RESUMEN
La hipercolesterolemia severa es un importante factor de riesgo cardiovascular. Su detección precoz y tratamiento puede reducir la incidencia de las enfermedades cardiovasculares. Dada la alta prevalencia de hipercolesterolemia en Andalucía, el desarrollo de una estrategia oportunista para su detección en atención primaria puede ser una medida eficiente. Objetivo: Identificar pacientes en atención primaria con hipercolesterolemias severas que puedan incrementar su riesgo cardiovascular mediante una consulta del colesterol- LDL al sistema informático de laboratorio. Material y métodos: Estudio observacional, retrospectivo, multicéntrico, en 16 hospitales de Andalucía y Ceuta. Se adquirieron datos analíticos anonimizados de los diferentes sistemas informáticos de laboratorio del año 2018 y exclusivamente del Hospital Virgen Macarena para el año 2019. Resultados: De un total de 1.969.035 determinaciones≥18 años se detectaron 2.791 pacientes (0,14%) con colesterol-LDL>250mg/dl, y en menores de 18 años, sobre un total de 2.327.211 determinaciones estudiadas, se detectaron 3.804 pacientes (0,16%) con colesterol-LDL>135mg/dl. La mayor incidencia de posibles hipercolesterolemias genéticas en adultos correspondió a la provincia Sevilla con 23,6 casos/1.000 determinaciones, mientras que en menores la mayor incidencia correspondió a la provincia de Cádiz, con 75 posibles casos/1.000 determinaciones. Se observa un triángulo geográfico de mayor prevalencia entre las provincias de Sevilla, Huelva y Cádiz. Conclusiones: El desarrollo de una estrategia oportunista mediante consulta informática del colesterol-LDL en atención primaria detecta un gran número de sujetos con hipercolesterolemias severas que se podrían beneficiar de una intervención precoz.(AU)
Severe hypercholesterolaemia is a major cardiovascular risk factor. Early detection and treatment can reduce the incidence of cardiovascular disease. Given the high prevalence of hypercholesterolaemia in Andalusia, the development of a screening strategy for its detection in Primary Care may be an efficient measure. Objective: To identify patients in Primary Care with severe hypercholesterolaemia that may increase their cardiovascular risk by reviewing LDL-cholesterol results in computerised laboratory systems. Material and methods: Observational, retrospective, multi-centre study in 16 hospitals in Andalusia and Ceuta. Anonymous analytical data were acquired from the different laboratory computer systems for the year 2018, and exclusively from Macarena Hospital for the year 2019. Results: From a total of 1,969,035 determinations on≥18 years old, 2,791 patients (0.14%) were detected with LDL-cholesterol>250mg/dl and from a total of 2.327.211 determinations studied in children under 18 years old, 3,804 patients (0.16%) were detected with LDL-cholesterol>135mg/dL. The highest incidence of possible genetic hypercholesterolaemia in adults corresponded to the province of Seville with 23.6 cases/1,000 determinations, while in minors, the highest incidence corresponded to the province of Cadiz with 75 possible cases/1,000 determinations. A geographical triangle of greater prevalence is observed between the provinces of Seville, Huelva and Cadiz. Conclusions: The development of a screening strategy using a computerised review of LDL-cholesterol in Primary Care detects a large number of subjects with severe hypercholesterolaemia that could benefit from an early intervention.(AU)
Asunto(s)
Humanos , Hipercolesterolemia , Atención Primaria de Salud , Hospitales , Laboratorios , Dislipidemias , Prevalencia , Factores de Riesgo , España , Estudios Retrospectivos , Estudios TransversalesRESUMEN
Objectives: Non-invasive prenatal screening (NIPS) is a test for the detection of major fetal chromosomal abnormalities in maternal blood during pregnancy. The purpose of this study was to assess the performance of NIPS implemented within the framework of the Screening Program for Congenital Abnormalities of the Andalusian Health System. Methods: A retrospective observational study was undertaken to determine the number of NIPS tests performed since its introduction. The number of invasive diagnostic tests done after the implementation of NIPS in the patients included in the program between March 2016 and August 2017 was also quantified. Results: A total of 6,258 combined first- and second trimester screening tests were performed, covering 95% of the population. In total, 250 subjects were identified as high risk, of whom 200 underwent NIPS after loss to follow-up. NIPS showed a sensitivity of 100% (95% CI: 76.84-100%) and a specificity of 99.46% (95% CI: 97.04-99.99%). Conclusions: This test has proven to have a very high sensitivity and specificity. The results obtained demonstrate that the incorporation of NIPS in clinical practice minimizes the rate of miscarriages and reduces the frequency of invasive procedures by 70%.