstructive pulmonary disease mortality in Spain between 1999 and 2019. Med Clin (Barc) 2024; 162:9-14. [PMID: 37813726 DOI: 10.1016/j.medcli.2023.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION Mortality from COPD has decreased in Spain in recent years, but it is unknown whether this decline has been homogeneous among the different regions. METHODS From the Statistical Portal of the Ministry of Health of Spain we obtained the age-adjusted mortality rates/100,000 inhabitants for men and women in Spain and the Autonomous Communities for the years 1999-2019, using the coding of the International Classification of Diseases (ICD 10, sections J40-J44). With the adjusted rates we performed a jointpoint regression analysis to estimate an annual percentage change (APC), as well as identify possible points of trend change. Statistical significance was considered for a value of p<0.05. RESULTS During the study period, COPD mortality rates adjusted in Spain decreased from 28.77 deaths/100,000 inhabitants in 1999 to 12.14 deaths/100,000 inhabitants in 2019. We observed a linear decline in COPD mortality in men at national level of -3.67% per year (95% CI -4.1 to -3.4; p<0.001), with differences between the Autonomous Communities. Mortality in women also experienced a decrease in mortality in two phases, with a first period from 1999 to 2006 with a fall of -6.8% per year (95% CI -8.6 to -5.0; p<0.001) and a second period from 2006 to 2019 with a decrease in mortality of -2.1% (95% CI -2.8 to -1.3; p<0.001), with again differences between the Autonomous Communities. CONCLUSION Mortality rates from COPD have decreased heterogeneously among the different Autonomous Communities in both men and women.
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Affiliation(s)
| | | | | | | | | | - Bernardino Alcázar-Navarrete
- Respiratory Department, Hospital Universitario Virgen de las Nieves, Granada, Spain; Medicine Department, Universidad de Granada, Granada, Spain; IBS Granada, Granada, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
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10
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Soriano JB, Peláez A, Fernández E, Ancochea J. Impact of the COVID-19 pandemic in mortality due to respiratory diseases: A comparative analysis of 2021 and 2020 vs 2019 in Spain. Med Clin (Barc) 2023; 161:192-198. [PMID: 37394353 PMCID: PMC10167373 DOI: 10.1016/j.medcli.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/06/2023] [Accepted: 04/09/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION We previously reported an increase in respiratory mortality in 2020 in Spain after COVID-19. It is unclear if this rise is sustained in the longer-term. We aimed to determine whether respiratory mortality in 2021 in Spain returned to pre-pandemic levels. MATERIAL AND METHODS In an observational, large study using official National Institute of Statistics data, we explored deaths due to respiratory diseases, that is, all causes of death by the standard WHO list of diseases of the respiratory system plus COVID-19, tuberculosis and lung cancer. Using the latest available official data of Spain, we analyzed changes in the mortality pattern in Spain from January 2019 to December 2021. We endorsed STROBE guidance for observational research. RESULTS There were 98,714 deaths due to respiratory diseases in 2021 in Spain, corresponding to 21.9% of all deaths, becoming second in the ranking of causes of death. Respiratory diseases mortality in Spain has not returned to pre-pandemic levels in 2021, still with an increase of 30.3% (95% CI 30.2-30.4) compared to rates in 2019. All respiratory-specific causes of death decreased in 2021, except for lung cancer, that increased in women and decreased in men compared to 2019 (both p<0.05). In a multivariate analysis some established risk factors for respiratory diseases mortality were confirmed, such as male gender and older age; further, an association with reduced mortality in rural Spain was observed, still with a large geographical variability. CONCLUSIONS The COVID-19 pandemic has had a lasting impact on deaths due to respiratory diseases and certain specific causes of death in 2021, and it has disproportionately affected certain regions.
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Affiliation(s)
- Joan B Soriano
- Facultat de Medicina, Universitat de les Illes Balears, Palma, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Adrián Peláez
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain
| | - Esteve Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, Barcelona, Spain; Grupo de Investigación en Control del Tabaco, Programa de Epidemiología y Salud Pública (EPIBELL), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Julio Ancochea
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain; Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
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11
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González-Domínguez Á, Belmonte T, Domínguez-Riscart J, Ruiz-Ocaña P, Muela-Zarzuela I, Saez-Benito A, Montañez-Martínez R, Mateos RM, Lechuga-Sancho AM. Altered insulin secretion dynamics relate to oxidative stress and inflammasome activation in children with obesity and insulin resistance. J Transl Med 2023; 21:559. [PMID: 37599368 PMCID: PMC10440893 DOI: 10.1186/s12967-023-04337-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/09/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Insulin resistance (IR) is considered the main driver of obesity related metabolic complications, and is related to oxidative stress and inflammation, which in turn promote each other. There is currently no specific definition of IR in children, rather, that for adult population is used by pediatric endocrinologists instead. Altered insulin secretion dynamics are associated with worse metabolic profiles and type 2 diabetes mellitus development, thus we aimed to test whether insulin response relates to oxidative stress and inflammation in children. METHODS We conducted a case-control study, including 132 children classified as follows: 33 children without obesity (Lean); 42 with obesity but no IR according to the American Diabetes Association criteria for adults (OBIR-); 25 with obesity and IR and an early insulin response to an oral glucose tolerance test (OGTT) (EP-OBIR +); 32 with obesity, IR, and a late insulin peak (LP-OBIR +); and studied variables associated with lipid and carbohydrate metabolism, oxidative stress, inflammation and inflammasome activation. RESULTS The measured parameters of children with obesity, IR, and an early insulin response were similar to those of children with obesity but without IR. It was late responders who presented an impaired antioxidant system and elevated oxidative damage in erythrocytes and plasma, and inflammasome activation at their white blood cells, despite lower classical inflammation markers. Increased uric acid levels seems to be one of the underlying mechanisms for inflammasome activation. CONCLUSIONS It is insulin response to an OGTT that identifies children with obesity suffering oxidative stress and inflammasome activation more specifically. Uric acid could be mediating this pathological inflammatory response by activating NLRP3 in peripheral blood mononuclear cells.
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Affiliation(s)
- Álvaro González-Domínguez
- Grupo de Inflamación, Nutrición, Metabolismo y estrés Oxidativo, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), c/Doctor Marañón, 3 - Edificio Andrés Segovia, 11002, Cádiz, Spain
| | - Thalía Belmonte
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jesús Domínguez-Riscart
- Grupo de Inflamación, Nutrición, Metabolismo y estrés Oxidativo, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), c/Doctor Marañón, 3 - Edificio Andrés Segovia, 11002, Cádiz, Spain
- Unidad de Endocrinología Pediátrica y Diabetes, Servicio de Pediatría, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Pablo Ruiz-Ocaña
- Grupo de Inflamación, Nutrición, Metabolismo y estrés Oxidativo, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), c/Doctor Marañón, 3 - Edificio Andrés Segovia, 11002, Cádiz, Spain
- Unidad de Endocrinología Pediátrica y Diabetes, Servicio de Pediatría, Hospital Universitario de Jerez, Jerez de la Frontera, Spain
| | - Inés Muela-Zarzuela
- Grupo de Inflamación y Metabolismo Durante el Envejecimiento, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Ana Saez-Benito
- Servicio de Análisis Clínicos, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Grupo de Diabetes Mellitus - Autoinmunidad y complicaciones crónicas, Implicaciones Patológicas, clínicas y terapéuticas, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Raúl Montañez-Martínez
- Grupo de Daño cerebral Perinatal, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Rosa M Mateos
- Grupo de Inflamación, Nutrición, Metabolismo y estrés Oxidativo, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), c/Doctor Marañón, 3 - Edificio Andrés Segovia, 11002, Cádiz, Spain.
- Departamento de Biomedicina, Facultad de Ciencias, Biotecnología y Salud Pública y Salud Pública, Universidad de Cádiz, Puerto Real, Spain.
| | - Alfonso M Lechuga-Sancho
- Grupo de Inflamación, Nutrición, Metabolismo y estrés Oxidativo, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), c/Doctor Marañón, 3 - Edificio Andrés Segovia, 11002, Cádiz, Spain.
- Unidad de Endocrinología Pediátrica y Diabetes, Servicio de Pediatría, Hospital Universitario Puerta del Mar, Cádiz, Spain.
- Departamento Materno Infantil y Radiología, Facultad de Medicina, Universidad de Cádiz, Cádiz, Spain.
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Gómez-Gómez C, Moya-Molina MÁ, Tey-Aguilera MJ, Flores-Azofra J, González-Caballero JL. Baseline Profiles of Drug Prescriptions Prior to Diagnosis of Mild Cognitive Impairment (MCI) Obtained by Latent Class Analysis (LCA), and Assessment of Their Association with Conversion to Dementia. Healthcare (Basel) 2023; 11:2219. [PMID: 37570459 PMCID: PMC10419237 DOI: 10.3390/healthcare11152219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Polypharmacy has been linked to cognitive decline. However, interventions targeting modifiable risk factors, some of which are targets of the most commonly used drugs, could reduce the prevalence of dementia. Our aim was to determine the drug prescription regimen at baseline, prior to the diagnosis of mild cognitive impairment (MCI), and its possible association with progression to dementia. Data were collected from the electronic medical records of 342 MCI outpatients diagnosed during 2006-2017 at their first neurology consultation. We followed the classical three-step method of statistical analysis, starting with a Latent Class Analysis (LCA) to discover subgroups of drug prescription probability. Half of the patients were under polypharmacy (≥5 drugs), 17.5% had no recorded medication, 33.3% progressed to dementia (94.7% in ≤5 years), and 84.1% of them to Alzheimer's disease (AD). According to the LCA and based on 20 therapeutic indicators obtained from 240 substances and regrouped according the Anatomical Therapeutic Chemical Classification, we identified a four-profile model: (1) low (35.7% of patients); (2) mixed (28.7%); (3) cardio-metabolic (19.3%); and (4) psychotropic (16.4%). The binomial regression logistic model showed that profiles 2 and 3 (and 4 for AD), with a higher drug prescription conditioned probability against classic risk factors, were protective than profile 1 (OR = 0.421, p = 0.004; OR = 0.278, p = 0.000; OR = 0.457, p = 0.040, respectively), despite polypharmacy being significant in profiles 2 and 3 (mean > 7 drugs) vs. profile 1 (1.4 ± 1.6) (p = 0.000). Patients in the latter group were not significantly older, although being aged 65-79 years old quadrupled (OR = 4.217, p = 000) and being >79 tripled (OR = 2.945, p = 0.010) the conversion risk compared to patients <65 years old. According to the proposed analytical model, profiling the heterogeneous association of risk factors, which were taken prior to diagnosis, could be explored as an indicator of prior care and a predictor of conversion to dementia.
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Affiliation(s)
- Carmen Gómez-Gómez
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Cadiz, 11002 Cádiz, Spain; (M.J.T.-A.); (J.F.-A.)
| | - Miguel Ángel Moya-Molina
- Department of Neurology, Hospital Universitario Puerta del Mar (HUPM), University of Cadiz, 11009 Cádiz, Spain
| | - Manuel Jesús Tey-Aguilera
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Cadiz, 11002 Cádiz, Spain; (M.J.T.-A.); (J.F.-A.)
| | - Jorge Flores-Azofra
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Cadiz, 11002 Cádiz, Spain; (M.J.T.-A.); (J.F.-A.)
