Epidemiological characteristics and hospitalization trajectories prior to suicide in Galicia between 2013 and 2016.

INTRODUCTION: Addressing suicide requires an understanding of regional patterns of epidemiology, with health variables being central. However, the clinical profile of people who commit suicide has received little attention. The objectives of this study were to analyze the sociodemographic, clinical, and forensic characteristics of persons who committed suicide in Galicia between 2013 and 2016, analyze suicide mortality rates, and identify trajectories of hospitalizations and associated variables. MATERIAL AND METHODS: A population study was carried out on the 1354 people who died by suicide in Galicia. RESULTS: The most common profile was a retired man, 57.9 years old (SD=18.5), from an urban and inner area. 43.6% had been previously hospitalized, 41.6% had been diagnosed with physical disorders, and 26.8% with mental disorders. 48.2% had been prescribed psychiatric medications and 29.6% had received outpatient psychiatric care. The highest prevalence of death by suicide (27.5%) was in 2014, with the predominant method being hanging (59.1%). The average raw rate was 12.3/100,000. Three trajectories of hospitalizations emerged: 94.83% had experienced few hospitalizations; 2.95% an increasing pattern; and 2.22% a decreasing pattern. These trajectories were associated with number of psychiatric appointments, prescription of psychiatric medications, and diagnoses of physical and mental disorders. CONCLUSIONS: These findings are crucial for detection and prevention.

[Impact of COVID-19 pandemic in terms of incidence and lethality in nursing homes in Galicia (Spain)]. / Impacto de la pandemia de COVID-19 en términos de incidencia y letalidad en los centros residenciales de mayores de Galicia.

OBJECTIVES: To know the impact of COVID-19 in incidence and lethality in nursing homes in Galicia. METHODS: This is a descriptive study of nursing homes residents and workers with confirmed COVID-19. The analysis spanned from March 1, 2020 to March 27, 2022, stratified into 6 periods (one per wave). The impact on incidence (attack rate, number of outbreaks, reinfections, sex, age, and diagnostic technique) and lethality (by sex, age, place of death, and number of centers with deaths) was analyzed. RESULTS: There were 15,819 people affected, 51.9% of the jobs and 47.0% of the workers. The attack rate in residents was: 5.8% in the first wave, 10.4% in the second, 6.3% in the third, 0.1% in the fourth, 2.1% in the fifth and 27.3% in the sixth. In the sixth wave, there were 11.3% reinfections and the number of outbreaks in was 3 times higher than in the second. The case fatality in residents was higher during the first wave (21.8%) and lower during the sixth (2.4%). He only had one worker in relation to COVID-19. CONCLUSIONS: Surveillance of COVID-19 in nursing homes was essential to understand the dynamics of the disease. The sixth wave was the one with the highest incidence and the lowest lethality. Lethality was higher in the first wave. The fourth and fifth waves had a lower incidence due to the effects of vaccination.

Where Do Chronic Obstructive Pulmonary Disease Patients Die? 8-Year Trend, with Special Focus on Sex-Related Differences.

Background: To plan end-of-life care it is essential to ascertain where patients die. There is very little information on the place of death of chronic obstructive pulmonary disease (COPD) patients. Accordingly, this study set out to describe the place of death of all COPD-related deaths in a Spanish region across the period 2009-2017, taking into account the sex and age of the deceased. Methods: We analyzed COPD deaths, codes J41-44 of the International Classification of Diseases-10th revision, in the Galician Autonomous Region from 2009 to 2017. Using death certificate data furnished by the Galician Mortality Registry, information was extracted on place of death, categorized as "hospital", "nursing home", "patient's home", "other" or "not shown". Results: There were 10,274 deaths, with a male:female ratio of 2.52; 39.0% of deaths occurred in hospital and 41.4% at home, with these data varying according to sex and age. Across the study period, no reduction was observed in the number of deaths that occurred in hospital. For all the period analyzed, deaths among women occurred mostly at home, with an increase being seen in the number of deaths in nursing homes over the course of the study. Patients aged under 70 years tended to die more frequently in hospital, and those over this age died more frequently at home or in nursing homes. Conclusion: A very high percentage of COPD patients still die in hospital, a trend that has shown no decline in recent years. Even so, there are important variations by sex and age on the place of death of these patients.