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Cordero A, Dalmau González-Gallarza R, Masana L, Fuster V, Castellano JM, Ruiz Olivar JE, Zsolt I, Sicras-Mainar A, González Juanatey JR. Economic Burden Associated with the Treatment with a Cardiovascular Polypill in Secondary Prevention in Spain: Cost-Effectiveness Results of the NEPTUNO Study. CLINICOECONOMICS AND OUTCOMES RESEARCH 2023; 15:559-571. [PMID: 37489131 PMCID: PMC10363366 DOI: 10.2147/ceor.s396290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/23/2023] [Indexed: 07/26/2023] Open
Abstract
Purpose The aim of this study was to estimate health-care resources utilization, costs and cost-effectiveness associated with the treatment with CNIC-Polypill as secondary prevention of atherosclerotic cardiovascular disease (ASCVD) compared to other treatments, in clinical practice in Spain. Patients and Methods An observational, retrospective study was performed using medical records (economic results [healthcare perspective], NEPTUNO-study; BIG-PAC-database) of patients who initiated secondary prevention between 2015 and 2018. Patients were followed up to 2 years (maximum). Four cohorts were balanced with a propensity-score-matching (PSM): 1) CNIC-Polypill (aspirin+atorvastatin+ramipril), 2) Monocomponents (same separate drugs), 3) Equipotent (equipotent drugs) and 4) Other therapies ([OT], other cardiovascular drugs). Incidence of cardiovascular events, health-care resources utilization and healthcare and non-healthcare costs (2020 Euros) were compared. Incremental cost-effectiveness ratios per cardiovascular event avoided were estimated. Results After PSM, 1614 patients were recruited in each study cohort. The accumulated incidence of cardiovascular events during the 24-month follow-up was lower in the CNIC-Polypill cohort vs the other cohorts (19.8% vs Monocomponents: 23.3%, Equipotent: 25.5% and OT: 26.8%; p<0.01). During the follow-up period, the CNIC-Polypill cohort also reduced the health-care resources utilization per patient compared to the other cohorts, particularly primary care visits (16.6 vs Monocomponents: 18.7, Equipotent: 18.9 and OT: 21.0; p<0.001) and hospitalization days (2.3 vs Monocomponents: 3.4, Equipotent: 3.7 and OT: 4.0; p<0.001). The treatment cost in the CNIC-Polypill cohort was lower than that in the other cohorts (€4668 vs Monocomponents: €5587; Equipotent: €5682 and OT: €6016; p<0.001) (Difference: -€919, -€1014 and -€1348, respectively). Due to the reduction of cardiovascular events and costs, the CNIC-Polypill is a dominant alternative compared to the other treatments. Conclusion CNIC-Polypill reduces recurrent major cardiovascular events and costs, being a cost-saving strategy as secondary prevention of ASCVD.
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Affiliation(s)
- Alberto Cordero
- Cardiology Service, San Juan University Hospital, Alicante, Spain
- Cardiovascular Diseases Network Research Center (CIBERCV), Madrid, Spain
| | | | - Lluis Masana
- Sant Joan University Hospital, Vascular Medicine and Metabolism Unit, Reus, Spain
- Pere Virgili Institute of Health Research (IISPV), Reus, Spain
- Center for Biomedical Research Network on Diabetes and Associated Metabolic Diseases (CIBERDEM), Reus, Spain
| | - Valentín Fuster
- National Center for Cardiovascular Research (CNIC), Carlos III Health Institute, Madrid, Spain
- Mount Sinai Medical Center, New York, NY, USA
| | - Jose Mª Castellano
- National Center for Cardiovascular Research (CNIC), Carlos III Health Institute, Madrid, Spain
- Integral Center for Cardiovascular Diseases (CIEC), Montepríncipe University Hospital, HM Hospitales Group, Madrid, Spain
- School of Medicine, CEU San Pablo University, Madrid, Spain
| | | | - Ilonka Zsolt
- Corporate Medical Affairs, Ferrer, Barcelona, Spain
| | | | - Jose Ramón González Juanatey
- Cardiovascular Diseases Network Research Center (CIBERCV), Madrid, Spain
- Cardiology Service, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Santiago de Compostela Health Research Institute (IDIS), Santiago de Compostela, Spain
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Rodríguez Hermosa JL, Miravitlles M, López-Campos JL, Calle Rubio M. Smoking and COPD Knowledge in the General Spanish Population: A CONOCEPOC Study. J Clin Med 2023; 12:4473. [PMID: 37445508 DOI: 10.3390/jcm12134473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/19/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The objective of this analysis is to evaluate tobacco use and the level of chronic obstructive pulmonary disease (COPD) knowledge among the general adult population in Spain and to compare these results to those obtained in the 2011 survey. METHODS A cross-sectional, observational, epidemiological study was conducted by telephone interviews and stratified by sex, age, and setting. The study design was identical to that of the study conducted in 2011. RESULTS Of a total of 89,601 phone contacts, there were 6534 respondents. The average age was 61.5 years. With respect to smoking, 30.9% reported being former smokers and 14.7% were current smokers, 63.6% of whom reported having attempted to quit. Among the current smokers, 19.7% claimed to use electronic cigarettes, although 88% believe these pose a health risk. No significant differences were found in smoking prevalence or frequency of attempts to quit according to residential setting (rural/urban). The highest prevalence of current smoking in men was recorded in the 55-64 years age range (31.6%), while in women it was from 45 to 54 years (34.6%). Smoking has decreased with respect to 2011, from 21.1% to 16.1% in men and from 17.9% to 13.2% in women, with a clear variability according to region. Of the population surveyed, 32.5% had spontaneous knowledge about COPD, with significant geographic variability. The most frequent sources of information about the disease were social media and the Internet (39.6%), followed by the media (35.2%). CONCLUSIONS The prevalence of tobacco use in adults has considerably decreased and there is greater knowledge about COPD in Spain, although there is significant variability according to region, which could explain the geographic variability in the prevalence of COPD. Strategies are needed to increase COPD education and awareness and to reinforce smoking prevention measures among women.
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Affiliation(s)
- Juan Luis Rodríguez Hermosa
- Pulmonary Department, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Department of Medicine, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain
| | - Marc Miravitlles
- Pulmonary Department, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, 28029 Madrid, Spain
| | - José Luis López-Campos
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, 28029 Madrid, Spain
- Medical-Surgical Unit for Respiratory Diseases, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/University of Seville, 41013 Seville, Spain
| | - Myriam Calle Rubio
- Pulmonary Department, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Department of Medicine, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain
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15
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Ripoll Perelló J, Barrés Fernández PC, Pick Martín J. [Study of correlation between different scales that measure smoking dependence]. Aten Primaria 2023; 55:102581. [PMID: 36796179 PMCID: PMC9958443 DOI: 10.1016/j.aprim.2023.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To analyze the correlation between the degrees of smoking dependence, measured with the Fagerström Test Nicotine Dependence (FTND), Glover-Nilsson Smoking Behavioral Dependence (GN-SBQ) and a measure of self-perceived-dependence (SPD). DESIGN Cross-sectional descriptive observational study. SITE: Urban primary health-care center. PARTICIPANTS Men and women between 18 and 65 years old, daily smokers, selected by non-random consecutive sampling. INTERVENTIONS Self-administration of various questionnaires though an electronic device. MAIN MEASUREMENTS Age, sex and nicotine dependence assessed by: FTND, GN-SBQ and SPD. Statistical analysis, with SPSS 15.0: descriptive statistics, Pearson correlation analysis and conformity analysis. RESULTS Two hundred fourteen smokers were included, 54.7% were women. Median age 52 years (range: 27-65). Depending on the test used, different results of the high/very high degree of dependence were found: FTND 17.3%, GN-SBQ 15.4% and SPD 69.6%. A moderate magnitude (r≈0.5) correlation between the 3 test was found. When assessing concordance, comparing the FTND with SPD, 70.6% of smokers didn't coincide in the severity of dependence, reporting a milder degree of dependence with the FTND than with SPD. Comparing GN-SBQ versus FTND, showed conformity in 44.4% of patients while in 40.7%, the FTND underestimated the severity of dependence. Likewise, when comparing SPD with the GN-SBQ, in the 64% GN-SBQ underestimates, while in 34.1% smokers conformity was demonstrated. CONCLUSIONS The number of patients who consider their SPD to be high/very high was four times higher compared to the GN-SBQ or the FNTD; the latter, being the most demanding, categorizing patients with very high dependence. Requiring a FTND score greater than 7 to prescribe drugs for smoking cessation may exclude subsidiary patients from receiving treatment.
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Affiliation(s)
- Jazmin Ripoll Perelló
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España; Universidad de Valencia, Valencia, España.
| | - Paula C Barrés Fernández
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España
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García Castillo E, Alonso Pérez T, Peláez A, Pérez González P, Miravitlles M, Alfageme I, Casanova C, Cosío BG, de Lucas P, García-Río F, Rodríguez González-Moro JM, Soler-Cataluña JJ, Sánchez G, Soriano JB, Ancochea J. Trends of COPD in Spain: Changes Between Cross Sectional Surveys 1997, 2007 and 2017. Arch Bronconeumol 2023; 59:142-151. [PMID: 36549937 DOI: 10.1016/j.arbres.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We aim to describe the changes in prevalence and risk factors associated to chronic obstructive pulmonary disease (COPD) in Spain, comparing three population-based studies conducted in three timepoints. METHODS We compared participants from IBERPOC conducted in 1997, EPISCAN conducted in 2007 and EPISCAN II in 2017. COPD was defined as a postbronchodilator FEV1/FVC (forced expiratory volume in 1s/forced vital capacity) ratio <0.70, according to GOLD criteria; subsequently, also as the FEV1/FVC below the lower limit of normal (LLN). RESULTS COPD prevalence in the population between 40 and 69 years decreased from 21.6% (95% CI 20.7%-23.2%) in 1997 to 8.8% (95% CI 8.2%-9.5%) in 2017, a 59.2% decline (p<0.001). In 2007, the prevalence was 7.7% (95% CI 6.8%-8.7%) with an upward trend of 1.1 percentage points in 2017 (p=0.073). Overall COPD prevalence decreased in men and women, although a significant increase was observed in the last decade in females (p<0.05). Current smokers significantly increased in the last decades (25.4% in 1997, 29.1% in 2007 and 23.4% in 2017; p<0.001). Regrettably, COPD underdiagnosis was constantly high, 77.6% in 1997, 78.4% in 2007, and to 78.2% in 2017 (p=0.95), higher in younger ages (40-49 yrs and 50-59 yrs) and also higher in women than in men in all three studies (p<0.05). CONCLUSIONS We report a significant reduction of 59.2% in the prevalence of COPD in Spain from 1997 to 2017 in subjects aged 40-69 years. Our study highlights the significant underdiagnosis of COPD, particularly sustained in women and younger populations.
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Affiliation(s)
- Elena García Castillo
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Tamara Alonso Pérez
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Adrián Peláez
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Patricia Pérez González
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain
| | - Marc Miravitlles
- Pulmonary Department, Hospital Universitari Vall d'Hebron-CIBERES, Barcelona, Spain
| | - Inmaculada Alfageme
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Ciro Casanova
- Pulmonary Department-Research Unit, Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain
| | - Borja G Cosío
- Pulmonary Department, Hospital Universitario Son Espases-IdISBa-Ciberes, Palma de Mallorca, Baleares, Spain
| | - Pilar de Lucas
- Pulmonary Department, Hospital General Gregorio Marañón, Madrid, Spain
| | - Francisco García-Río
- Pulmonary Department, Hospital Universitario La Paz-IdiPAZ-CIBERES, Madrid, Spain
| | | | - Juan José Soler-Cataluña
- Pulmonary Department, Hospital Arnau de Vilanova-Lliria, Universitat de València, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Joan B Soriano
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Julio Ancochea
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Arias-Fernández L, Carcedo-Argüelles L, Martín-Payo R, López-García E, Rodríguez-Artalejo F, Lana A. Association between neighborhood physical characteristics and mental health among older adults in Spain. Geriatr Nurs 2023; 49:170-177. [PMID: 36565591 DOI: 10.1016/j.gerinurse.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
The aim was to assess the impact of neighborhood physical environment on mental health among non-institutionalized older adults. A cross-sectional analysis was conducted over a representative sample of 5,071 people ≥65 years from the Spanish National Health Survey. The survey included nine items addressing the self-perceived degree of discomfort due to neighborhood physical problems. Participants were categorized into groups with "no problems", "some problems" (somewhat discomfort on 1-4 items) and "many problems" (somewhat discomfort on ≥5 items or very much discomfort on ≥1 item). Mental health status was assessed using the General Health Questionnaire, consisting of 12 items assessing the severity of a psychological distress over the past few weeks. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regressions. A dose-response association (p-trend<0.001) was found between living in neighborhoods with some (OR: 1.41; 95% CI: 1.14-1.75) or many problems (OR: 1.93; 95% CI: 1.55-2.42) affecting the physical environment with poor mental health of community dwelling older adults. Integrating and articulating health considerations into public policymaking regarding housing and the residential environment can have broad implications for healthy aging.
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Affiliation(s)
- Lucía Arias-Fernández
- Health Service of Asturias, Asturias, Spain; Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo / ISPA, Asturias, Spain
| | - Lucía Carcedo-Argüelles
- Health Service of Asturias, Asturias, Spain; Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo / ISPA, Asturias, Spain
| | - Rubén Martín-Payo
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo / ISPA, Asturias, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo / ISPA, Asturias, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Higuera-Gómez A, Ribot-Rodríguez R, Micó V, Cuevas-Sierra A, San Cristóbal R, Martínez JA. Lifestyle and Health-Related Quality of Life Relationships Concerning Metabolic Disease Phenotypes on the Nutrimdea Online Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:767. [PMID: 36613089 PMCID: PMC9819172 DOI: 10.3390/ijerph20010767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Obesity, diabetes and cardiovascular events are non-communicable diseases (NCDs) directly related to lifestyle and life quality. Rises on NCDs rates are leading to increases in early deaths concerning metabolic morbidities. Health-related quality of life (HRQoL) has been described as a subjective perception about the influence of health and personal features on human well-being. This study aimed to characterize phenotypic and lifestyle roles on the occurrence of metabolic diseases and determine the potential mutual interactions and with HRQoL. Data from an online adult population (NUTRiMDEA study, n = 17,332) were used to estimate an adapted Obesogenic Score (ObS), while logistic regression analyses were fitted in order to examine relevant factors related to the prevalence of different metabolic diseases including HRQoL. Sex and age showed significant differences depending on lifestyle and metabolic health (p < 0.05). Adherence to the Mediterranean diet and physical activity showed a mutual interaction concerning ObS (p < 0.001), as well with metabolic health (p = 0.044). Furthermore, metabolic diseases showed own features related to sociodemographic and lifestyle characteristics in this population. Metabolic syndrome components may be differently influenced by diverse lifestyle or socioeconomic factors which in turn affect the perceived HRQoL. These outcomes should be taken into account individually for a precision medicine and public health purposes.
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Affiliation(s)
- Andrea Higuera-Gómez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
| | - Rosa Ribot-Rodríguez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
| | - Victor Micó
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
| | - Amanda Cuevas-Sierra
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
| | - Rodrigo San Cristóbal
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels de L’Université Laval (INAF), Université Laval, Quebec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, Quebec, QC G1V 0A6, Canada
| | - Jose Alfredo Martínez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
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19
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Prevalence of Hyperuricemia and Its Association with Cardiovascular Risk Factors and Subclinical Target Organ Damage. J Clin Med 2022; 12:jcm12010050. [PMID: 36614852 PMCID: PMC9820920 DOI: 10.3390/jcm12010050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/05/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
The role of uric acid levels in the cardiovascular continuum is not clear. Our objective is to analyze the prevalence of hyperuricemia (HU) and its association with cardiovascular risk factors (CVRF), subclinical target organ damage (sTOD), and cardiovascular diseases (CVD). We evaluated the prevalence of HU in 6.927 patients included in the baseline visit of the IBERICAN study. HU was defined as uric acid levels above 6 mg/dL in women, and 7 mg/dL in men. Using adjusted logistic regression models, the odds ratios were estimated according to CVRF, sTOD, and CVD. The prevalence of HU was 16.3%. The risk of HU was higher in patients with pathological glomerular filtration rate (aOR: 2.92), heart failure (HF) (aOR: 1.91), abdominal obesity (aOR: 1.80), hypertension (HTN) (aOR: 1.65), use of thiazides (aOR: 1.54), left ventricular hypertrophy (LVH) (aOR: 1.36), atrial fibrillation (AFIB) (aOR: 1.29), and albuminuria (aOR: 1.27). On the other hand, being female (aOR: 0.82) showed a reduced risk. The prevalence of HU was higher in men, in patients presenting CVRF such as HTN and abdominal obesity, and with co-existence of LVH, atrial fibrillation (AFIB), HF, and any form of kidney injury. These associations raise the possibility that HU forms part of the early stages of the cardiovascular continuum. This may influence its management in Primary Healthcare because the presence of HU could mean an increased CV risk in the patients.
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20
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Paly VF, Vallejo-Aparicio LA, Martin A, Izquierdo JL, Riesco JA, Soler-Cataluña JJ, Abreu C, Biswas C, Ismaila AS. Cost-Effectiveness of Once-Daily Single-Inhaler COPD Triple Therapy in Spain: IMPACT Trial. Int J Chron Obstruct Pulmon Dis 2022; 17:3097-3109. [PMID: 36561129 PMCID: PMC9766529 DOI: 10.2147/copd.s366765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Given between-country differences in healthcare systems, treatment costs, and disease management guidelines, country-specific cost-effectiveness analyses are important. This study evaluated the cost-effectiveness of once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus FF/VI and UMEC/VI among patients with symptomatic chronic obstructive pulmonary disease (COPD) at risk of exacerbations from a Spanish healthcare system perspective. Patients and Methods Baseline data and treatment effects from the IMPACT trial were populated into the validated GALAXY COPD progression model. Utilities were estimated using Spanish observational data. Direct healthcare costs (2019 €) were informed by Spanish public sources. A 3% discount rate for costs and benefits was applied. The time horizon and treatment duration were 3 years (base case). One-way sensitivity, scenario, and probabilistic sensitivity analyses were performed. Results FF/UMEC/VI treatment resulted in fewer exacerbations over 3 years (4.130 vs 3.648) versus FF/VI, with a mean (95% confidence interval [CI]) incremental cost of €444 (€149, €713) per patient and benefit of 0.064 (0.053, 0.076) quality-adjusted life years (QALYs), resulting in an incremental cost-effectiveness ratio (ICER) of €6887 per QALY gained. FF/UMEC/VI was a dominant treatment strategy versus UMEC/VI, resulting in fewer exacerbations (4.130 vs 3.360), with a mean (95% CI) incremental cost of -€450 (-€844, -€149) and benefit of 0.054 (0.043, 0.064) QALYs. FF/UMEC/VI was cost-effective versus FF/VI and UMEC/VI across all analyses. Conclusion FF/UMEC/VI was predicted to be a cost-effective treatment option versus FF/VI or UMEC/VI in symptomatic COPD patients at risk of exacerbations in Spain, across all scenarios and sensitivity analyses.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Afisi S Ismaila
- Value Evidence and Outcomes, GSK, Collegeville, PA, USA,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada,Correspondence: Afisi S Ismaila, Value Evidence and Outcomes, GSK, 1250 South Collegeville Road, Collegeville, PA, 19426-0989, USA, Tel +1 919 315 8229, Email
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21
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Lazarus JV, Ortiz A, Tyrovolas S, Fernández E, Guy D, White TM, Ma R, Hay SI, Naghavi M, Soriano JB. A GBD 2019 study of health and Sustainable Development Goal gains and forecasts to 2030 in Spain. Sci Rep 2022; 12:21154. [PMID: 36477107 PMCID: PMC9729199 DOI: 10.1038/s41598-022-24719-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
This study aimed to report mortality, risk factors, and burden of diseases in Spain. The Global Burden of Disease, Injuries, and Risk Factors 2019 estimates the burden due to 369 diseases, injuries, and impairments and 87 risk factors and risk factor combinations. Here, we detail the updated Spain 1990-2019 burden of disease estimates and project certain metrics up to 2030. In 2019, leading causes of death were ischaemic heart disease, stroke, chronic obstructive pulmonary disease, Alzheimer's disease, and lung cancer. Main causes of disability adjusted life years (DALYs) were ischaemic heart disease, diabetes, lung cancer, low back pain, and stroke. Leading DALYs risk factors included smoking, high body mass index, and high fasting plasma glucose. Spain scored 74/100 among all health-related Sustainable Development Goals (SDGs) indicators, ranking 20 of 195 countries and territories. We forecasted that by 2030, Spain would outpace Japan, the United States, and the European Union. Behavioural risk factors, such as smoking and poor diet, and environmental factors added a significant burden to the Spanish population's health in 2019. Monitoring these trends, particularly in light of COVID-19, is essential to prioritise interventions that will reduce the future burden of disease to meet population health and SDG commitments.
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Affiliation(s)
- Jeffrey V. Lazarus
- grid.5841.80000 0004 1937 0247Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 171, 08036 Barcelona, Spain ,grid.5841.80000 0004 1937 0247Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Alberto Ortiz
- grid.5515.40000000119578126Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain ,grid.411171.30000 0004 0425 3881Department of Nephrology and Hypertension, The Institute for Health Research Foundation Jiménez Díaz University Hospital, Madrid, Spain
| | - Stefanos Tyrovolas
- St. John of God Health Park, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain ,Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Esteve Fernández
- grid.417656.7Tobacco Control Unit, Catalan Institute of Oncology- ICO, WHO Collaborating Centre for Tobacco Control, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Tobacco Control Research Group, Bellvitge Biomedical Research Institute -IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Danielle Guy
- grid.5841.80000 0004 1937 0247Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 171, 08036 Barcelona, Spain
| | - Trenton M. White
- grid.5841.80000 0004 1937 0247Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 171, 08036 Barcelona, Spain
| | - Rui Ma
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA USA
| | - Simon I. Hay
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA USA
| | - Mohsen Naghavi
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA USA
| | - Joan B. Soriano
- grid.413448.e0000 0000 9314 1427Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ,grid.411251.20000 0004 1767 647XHospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
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22
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Estarlich M, Tolsa C, Trapero I, Buigues C. Circadian Variations and Associated Factors in Patients with Ischaemic Heart Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15628. [PMID: 36497700 PMCID: PMC9737286 DOI: 10.3390/ijerph192315628] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Circadian rhythms have been identified in cardiovascular diseases, and cardiovascular risk factors can modify the circadian rhythm. The purpose of this study was to describe the onset of ischaemic heart disease symptomatology in relation to the date and time, the day of the week of presentation, the season, AMI location and severity and the level of influence of individual patient characteristics in a retrospective cross-sectional study involving 244 ischaemic heart disease patients from the intensive care unit of La Ribera Hospital (Spain). The onset of pain was more frequent in the morning, the season with the highest frequency of ischaemic events was winter, and the lowest incidence was during weekends. Regarding the severity of ischaemic heart disease, the circadian rhythm variables of weekdays vs. weekends and seasons did not show a significant association. The length of hospital stay was associated with the onset of pain in the afternoon. The onset of pain at night was associated with the subendocardial location of the infarction. In conclusion, living in a Mediterranean country, the Spanish population showed a circadian pattern of AMI, where the onset of pain has an influence on AMI location and on the length of hospital stay and is the same in patients with different individual risk factors.
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Affiliation(s)
- Marisa Estarlich
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Avenida de Catalunya 21, 46020 Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28001 Madrid, Spain
| | - Carmen Tolsa
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Isabel Trapero
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Cristina Buigues
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain
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23
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Bartoll-Roca X, Rodríguez-Sanz M, Sánchez-Ledesma E, Pérez K, Borrell C. Inequalities in life expectancy by educational level and its decomposition in Barcelona, 2004-2018. GACETA SANITARIA 2022; 36:520-525. [PMID: 35337685 DOI: 10.1016/j.gaceta.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To analyse the gap in life expectancy by educational level in the city of Barcelona from 2004 to 2018 and to decompose this gap by age and causes of death. METHOD We computed abridged life tables at the age of 25 years by sex from 2004 to 2018 using standard methods. Educational level was categorised in two groups (lower secondary or less vs. upper secondary or higher education). The life expectancy gap was further decomposed by age and by causes of death based in Arriaga's method in 5-year age blocks up to the age of ≥ 90 years and broad causes of death using ICD-10 codes. RESULTS The life expectancy gap at 25 years by educational level oscillated without trend at around 3.08 years for men and 1.93 years for women. Decomposition by age showed a favourable significant shift in the contribution to this gap from young to older ages for men, with few changes for women. Decomposition by causes of death showed that the diseases concentrating the largest share of the contribution were neoplasms and respiratory and circulatory disease. There was a significant downward trend in external causes for men and in infectious diseases for both men and women but a significant upward trend for respiratory disease for both sexes. CONCLUSIONS The stability of the life expectancy gap by educational level during the period analysed resulted from a combination of divergent trends by age and causes of death among high and low educational levels.
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Affiliation(s)
- Xavier Bartoll-Roca
- Agència de Salut Pública de Barcelona, Barcelona (ASPB), Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
| | - Maica Rodríguez-Sanz
- Agència de Salut Pública de Barcelona, Barcelona (ASPB), Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Cièncias Experimentales i de la Salut, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Katherine Pérez
- Agència de Salut Pública de Barcelona, Barcelona (ASPB), Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona (ASPB), Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Cièncias Experimentales i de la Salut, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
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24
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Orozco-Beltrán D, Brotons Cuixart C, Banegas Banegas JR, Gil Guillén VF, Cebrián Cuenca AM, Martín Rioboó E, Jordá Baldó A, Vicuña J, Navarro Pérez J. [Cardiovascular preventive recommendations. PAPPS 2022 thematic updates. Working groups of the PAPPS]. Aten Primaria 2022; 54 Suppl 1:102444. [PMID: 36435583 PMCID: PMC9705225 DOI: 10.1016/j.aprim.2022.102444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of cardiovascular diseases (CVD) are presented. The following sections are included: epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; cardiovascular (CV) risk and recommendations for the calculation of CV risk; main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; indications for antiplatelet therapy, and recommendations for screening of atrial fibrillation, and recommendations for management of chronic conditions. The quality of testing and the strength of the recommendation are included in the main recommendations.
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Affiliation(s)
- Domingo Orozco-Beltrán
- Medicina Familiar y Comunitaria, Unidad de Investigación Centro de Salud Cabo Huertas, Departamento San Juan de Alicante. Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España.
| | - Carlos Brotons Cuixart
- Medicina Familiar y Comunitaria. Instituto de Investigación Biomédica (IIB) Sant Pau. Equipo de Atención Primaria Sardenya, Barcelona, España
| | - Jose R Banegas Banegas
- Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | - Vicente F Gil Guillén
- Medicina Familiar y Comunitaria, Hospital Universitario de Elda. Departamento de Medicina Clínica. Universidad Miguel Hernández, San Juan de Alicante, España
| | - Ana M Cebrián Cuenca
- Medicina Familiar y Comunitaria, Centro de Salud Cartagena Casco Antiguo, Instituto Murciano de Investigación Biosanitaria (IMIB), 30120 Murcia, España
| | - Enrique Martín Rioboó
- Medicina Familiar y Comunitaria, Especialista en Medicina Familiar y Comunitaria, Centro de Salud Poniente, Córdoba, IMIBIC Hospital Reina Sofía Córdoba. Colaborador del grupo PAPPS
| | - Ariana Jordá Baldó
- Medicina Familiar y Comunitaria, Centro de Salud San Miguel, Plasencia, Badajoz, España
| | - Johanna Vicuña
- Medicina Preventiva y Salud Pública, Hospital de la Sant Creu i Sant Pau, Barcelona, España
| | - Jorge Navarro Pérez
- Medicina Familiar y Comunitaria, Hospital Clínico Universitario. Departamento de Medicina. Universidad de Valencia. Instituto de Investigación INCLIVA, Valencia, España
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25
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Fernández Trujillo A, López Ortiz C, Cuñat Rodriguez O, Del Hoyo Buxo B, Parrilla FJ, Serrano-Blanco A, Berrade Zubiri JJ. History of mental disorder in an ICU and referrals to psychiatry. Med Intensiva 2022; 46:559-567. [PMID: 35637139 DOI: 10.1016/j.medine.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/15/2021] [Accepted: 03/21/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To describe the prevalence of patients with mental disorders (MD) admitted to the ICU. To compare the clinical characteristics according to the presence of psychiatric history. To review the relevance of the consultations made to Psychiatry. DESIGN Retrospective descriptive study. SETTING ICU of the General Hospital of the Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain. PATIENTS Patients admitted between January 2016 and June 2018. INTERVENTIONS None. MAIN VARIABLES OF INTEREST Severity level (APACHE II), reason for admission, days of admission, days of mechanical ventilation, psychiatric history and reason for psychiatric consultation. RESULTS A total of 1,247 patients were included; 194 (15.5%) met MD criteria, their mean age being younger (59 vs 68, P < .001) and with a lower mean score on the APACHE II scale (12 vs 14, P ≤ .003). There were 64 consultations to Psychiatry (5.1% of admissions), 59 of which were in patients with TM (92.1%). Regarding the reasons for the consultation, 22.6% were for attempted suicide, 61.3% for pharmacological adjustment, 11.3% to rule out mental disorder, and 4.8% for competence assessment. The probability of a consultation being carried out while it was indicated was 89.1%, while the probability of not carrying it out when it was not indicated was 99.4%. CONCLUSIONS This study supports the need to expand the specific recommendations for consultation to Psychiatry, beyond the assessment after a suicide attempt, since a large percentage (77.5%) of the pertinent consultations were for other reasons.
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Affiliation(s)
- A Fernández Trujillo
- Unidad de Cuidados Intensivos, Consorci Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain.
| | - C López Ortiz
- Unidad de Agudos de Psiquiatría, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - O Cuñat Rodriguez
- MIR Psiquiatría, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - B Del Hoyo Buxo
- MIR Psiquiatría, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - F J Parrilla
- Servicio de Medicina Intensiva, Hospital del Mar, Parc de Satlut Mar, GREPAC, IMIM, Barcelona, Spain
| | - A Serrano-Blanco
- Salud Mental, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - J J Berrade Zubiri
- Unidad de Medicina Intensiva, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
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Maldonado-Cárceles AB, Hernando-Arizaleta L, Palomar-Rodríguez JA, Morales-Ortiz A. Trends in hospitalisation for ischaemic stroke in young adults in the region of Murcia (Spain) between 2006 and 2014. Neurologia 2022; 37:524-531. [PMID: 32001039 DOI: 10.1016/j.nrl.2019.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/13/2019] [Accepted: 10/13/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Recent studies conducted in Europe and the United States suggest upward trends in both incidence and hospitalisation rates for ischaemic stroke in young adults; however, data for Spain are scarce. This study analyses the trend in hospitalisation due to ischaemic stroke in adults aged under 50 years in the region of Murcia between 2006 and 2014. METHOD We performed a retrospective study of patients discharged after hospitalisation due to cerebrovascular disease (CVD); data were obtained from the regional registry of the Minimum Basic Data Set. Standardised rates were calculated, disaggregated by age and CVD subtype. Time trends were analysed using joinpoint regression to obtain the annual calculated standardised rate and the annual percentage of change (APC). RESULTS A total of 27 064 patients with CVD were discharged during the 9-year study period. Ischaemic stroke was the most frequent subtype (61.0%). In patients aged 18 to 49 years, the annual number of admissions due to ischaemic stroke increased by 26%, and rates by 29.2%; however, the joinpoint regression analysis showed no significant changes in the trend (APC=2.74%, P≥.05). By contrast, a downward trend was identified in individuals older than 49 (APC=-1.24%, P<.05). CONCLUSIONS No significant changes were observed in the rate of hospitalisation due to ischaemic stroke among young adults, despite the decline observed in older adults. Identifying the causes of these disparate trends may be beneficial to the development of specific measures targeting younger adults.
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Affiliation(s)
- A B Maldonado-Cárceles
- Medicina Preventiva, Complejo Hospitalario Universitario de Cartagena, Murcia, España; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Murcia, Murcia, España.
| | - L Hernando-Arizaleta
- Servicio de Planificación y Financiación Sanitaria, Consejería de Salud, Murcia, España
| | - J A Palomar-Rodríguez
- Servicio de Planificación y Financiación Sanitaria, Consejería de Salud, Murcia, España
| | - A Morales-Ortiz
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
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Maldonado-Cárceles A, Hernando-Arizaleta L, Palomar-Rodríguez J, Morales-Ortiz A. Trends in hospitalisation for ischaemic stroke in young adults in the region of Murcia (Spain) between 2006 and 2014. NEUROLOGÍA (ENGLISH EDITION) 2022; 37:524-531. [DOI: 10.1016/j.nrleng.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 10/13/2019] [Indexed: 11/16/2022] Open
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Silent brain infarcts, peripheral vascular disease and the risk of cardiovascular events in patients with hypertension. J Hypertens 2022; 40:1469-1477. [PMID: 35881448 DOI: 10.1097/hjh.0000000000003154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS We aimed to study the relationship between cerebral small vessel disease (cSVD) lesions, as markers of subclinical target organ damage (TOD) in the brain, and incident cardiovascular events (CVE). METHODS Data from the ISSYS (Investigating Silent Strokes in hYpertensives Study), which is a longitudinal and observational study conducted in patients with hypertension aged 50-70 years, and stroke-free at the inclusion. At the baseline visit, participants underwent a clinical interview, a brain MRI, urine and blood sampling collection and vascular testing studies. Therefore, we obtained markers of TOD from the brain [white matter hyperintensities, silent brain infarcts (SBI), cerebral microbleeds and enlarged perivascular spaces (EPVS)], from kidney (microalbuminuria, glomerular filtration) and regarding large vessels [ankle-to-brachial index (ABI), carotid-femoral pulse wave velocity]. Survival analyses were used to assess the relationship between these predictors and the incidence of cardiovascular events (CVE). RESULTS We followed-up 964 individuals within a median time of 5 years (4.7-5), representing 4377.1 persons-year. We found 73 patients presenting incident CVE, which corresponds to a rate of 8.2%. We found ABI less than 0.9 [hazard ratio, 2.2; 95% confidence interval (CI) 1.17-4.13, P value = 0.014] and SBI (hazard ratio, 2.9; 95% CI 1.47-5.58, P value = 0.002) independently associated with higher risk of incident CVE. The inclusion of both variables in a clinical model resulted in an increased discrimination of individuals with new CVE of 4.72%, according to the integrated discrimination index. CONCLUSION Assessment of SBI and ABI less than 0.9 may refine the cardiovascular risk stratification in patients with hypertension.
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Stable Gender Gap and Similar Gender Trend in Chronic Morbidities between 1997-2015 in Adult Canary Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159404. [PMID: 35954761 PMCID: PMC9368162 DOI: 10.3390/ijerph19159404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
There is little information about the trend of the gender gap in chronic morbidities and whether the trend of expansion occurs equally in the age and gender groups. The objectives were to examine the consistency and stability of the gender gap in the main self-reported chronic morbidities in the general population, and, likewise, to analyze the trend of major chronic morbidities between 1997 and 2015 in men and women across age groups. The data were extracted from the Canary Health Survey, which uses a probabilistic sampling in the population >16 years of age, for the years 1997 (n = 2167), 2004 (n = 4304), 2009 (n = 4542), and 2015 (n = 4560). The data for the twelve most frequent chronic morbidities were analyzed using logistic regression, estimating the annual change ratio between 1997 and 2015, adjusting for age and educational level. The interaction of age with the period (1997−2015) was examined to analyze the rate of change for each morbidity in the age groups. Musculoskeletal diseases, headaches, anxiety and depression, and peripheral vascular diseases showed a stable gender gap across observed years. High cholesterol and high blood pressure tended to a gap reduction, while heart disease, diabetes, and respiratory disease did not show a significant gender gap along the period. The trend of the main chronic morbidities increased similarly in men and women in all age groups, but significantly in women older than 60 years and in men older than 45 years. Aging explained a substantial part of the trend of increasing prevalence of the main chronic morbidities, but not totally. Factors other than age and education are driving the increase in chronic morbidity in older age groups.
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Rojas-Acuña D, Polo-Samillan N, Vasquez-Chavesta AZ, Escalante-Arias C, Rios-Perez CJ, Toro-Huamanchumo CJ. Morbimortality Associated with Liver Cirrhosis in Peru: An Ecological Analysis for the Period of 2004-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9036. [PMID: 35897403 PMCID: PMC9332628 DOI: 10.3390/ijerph19159036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
Liver cirrhosis (LC) is an irreversible, chronic disease and constitutes the last clinical stage of many different liver diseases. The main cause of death is upper gastrointestinal bleeding caused by esophageal variceal rupture. We aim to depict the trend and estimate the morbimortality. For this, we conducted an ecological study and analyzed data from 2004-2016 using the public information provided by the Peruvian Ministry of Health (Ministerio de Salud del Perú, MINSA). Morbidity and mortality were presented according to 5-year groups. Regions were divided according to age quintiles for each studied year, and standardized morbidity and mortality rates were calculated for each natural geographic region; we found that LC-related morbidity per 100,000 people was 52.3 in 2004 and 117.9 in 2016. LC-related mortality had increased from 13.6 deaths per 100,000 people in 2004-2005 to 16.8 deaths per 100,000 people in 2015-2016. Morbidity showed an upward trend in Peru, especially in the departments of Callao, Ica, and Tumbes, whereas mortality showed an upward trend in the departments of Lambayeque, Ica, and Callao.
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Affiliation(s)
- Daniela Rojas-Acuña
- School of Medicine, Universidad Católica Santo Toribio de Mogrovejo, Chiclayo 14012, Peru; (D.R.-A.); (N.P.-S.); (A.Z.V.-C.); (C.E.-A.); (C.J.R.-P.)
- Asociación Científica Médico Estudiantil USAT, Chiclayo 14012, Peru
| | - Nilo Polo-Samillan
- School of Medicine, Universidad Católica Santo Toribio de Mogrovejo, Chiclayo 14012, Peru; (D.R.-A.); (N.P.-S.); (A.Z.V.-C.); (C.E.-A.); (C.J.R.-P.)
- Asociación Científica Médico Estudiantil USAT, Chiclayo 14012, Peru
| | - Angie Z. Vasquez-Chavesta
- School of Medicine, Universidad Católica Santo Toribio de Mogrovejo, Chiclayo 14012, Peru; (D.R.-A.); (N.P.-S.); (A.Z.V.-C.); (C.E.-A.); (C.J.R.-P.)
- Asociación Científica Médico Estudiantil USAT, Chiclayo 14012, Peru
| | - Crist Escalante-Arias
- School of Medicine, Universidad Católica Santo Toribio de Mogrovejo, Chiclayo 14012, Peru; (D.R.-A.); (N.P.-S.); (A.Z.V.-C.); (C.E.-A.); (C.J.R.-P.)
- Asociación Científica Médico Estudiantil USAT, Chiclayo 14012, Peru
| | - Cristhian J. Rios-Perez
- School of Medicine, Universidad Católica Santo Toribio de Mogrovejo, Chiclayo 14012, Peru; (D.R.-A.); (N.P.-S.); (A.Z.V.-C.); (C.E.-A.); (C.J.R.-P.)
- Asociación Científica Médico Estudiantil USAT, Chiclayo 14012, Peru
| | - Carlos J. Toro-Huamanchumo
- Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru
- Clínica Avendaño, Unidad de Investigación Multidisciplinaria, Lima 15074, Peru
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Alcázar-Navarrete B, Jamart L, Sánchez-Covisa J, Juárez M, Graefenhain R, Sicras-Mainar A. Clinical Characteristics, Treatment Persistence, and Outcomes Among Patients With COPD Treated With Single- or Multiple-Inhaler Triple Therapy: A Retrospective Analysis in Spain. Chest 2022; 162:1017-1029. [DOI: 10.1016/j.chest.2022.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 01/22/2023] Open
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Rentería E, Zueras P. Macro-level factors explaining inequalities in expected years lived free of and with chronic conditions across Spanish regions and over time (2006–2019). SSM Popul Health 2022; 19:101152. [PMID: 35865801 PMCID: PMC9293933 DOI: 10.1016/j.ssmph.2022.101152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/27/2022] Open
Abstract
Life expectancy has long been associated with macro-level factors, including health expenditures, but little research has focused on the relationship with morbidity measures. This paper examines the relationship between the expected years lived free of and with chronic conditions (YLFCC and YLCC) at age 50 and macroeconomic and social factors including, for the first time, several indicators of public health expenditure. We calculate YLFCC and YLCC for Spanish regions using the Sullivan method over a long period of time (2006–2019). Spain is a good case study due to two reasons. First, its national health system is decentralized among regional administrations since 2002. Second, the financial crisis of 2008 led to public health cuts in 2010–2014 that each region handled differently. We use fixed-effects models to assess the relationship between changes in macro-level regional indicators (socioeconomic factors, healthcare resources, health behavior and public health expenditures) with YLFCC and YLCC across regions and over time. Results show that socioeconomic levels, public health expenditure, healthcare resources and health behaviors are associated with years lived free of and with chronic conditions when analyzing them independently. However, in the global model including all these dimensions only public health expenditure is associated with both YLFCC and YLCC for men and women, showing that a higher level of expenditures is correlated with more YLFCC and less YLCC. Therefore, regional authorities need to pay special attention to the level of investments on health services, as they are clearly associated with a better quality of living of the middle age and older population. Regional and gender differences exist in expected years lived with chronic diseases in Spain. The 2008 economic crisis relates with an increase in years lived with bad health. More expenditure in public health relates with more years lived free of chronic conditions and less years lived with. Socioeconomic and behavioral factors have different effects on years lived free of and with chronic conditions by sex.
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Affiliation(s)
- Elisenda Rentería
- Centre d’Estudis Demogràfics, Carrer de Ca n’Altayó, Edifici E2, Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
- Corresponding author.
| | - Pilar Zueras
- Centre d’Estudis Demogràfics, Carrer de Ca n’Altayó, Edifici E2, Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
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Bermejo-Pareja F, Gómez de la Cámara A, Del Ser T, Contador I, Llamas-Velasco S, López-Arrieta JM, Martín-Arriscado C, Hernández-Gallego J, Vega S, Benito-León J. The health status: the ignored risk factor in dementia incidence. NEDICES cohort. Aging Clin Exp Res 2022; 34:1275-1283. [PMID: 35025095 DOI: 10.1007/s40520-021-02045-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/28/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The causes of the dementia decrease in affluent countries are not well known but health amelioration could probably play a major role. Nevertheless, although many vascular and systemic disorders in adult life are well-known risk factors (RF) for dementia and Alzheimer disease (AD), health status is rarely considered as a single RF. AIM To analyse whether the health status and the self-perceived health (SPH) could be RF for dementia and AD and to discuss its biological basis. METHODS We analysed different objective health measures and SPH as RF for dementia and AD incidence in 4569 participants of the NEDICES cohort by means of Cox-regression models. The mean follow-up period was 3.2 (range: 0.03-6.6) years. RESULTS Ageing, low education, history of stroke, and "poor" SPH were the main RF for dementia and AD incidence, whereas physical activity was protective. "Poor" SPH had a hazard ratio = 1.66 (95% CI 1.17-2.46; p = 0.012) after controlling for different confounders. DISCUSSION According to data from NEDICES cohort, SPH is a better predictor of dementia and AD than other more objective health status proxies. SPH should be considered a holistic and biologically rooted indicator of health status, which can predict future development of dementia and AD in older adults. CONCLUSIONS Our data indicate that it is worthwhile to include the SPH status as a RF in the studies of dementia and AD incidence and to explore the effect of its improvement in the evolution of this incidence.
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Affiliation(s)
- Félix Bermejo-Pareja
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
| | - Agustín Gómez de la Cámara
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
| | - Teodoro Del Ser
- Alzheimer's Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofia Foundation Alzheimer Research Center, Madrid, Spain
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioural Science, University of Salamanca, Salamanca, Spain
| | - Sara Llamas-Velasco
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain.
| | | | - Cristina Martín-Arriscado
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
| | - Jesús Hernández-Gallego
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
- Department of Medicine, Faculty of Medicine, Complutense University of Madrid (UCM), Madrid, Spain
| | | | - Julián Benito-León
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
- Department of Medicine, Faculty of Medicine, Complutense University of Madrid (UCM), Madrid, Spain
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Córdoba García R, Camarelles Guillem F. [Screening and brief intervention on alcohol consumption]. Aten Primaria 2022; 54:102349. [PMID: 35550977 PMCID: PMC9108444 DOI: 10.1016/j.aprim.2022.102349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
Abstract
La morbilidad asociada al consumo de alcohol incluye patología digestiva, psiquiátrica, neurológica, infecciosa, cáncer de diversos tipos, enfermedades cardiovasculares, lesiones intencionales, no intencionales, patología social y problemas familiares. Las evidencias más recientes no indican que el consumo «moderado» sea beneficioso para la salud. Por lo tanto, debe enfatizarse más bien la idea de evitar los consumos de riego y transmitir a los pacientes que lo más beneficioso para la salud sería no consumir alcohol o hacerlo en dosis de bajo riesgo. El instrumento más adecuado de cribado es el AUDIT-C. Las bases de la intervención breve consisten en estrategias cognitivo-conductuales y motivacionales. Hay que dar una información positiva sobre los beneficios de la moderación e informar sobre el peligro de la ingesta de alcohol. En fases precoces de la dependencia se contempla la oferta de tratamiento farmacológico de desintoxicación, deshabituación y seguimiento. Los casos más graves requieren coordinación con los servicios de adicciones. En España se ha podido comprobar que la intervención breve es efectiva y que disminuye el consumo 100 gramos de alcohol a la semana. Las estrategias comunitarias son el marco normativo adecuado para lograr los mejores resultados de la intervención breve. Estas deberán ir encaminadas a reducir la oferta y la disponibilidad para el consumo, mediante la adopción de medidas legislativas, de manera que se limite tanto la accesibilidad económica como la física. Por otra parte, habrá que implementar medidas para disminuir la demanda del alcohol mediante la educación para la salud a determinados grupos de riesgo.
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Aragonès E, López-Cortacans G, Cardoner N, Tomé-Pires C, Porta-Casteràs D, Palao D. Barriers, facilitators, and proposals for improvement in the implementation of a collaborative care program for depression: a qualitative study of primary care physicians and nurses. BMC Health Serv Res 2022; 22:446. [PMID: 35382822 DOI: 10.1186/s12913-022-07872-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care program for the management of depression in primary health care centers across Catalonia. The aim of this qualitative study was to evaluate a trial implementation of the program to identify barriers, facilitators, and proposals for improvement. METHODS One year after the implementation of the INDI program in 18 public primary health care centers we performed a qualitative study in which the opinions and experiences of 23 primary care doctors and nurses from the participating centers were explored in focus groups. We performed thematic content analysis of the focus group transcripts. RESULTS The results were organized into three categories: facilitators, barriers, and proposals for improvement as perceived by the health care professionals involved. The most important facilitator identified was the perception that the INDI collaborative care program could be a useful tool for reorganizing processes and improving the management of depression in primary care, currently viewed as deficient. The main barriers identified were of an organizational nature: heavy workloads, lack of time, high staff turnover and shortages, and competing demands. Additional obstacles were inertia and resistance to change among health care professionals. Proposals for improvement included institutional buy-in to guarantee enduring support and the organizational changes needed for successful implementation. CONCLUSIONS The INDI program is perceived as a useful, viable program for improving the management of depression in primary care. Uptake by primary care centers and health care professionals, however, was poor. The identification and analysis of barriers and facilitators will help refine the strategy to achieve successful, widespread implementation. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03285659 ; Registered 18th September, 2017.
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Affiliation(s)
- Enric Aragonès
- Primary Care Area Camp de Tarragona, Catalan Health Institute, Carrer dels Horts, 6, 43120, Constantí, Tarragona, Spain. .,Primary Care Research Institute IDIAP Jordi Gol, Barcelona, Spain.
| | - Germán López-Cortacans
- Primary Care Area Camp de Tarragona, Catalan Health Institute, Carrer dels Horts, 6, 43120, Constantí, Tarragona, Spain.,Primary Care Research Institute IDIAP Jordi Gol, Barcelona, Spain
| | - Narcís Cardoner
- Mental Health Department, University Hospital Parc Taulí, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center Consortium on Mental Health (CIBERSAM), Madrid, Spain
| | - Catarina Tomé-Pires
- Psychology Research Center CIP, Autonomous University of Lisbon, Lisbon, Portugal
| | - Daniel Porta-Casteràs
- Mental Health Department, University Hospital Parc Taulí, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Diego Palao
- Mental Health Department, University Hospital Parc Taulí, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center Consortium on Mental Health (CIBERSAM), Madrid, Spain
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Soriano JB, Peláez A, Fernández E, Moreno L, Ancochea J. The Emergence of COVID-19 as a Cause of Death in 2020 and its Effect on Mortality by Diseases of the Respiratory System in Spain: Trends and Their Determinants Compared to 2019. Arch Bronconeumol 2022; 58:13-21. [PMID: 35340748 PMCID: PMC8935969 DOI: 10.1016/j.arbres.2022.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 01/27/2023]
Abstract
Objective To analyze the causes of death by diseases of the respiratory system in Spain in 2020, with special interest in COVID-19; also its trends and determinants, and compare them with 2019. Material and methods Retrospective cohort study. The coding of all those causes of death by diseases of the respiratory system were regrouped. A descriptive analysis of all deaths and by gender, age, and the 17 Autonomous Communities (CC.AA.) was performed. Also, odds ratios of death in crude and multivariate analysis by logistic regression were estimated. Results In Spain in 2020, 60,358 deaths were attributed to "COVID-19 virus identified" and another 14,481 to "COVID-19 virus not identified (suspicious)". Regrouping the specific causes of death, in 2020 the diseases of the respiratory system caused a total of 139,880 deaths, which corresponds to 28.3% of all deaths in Spain. Compared to 2019, an increase of 68.5% was observed. By gender, deaths by diseases of the respiratory system were higher in men (32.0%) than in women (24.6%), although in specific causes the percentage was higher in women with suspected COVID-19, asthma, respiratory insufficiency and other diseases of the respiratory system. Finally, the variables associated with death from COVID-19 in the multivariate analysis were being male, increasing age (maximum at 80 years), completed studies up to secondary level, employed, and single or widowed marital status, although with a marked variation by CC.AA. Conclusions In Spain in 2020, COVID-19 produced a large increase (68.5%) in deaths by diseases of the respiratory system compared to the previous year.
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Affiliation(s)
- Joan B Soriano
- Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Adrián Peláez
- Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Esteve Fernández
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Laura Moreno
- Facultad de Medicina, Universitat de les Illes Balears, Palma, Spain
| | - Julio Ancochea
- Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Calle Rubio M, Álvarez-Sala JL, Vargas Centanaro G, Navarro AMH, Hermosa JLR. Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study. J Clin Med 2022; 11:1347. [PMID: 35268438 PMCID: PMC8910945 DOI: 10.3390/jcm11051347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 12/18/2022] Open
Abstract
Background: Vitamin D deficiency has been associated with an accelerated deterioration in lung function and increased exacerbations in chronic obstructive pulmonary disease (COPD). 25(OH) vitamin D levels have been indicated as a potentially useful marker for adverse results related to COPD. Methods: VITADEPOC is a cross-sectional clinical study recruiting consecutive patients with high-risk COPD. The objective of our study was to investigate vitamin D determination frequency in patients with high-risk COPD in clinical practice at outpatient clinics in Spain and to describe the factors associated with vitamin D testing. We also aimed to determine the frequency of vitamin D deficiency in these patients. Results: Only 51 (44%) patients underwent vitamin D determination and 33 (28.4%) had received vitamin D supplements in clinical practice. The patients who underwent testing for vitamin D in clinical practice were more often women (58.8% vs. 26.2%, p < 0.001) with comorbidities such as osteoporosis (19.6% vs. 6.2%, p < 0.001) or chronic renal failure (7.8% vs. 0%, p < 0.001) and with exacerbator phenotype (55% vs. 32.3%, p = 0.015). A total of 63 (54.3%) patients had serum vitamin D levels <20 ng/mL at the inclusion visit. Of these, 29 (46%) had serum vitamin D levels <12 ng/mL (severe deficiency). Having a history of inhaled corticosteroids (OR 3.210, p < 0.016), being treated with a cycle of systemic corticosteroids (OR 2.149, p < 0.002), and having a lower physical activity level (OR 3.840, p < 0.004) showed a statistically significant positive association with vitamin D deficiency. Conclusion: The testing of vitamin D levels in patients with high-risk COPD treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, a severe deficiency is detected in one in four patients. Efforts to optimize case detection in COPD are needed.
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Affiliation(s)
- Myriam Calle Rubio
- Pulmonary Department, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.C.R.); (J.L.Á.-S.); (G.V.C.)
- Department of Medicine, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain
| | - José Luis Álvarez-Sala
- Pulmonary Department, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.C.R.); (J.L.Á.-S.); (G.V.C.)
- Department of Medicine, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain
| | - Gianna Vargas Centanaro
- Pulmonary Department, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.C.R.); (J.L.Á.-S.); (G.V.C.)
- Department of Medicine, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain
| | - Ana María Humanes Navarro
- Clinical Management Unit of Medicina Preventiva, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Juan Luis Rodríguez Hermosa
- Pulmonary Department, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.C.R.); (J.L.Á.-S.); (G.V.C.)
- Department of Medicine, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain
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Feliu A, Martínez C, Fernández E. [Lights and shadows for public health: A critical analysis of the tobacco legislation in Spain]. GACETA SANITARIA 2022; 36:48-52. [PMID: 34419288 DOI: 10.1016/j.gaceta.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/04/2022]
Abstract
Tobacco smoking is a chronic disease that is the leading preventable cause of death in developed countries. In Spain, the prevalence of tobacco use has decreased driven by the implementation of tobacco control policies; however, current legislation does not establish a harmonized regulation for all tobacco products. The aim of this article is to review the current legislation and critically analyze its limitations in relation to the principles of good administration now defined in the Law 39/2015. Spanish in force tobacco control policies main limitations can be divided into four areas: the lack of specific regulation for new tobacco products; the differences in their regulation; the lack of information to the general population on their harmful effects and the new developments in the regulation of smoke-free spaces; and the lack of adaptation of the regulation to the most recent scientific evidence. All in all, the quality of tobacco control regulations in Spain, despite the successes achieved with the Law 28/2005, has been compromised by the State's laxity in the legislative, regulatory, and administrative spheres, which has led to a regulatory stagnation that runs counter to the principles of good regulation. This review should encourage scientific organizations and civil society associations to call for an actualization of the tobacco legislation, with determined and coordinated prevention and control policies to promote a tobacco-free Spain.
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Affiliation(s)
- Ariadna Feliu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), España; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America.
| | - Cristina Martínez
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), España; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America
| | - Esteve Fernández
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), España
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Abstract
The uptake of the current concept of chronic kidney disease (CKD) by the public, physicians and health authorities is low. Physicians still mix up CKD with chronic kidney insufficiency or failure. In a recent manuscript, only 23% of participants in a cohort of persons with CKD had been diagnosed by their physicians as having CKD while 29% has a diagnosis of cancer and 82% had a diagnosis of hypertension. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. A prevalent view is that for those in whom kidneys fail, the problem is "solved" by dialysis or kidney transplantation. However, the main burden of CKD is accelerated aging and all-cause and cardiovascular premature death. CKD is the most prevalent risk factor for lethal COVID-19 and the factor that most increases the risk of death in COVID-19, after old age. Moreover, men and women undergoing KRT still have an annual mortality which is 10-100-fold higher than similar age peers, and life expectancy is shortened by around 40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth global cause of death by 2040 and the second cause of death in Spain before the end of the century, a time when 1 in 4 Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded CIBER network research structure in Spain. Leading Spanish kidney researchers grouped in the kidney collaborative research network REDINREN have now applied for the RICORS call of collaborative research in Spain with the support of the Spanish Society of Nephrology, ALCER and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true. However, only the highest level of research funding through the CIBER will allow to adequately address the issue before it is too late.
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40
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García-Carmona J, Conesa-García E, Vidal-Mena D, González-Morales M, Ramos-Arenas V, Sánchez-Vizcaíno-Buendía C, Soria-Torrecillas J, Pérez-Vicente J, García-de-Guadiana-Romualdo L. Increased plasma levels of N-terminal pro-B-type natriuretic peptide as biomarker for the diagnosis of cardioembolic ischaemic stroke. Neurologia 2022. [DOI: 10.1016/j.nrl.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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41
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Abstract
The uptake of the current concept of chronic kidney disease (CKD) by the public, physicians and health authorities is low. Physicians still mix up CKD with chronic kidney insufficiency or failure. In a recent manuscript, only 23% of participants in a cohort of persons with CKD had been diagnosed by their physicians as having CKD while 29% has a diagnosis of cancer and 82% had a diagnosis of hypertension. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. A prevalent view is that for those in whom kidneys fail, the problem is “solved” by dialysis or kidney transplantation. However, the main burden of CKD is accelerated aging and all-cause and cardiovascular premature death. CKD is the most prevalent risk factor for lethal COVID-19 and the factor that most increases the risk of death in COVID-19, after old age. Moreover, men and women undergoing KRT still have an annual mortality which is 10–100-fold higher than similar age peers, and life expectancy is shortened by around 40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth global cause of death by 2040 and the second cause of death in Spain before the end of the century, a time when 1 in 4 Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded CIBER network research structure in Spain. Leading Spanish kidney researchers grouped in the kidney collaborative research network REDINREN have now applied for the RICORS call of collaborative research in Spain with the support of the Spanish Society of Nephrology, ALCER and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true. However, only the highest level of research funding through the CIBER will allow to adequately address the issue before it is too late.
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42
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Ortiz A, Roger M, Jiménez VM, Perez JCR, Furlano M, Atxer LS, Zurro DG, Casabona CMR, Zurro DG, Gómez CG, Bermúdez PP, Armisen MA, López SA, Porras IG, Ruiz JG, Orgaz JMM, Barón MM, Ortiz PDS, Fuente GDADL, Gili BQ, Fresnedo GF, Cabrera SS, Contreras JP, Pelicano MB, Blanca AM, Portillo MR, Álvarez JES, Romeo MJS, Pérez MG, Diezhandino MG, Marrero DH, Campo CF, García EM, Carmona DGC, Ramírez AT, Bellvis LM, Haym MB, Gómez MB, Martínez JMC, Garrit JMC, Garrido RSJ, Delgado JB, Marimont MB, Muñoz MOV, Villares JMP, Velázquez ÁS, Bonet LA, Bravo MÁG, Mateos FJM, Amador MM, Blanca AM, Miñano JAP, Belmonte AA, Jover AS, Rituerto DC, Sánchez FP, Arenas MD, Hernández RM, Serrano BM, Arduan AO, Sanz AB, Ramos AM, Córdoba-David G, García-Jiménez J, Fontecha-Barriuso M, Guerrero-Mauvecin J, Lopez-Díaz AM, Sánchez-Niño MD, Valiño-Rivas L, Cuarental L, Ribagorda M, Pintor-Chocano A, Favero C, Alvarez-Llamas G, Catalina MC, Fernández-Fernández B, Pérez-Gómez MV, Montaner ERAD, Prado RF, Rivera JR, Verde AMR, Luis-Lima S, Sánchez-Rodríguez J, Sánchez SP, Ortega MR, Parra EG, Mateos SR, Ortiz PJC, Expósito LM, Tejera-Muñoz A, Marchant V, Tejedor-Santamaria L, Agilar MA, Diekmann F, Genis BB, Salinas FO, Bajo MJR, Maneus EB, Guillen MA, Juárez JR, Rodríguez ML, Vicente IR, Pelicano JMB, Porras LFQ, Aguiar PVA, Font MX, Andujar AM, Cucchiari D, Marrah EM, M J, Piñeiro GJ, Salgado CM, Morales Martín AI, López Hernández FJ, Balboa NE, Vicente MP, Calvo IF, González LR, Vicente LV, Martínez SMS, Casanova Paso AG, Garriel MP, López JJV, Palacios AMC, Saénz DS, García PG, Bonilla JLA, Fernández Rodríguez MA, Galán AD, Marcos EM, Pérez-Aradros JC, José RMS, Zelaya FM, Panadés ES, Molina ÁG, Salido JA, Balcells RT, Criach EA, Encarnación MD, Perich LG, Furlano M, Girol CC, Terroba YA, Oliveras MP, Vila LE, Cabañas NS, Molas CF, Torres IS, Pelaez SL, Serra CR, Torres CC, Fajardo JPT, Lahuerta JIH, Herranz VM, Portillo MR, Malo AM, Cabrera SS, Castañeda JRM, Ortiz MER, Moreno JMM, Bermúdez AIR, Olmo RS, Pavón FG, Peregrin CM, Tejero EA, Villalba IL, Muñoz AC, Mier MVPRD, Martos CMP, Baltanas RL, Haad CR, Bartolomé MF, Valdemoros RL, Serres FEB, Díaz MN, Mariño FJJ, Sole LC, Saborido MIT, Majoral JS, Martínez ML, Calabia ER, Millán JCRS, López-Hoyos M, Benito-Hernández A, Fresnedo GF, Segundo DS, Valero R, García EC, Ona JGD, Llavona EC, Rodríguez FS, Gutiérrez RL, Peña HG, Pérez MG, Marrero DH, López V, Sola E, Cabello M, Caballero A, León M, Ruiz P, Alonso J, Navarro-González J, Mora-Fernández MDC, Donate-Correa J, Martín-Nuñez E, Delgado NP, Gigarrán-Guldris S, Pérez JCR, Teruel JLG, Castelao AM, Revilla JMV, Martínez CM, Stanojevic MB, Boque EC, Rosell MNS, Lamo VMD, Tocados JMD, Carrasco AG, López MB, Enriquez MC, Bardaji AM, Masot ND, Gómez AP, Sanjuan AE, Ortega AO, Fuentes RW, Guindo MDCDG, Fuentes MDCR, Ravassa FO, Molina MC, Tortosa CLR, Garrido RGDM, Romeo MJS, Jacobs-Cachá C, Matamoros OB, Mateos FM, Meneghini MAE, Roig JS, Betsabé IT, Larrea CL, Álvarez BS, Corte MDCD, Rodrigues-Diez RR, Vázquez AL, Rodríguez SG, Castiñeira JRV, Martín CM, Álvarez MLS, Iglesias VC, Borra JM, Rubio MAB, Gilsanz GDP, Cabrera ML, Heffernan JAJ, González MO, González OC, García MEG, Martín CJ, Correa PS, Ramos SA, Oliva ML, Becerra BR, Cabrera CV, Mateo GTG, Villanueva RS, García LÁ, Cannata Andía JB, Díaz MN, Martín JLF, López NC, García SP, Montes CA, García MR, Luengas ILM, Álvarez ES, Arias LM, Carro BM, Virgala JM, González MG, Barreiro JML, Fontan MP, González AO, Barja LMC, Barreiro AS, Arias BP, Hernández ÁA, Pérez MP, Varela JC, Lechuga JA, Rodríguez CD, Murias MG, Iglesia AMBDL, Piñeiro PB, González ÁG, Eijo AC, Cachaza NC, González MV, Garrit JMC, Blanch NL, Martínez AMS, Val MH, BordignonDraibe J, Melilli E, Montero AM, Pérez NM, Oliveras XF, Barrio MC, Santos JP, Barrera CB, Sáez MJP, Pachón MDR, Cabrales CA, Porras AB, García ER, Atxer LS, González VP, Mallol LL, Oliva MR, Puyol DR, Torres MPR, Ongil SL, Basilio LC, Centenera GO, Miguel PMD, Rodríguez LF, Nadah HB, Fernández MP, Chamond MRR, Ortiz PS, Fernández NG, Boillos AB, Cenarruzabeitia NV, Seara MAF, Moreno IDDPM, Lavilla FJ, Torres A, Miranda DM, Hernández APR, Redondo EDB, Porrini E, Caso MDLÁC, Tamajón MLP, Hernández MR, Rebollo MSG, Mallen PD, González AÁ, Rinne AMG, Rodríguez RM, Torres SE, Sosa DÁ, Cabrera BE, Rodríguez NZ, Hernández AF, Gamboa MJR, Caso C, Angeles MDL, Tamajon P, Lourdes M, Hernandez MR, Rebollo G, Sagrario M, Mallen PD, Gonzalez A, Alejandra, Rinne G, Maria A, Rodriguez RM, Torres SE, Sosa DA, Cabrera BE, Rodiguez NZ, Hernandez AF, Gamboa R, Jose M, Bermejo MLG, Lucas MF, Moreno EC, Muñoz LS, Huertas SS, Serrano EMR, Muñoz MER, Toro LC, Agudo CPB, Álvarez CG, Portoles J, Marqués M, Rubio E, Sánchez-Sobrino B, García-Menéndez E, Fernández AL, Diezhandin MG, Benítez PR, González MÁGN, Gallardo ML, Juárez GMF, Martínez EG, Terente MP, Ribera AT, Escribano TC, Fontan FC, Fernández AS, Pérez - Monteoliva NRR, Huerta EL, Rodríguez GG, Hernández SB, Zamorano SM, Gómez JML, Gallego RH. RICORS2040: the need for collaborative research in chronic kidney disease. Clin Kidney J 2021; 15:372-387. [PMID: 35211298 PMCID: PMC8862113 DOI: 10.1093/ckj/sfab170] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Indexed: 01/17/2023] Open
Abstract
Abstract
Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is ‘solved’ by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020–2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true.
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Oyagüez I, Gómez-Peralta F, Artola S, Carrasco FJ, Carretero-Gómez J, García-Soidan J, Gómez-Huelgas R, Merino-Torres JF, Pérez A. Cost Analysis of FreeStyle Libre ® 2 System in Type 2 Diabetes Mellitus Population. Diabetes Ther 2021; 12:2329-2342. [PMID: 33948909 PMCID: PMC8096131 DOI: 10.1007/s13300-021-01064-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/20/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION FreeStyle Libre® 2 system is a sensor-based flash-monitoring system that measures interstitial fluid glucose. The study aimed to compare cost of FreeStyle Libre 2 system and self-monitoring of blood glucose (SMBG) in the type 2 diabetes mellitus (T2DM) population from the Spanish Health System perspective. METHODS On the basis of data collected from a literature review, the cost of glucose monitoring was modelled for patients with T2DM on a basal-bolus insulin regimen. The cost estimate included annual consumption for glucose monitoring (strips, lancets and sensors) and severe hypoglycaemic events (SHE) management. A published rate of SHE (2.5 episodes/patient-year) was considered. A reduction of SHE (- 48.8%) associated with FreeStyle Libre 2 system, derived from the REPLACE trial, was applied. Hospital attendance for 20.5% of SHEs (with subsequent hospitalization in 16.0%) was applied. Consumption of strips and lancets was set at 6/day for SMBG (derived from national monitoring recommendations), and 0.2/day for FreeStyle Libre 2 system users, with 26 FreeStyle Libre 2 sensors/year. Unitary costs (€, year 2020 excluding VAT) were derived from literature (€0.28/strip; €0.09/lancet; €3.09/daily FM sensor; €3804/hospitalized SHE; €1794/hospital-attended non-admitted SHE; €389/community-attended SHE). RESULTS Costs were €2700 and €2120/year/patient using SMBG or FreeStyle Libre 2 system, respectively. For 1000 patients with T2DM using basal-bolus insulin, 1220 SHEs/year (with 48 hospitalizations) could be prevented and FreeSytle Libre 2 system could generate cost savings of up to €580,953/year versus SMBG (- 21.5%). CONCLUSION FreeStyle Libre 2 system is a potential cost-saving strategy in patients with T2DM in Spain on a basal-bolus insulin regimen.
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Affiliation(s)
- Itziar Oyagüez
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 - letra I, Pozuelo de Alarcón, 28224, Madrid, Spain.
| | | | | | | | | | | | - Ricardo Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga; and Ciber Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan F Merino-Torres
- Endocrinología y Nutrición, Departamento Medicina, Hospital Universitario y Politécnico La Fe, Universitat de València, Valencia, Spain
| | - Antonio Pérez
- Servicio de Endocrinología y Nutrición. Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, CIBERDEM, Universitat Autònoma de Barcelona, Barcelona, Spain
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Cayuela L, Gómez Enjuto S, Olivares Martínez B, Rodríguez-Domínguez S, Cayuela A. Is the pace of decline in cardiovascular mortality decelerating in Spain? REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:750-756. [PMID: 33115628 DOI: 10.1016/j.rec.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES To update the information on mortality from cardiovascular diseases and assess recent trends in Spain. METHODS Deaths from cardiovascular diseases (codes I20-I25, I50, I05-I09, I00-I02, I26-I49, I51, I52, I60-I69, I10-I15, and I70-I79 of the 10th revision of the International Classification of Diseases and Causes of Death) were obtained from the National Statistics Institute. Trends were analyzed using Joinpoint regression models. The results revealed the years (periods) composing each trend, as well as the annual percent change for each of them. The direction and magnitude of recent trends (last available 5-year period) were assessed by using the average annual percent change. RESULTS The decline in mortality rates from cardiovascular diseases slowed from -3.7% and -4.0% in 1999-2013 to -1.7% and -2.2% since 2013 in men and women, respectively. During the study period (1999-2018) all the analyzed causes decreased significantly. Nevertheless, recent trends differed according to age, sex, and the cause analyzed. Truncated rates (35-64 years) slowed (cardiovascular disease and stroke in men and ischemic heart disease in both sexes), stabilized (cardiovascular disease, stroke, and other heart diseases in women, and blood vessel disease in men), or increased (other diseases of the heart in men and diseases of the blood vessels in women). CONCLUSIONS In Spain, as in other countries, the reduction in mortality rates from cardiovascular diseases slowed (overall rates for both sexes and truncated in men) or stabilized (truncated rates in women) from 2014 to 2018.
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Affiliation(s)
- Lucía Cayuela
- Departamento de Medicina Interna, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Sara Gómez Enjuto
- Servicio de Neurología, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | | | | | - Aurelio Cayuela
- Unidad de Salud Pública, Prevención y Promoción de la Salud, Área de Gestión Sanitaria Sur de Sevilla, Seville, Spain
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Cayuela L, Gómez Enjuto S, Olivares Martínez B, Rodríguez-Domínguez S, Cayuela A. ¿Se está desacelerando el ritmo de disminución de la mortalidad cardiovascular en España? Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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López-Bueno R, Smith L, Tully MA, Shin JI, Calatayud J, López-Sánchez GF, Andersen LL, Casajús JA. Increase in Regular Leisure-Time Physical Activity in Spanish Adults Between 1987 and 2017. Am J Prev Med 2021; 61:e73-e79. [PMID: 33785277 DOI: 10.1016/j.amepre.2021.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/13/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The prevalence of leisure-time physical activity has increased in recent decades, but values differ significantly among countries. Owing to the improvement of living standards, a higher frequency of leisure-time physical activity is expected in Western countries such as Spain, but there is a lack of research involving large, representative samples during a prolonged temporal frame to confirm this tendency. METHODS Individual representative data from the 1987, 1993, 1995, 1997, 2001, 2011, and 2017 rounds of the Spanish National Health Survey were used. Statistical analyses were conducted from April 9, 2020 to May 5, 2020. RESULTS A total of 114,813 participants (aged 43.9 [SD=16.7] years, 51.8% women) were included in the study. Crude linear trends in regular monthly and weekly leisure-time physical activity were estimated together using linear regression models across the survey years, which also served to estimate the regression coefficients (β) and 95% CIs for every year change. All age groups experienced significantly increased prevalence of regular leisure-time physical activity-either several times a month or several times a week-over time (p<0.001 for trend). Participants aged 16-17 years had the highest increase in the annual prevalence of regular leisure-time physical activity (β=0.8, 95% CI=0.7, 1.0). Additional adjusted multivariable logistic regression confirmed these trends. CONCLUSIONS This study shows an increase in regular leisure-time physical activity among the adult Spanish population during the period from 1987 to 2017. Younger participants consistently presented higher prevalence levels than older participants.
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Affiliation(s)
- Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Belfast, Northern Ireland
| | - Jae Il Shin
- Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | | | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - José A Casajús
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
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Abstract
Nowadays, the percentage of time that the population spends sitting has increased substantially due to the use of computers as the main tool for work or leisure and the increase in jobs with a high office workload. As a consequence, it is common to suffer musculoskeletal pain, mainly in the back, which can lead to both temporary and chronic damage. This pain is related to holding a posture during a prolonged period of sitting, usually in front of a computer. This work presents a IoT posture monitoring system while sitting. The system consists of a device equipped with Force Sensitive Resistors (FSR) that, placed on a chair seat, detects the points where the user exerts pressure when sitting. The system is complemented with a Machine Learning model based on Artificial Neural Networks, which was trained to recognize the neutral correct posture as well as the six most frequent postures that involve risk of damage to the locomotor system. In this study, data was collected from 12 participants for each of the seven positions considered, using the developed sensing device. Several neural network models were trained and evaluated in order to improve the classification effectiveness. Hold-Out technique was used to guide the training and evaluation process. The results achieved a mean accuracy of 81% by means of a model consisting of two hidden layers of 128 neurons each. These results demonstrate that is feasible to distinguish different sitting postures using few sensors allocated in the surface of a seat, which implies lower costs and less complexity of the system.
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Soria-Oliver M, López JS, Torrano F, García-González G. Do psychosocial factors mediate the appearance of musculoskeletal symptoms? Evidence of an empirical study about the role of mental workload in computer workers. PLoS One 2021; 16:e0252179. [PMID: 34138890 PMCID: PMC8211229 DOI: 10.1371/journal.pone.0252179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/11/2021] [Indexed: 11/26/2022] Open
Abstract
The emergence of musculoskeletal symptoms (MSSs) in computer workers is a relevant occupational health problem. This study tests a multilevel model of analysis of risk factors in the appearance of musculoskeletal pain and discomfort in computer workers that integrates indicators from different areas: temporal usage patterns, ergonomic factors, psychosocial factors, and individual variables, specifically testing the possible mediating role of the mental workload. A cross-sectional study was performed through online registration with a non-probabilistic sample of 1198 workers from Spanish organizations. The results show that mental workload has a higher association than the rest of the factors with the onset of pain and discomfort in various body areas: neck in men, neck, shoulders and upper back in women. They also support the mediation role of mental workload in the relationship between usage patterns and the appearance of musculoskeletal symptoms. The use of multilevel theoretical models that adequately consider the complexity of the relationships between the different risk factors is necessary for a better understanding and intervention on MSSs in computer workers.
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Affiliation(s)
- María Soria-Oliver
- Facultad de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, Navarra, Spain
| | - Jorge S. López
- Facultad de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, Navarra, Spain
- IdiSNA-Instituto de Investigaciones Sanitarias de Navarra, Pamplona, Spain
| | - Fermín Torrano
- UNIR-Universidad Internacional de la Rioja, Logroño, La Rioja, Spain
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Palacios-Ceña D, Albaladejo-Vicente R, Hernández-Barrera V, Lima-Florencio L, Fernández-de-Las-Peñas C, Jimenez-Garcia R, López-de-Andrés A, de Miguel-Diez J, Perez-Farinos N. Female Gender Is Associated with a Higher Prevalence of Chronic Neck Pain, Chronic Low Back Pain, and Migraine: Results of the Spanish National Health Survey, 2017. PAIN MEDICINE 2021; 22:382-395. [PMID: 33164071 DOI: 10.1093/pm/pnaa368] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine headache (MH) in the Spanish population and to identify sociodemographic and health-related variables associated with CNP, CLBP, and MH. DESIGN Observational study. SETTING Spain. SUBJECTS A total of 22,511 persons 18 years of age or older (10,304 males and 12,207 females) who participated in the 2017 Spanish National Health Survey. METHODS Stratified three-stage sampling was applied. CNP, CLBP, and MH were the dependent variables. The analysis was conducted separately by gender. Sociodemographic features, self-perceived health status, lifestyle habits, comorbidities, and pain features were analyzed by using logistic regression models. RESULTS Females reported a higher prevalence of CNP, CLBP, and MH (P < 0.001) than males. For both sexes, anxiety and/or depression and poor self-rated health were associated with a significantly increased prevalence of CNP, CLBP, and MH. For CNP and CLBP, the identified associated factors were older age and limitations to usual activity. For CNP and MH, the most common associated factor was comorbid respiratory disease. CONCLUSIONS Our study identified several factors associated with CNP, CLBP, and MH in Spanish female and male adults, with potential implications for health care providers.
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Affiliation(s)
- Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
| | - Romana Albaladejo-Vicente
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Lidiane Lima-Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
| | - Cesar Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana López-de-Andrés
- Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid, Spain
| | - Javier de Miguel-Diez
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Napoleon Perez-Farinos
- Department of Public Health and Psychiatry, Faculty of Medicine, Universidad de Málaga, Málaga, Spain
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50
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Fernández Trujillo A, López Ortiz C, Cuñat Rodriguez O, Del Hoyo Buxo B, Parrilla Gomez FJ, Serrano Blanco A, Berrade Zubiri JJ. History of mental disorder in an ICU and referrals to psychiatry. Med Intensiva 2021; 46:S0210-5691(21)00072-3. [PMID: 33972138 DOI: 10.1016/j.medin.2021.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/15/2021] [Accepted: 03/21/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To describe the prevalence of patients with mental disorders (MD) admitted to the ICU. To compare the clinical characteristics according to the presence of psychiatric history. To review the relevance of the consultations made to Psychiatry. DESIGN Retrospective descriptive study. SETTING ICU of the General Hospital of the Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain. PATIENTS Patients admitted between January 2016 and June 2018. INTERVENTIONS None. MAIN VARIABLES OF INTEREST Severity level (APACHEII), reason for admission, days of admission, days of mechanical ventilation, psychiatric history and reason for psychiatric consultation. RESULTS A total of 1,247 patients were included; 194 (15.5%) met MD criteria, their mean age being younger (59 vs 68, P<.001) and with a lower mean score on the APACHEII scale (12 vs 14, P≤.003). There were 64 consultations to Psychiatry (5.1% of admissions), 59 of which were in patients with TM (92.1%). Regarding the reasons for the consultation, 22.6% were for attempted suicide, 61.3% for pharmacological adjustment, 11.3% to rule out mental disorder, and 4.8% for competence assessment. The probability of a consultation being carried out while it was indicated was 89.1%, while the probability of not carrying it out when it was not indicated was 99.4%. CONCLUSIONS This study supports the need to expand the specific recommendations for consultation to Psychiatry, beyond the assessment after a suicide attempt, since a large percentage (77.5%) of the pertinent consultations were for other reasons.
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Affiliation(s)
- A Fernández Trujillo
- Unidad de Cuidados Intensivos, Consorci Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, España.
| | - C López Ortiz
- Unidad de Agudos de Psiquiatría, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España
| | - O Cuñat Rodriguez
- MIR Psiquiatría, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España
| | - B Del Hoyo Buxo
- MIR Psiquiatría, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España
| | - F J Parrilla Gomez
- Servicio de Medicina Intensiva, Hospital del Mar, Parc de Satlut Mar, GREPAC, IMIM, Barcelona, España
| | - A Serrano Blanco
- Salud Mental, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España
| | - J J Berrade Zubiri
- Unidad de Medicina Intensiva, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España
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