Associations of diabesity with all-cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study.

AIM: To investigate the joint associations of diabetes and obesity with all-cause and cardiovascular disease (CVD) mortality in the Mexico City Prospective Study. MATERIALS AND METHODS: In total, 154 128 participants (67.2% women) were included in this prospective analysis. Diabetes was self-reported, while body mass index was used to calculate obesity. Using diabetes and obesity classifications, six groups were created: (a) normal (no diabetes and normal weight); (b) normal weight and diabetes; (c) overweight but not diabetes (overweight); (d) overweight and diabetes (prediabesity); (e) obesity but not diabetes (obesity); and (f) obesity and diabetes (diabesity). Associations between these categories and outcomes were investigated using Cox proportional hazard models adjusted for confounder factors. RESULTS: During 18.3 years of follow-up, 27 197 (17.6%) participants died (28.5% because of CV causes). In the maximally adjusted model, participants those with the highest risk {hazard ratio (HR): 2.37 [95% confidence interval (CI): 2.24-2.51]}, followed by those with diabesity [HR: 2.04 (95% CI: 1.94-2.15)]. Similar trends of associations were observed for CVD mortality. The highest CV mortality risk was observed in individuals with diabesity [HR: 1.80 (95% CI: 1.63-1.99)], followed by normal weight and diabetic individuals [HR: 1.78 (95% CI: 1.60-1.98)]. CONCLUSION: This large prospective study identified that diabetes was the main driver of all-cause and CVD mortality in all the categories studied, with diabesity being the riskiest. Given the high prevalence of both conditions in Mexico, our results reinforce the importance of initiating prevention strategies from an early age.

Predictive ability of both the healthy aging index and the frailty index for all-cause mortality.

AIM: We aimed to develop and assess a modified healthy aging index (HAI) among Chileans aged 60 years and older and compare its predictive ability for all-cause mortality risk with the frailty index (FI). METHODS: This prospective study analyzed data from the Chilean National Health Survey (CNHS) conducted in 2009-2010. We included 847 adults with complete data to construct the HAI and FI. The HAI comprised five indicators (lung function, systolic blood pressure, fasting glucose, cognitive status, and glomerular filtration rate), while the FI assessed frailty using a 36-item scale. HAI scores were calculated by summing the indicator scores, ranging from 0 to 10, with higher scores indicating poorer health. Receiver operating curves (ROC) and area under the curve (AUC) were used to assess predictive validity. Associations with all-cause mortality were assessed using Cox proportional hazard models adjusted by confounders. RESULTS: The mean HAI score was 4.06, while the FI score was 0.24. The AUC for mortality was higher for the HAI than the FI (0.640, 95% confidence interval (CI) 0.601 to 0.679 vs. 0.586, 95% CI 0.545 to 0.627). After adjusting for confounders, the FI showed a higher mortality risk compared to the HAI (2.63, 95% CI 1.76 to 3.51 vs. 1.16, 95% CI 1.08 to 1.26). CONCLUSION: The FI and HAI were valid predictors for all-cause mortality in the Chilean population. Integrating these indices into research and clinical practice can significantly enhance our capacity to identify at-risk individuals.

Association between a lifestyle score and all-cause mortality: a prospective analysis of the Chilean National Health Survey 2009-2010.

OBJECTIVE: To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. DESIGN: Prospective study. SETTINGS: The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0-2 points), moderately healthy (3-4 points) and the healthiest (5-7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. PARTICIPANTS: 2706 participants from the Chilean National Health Survey 2009-2010. RESULTS: After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. CONCLUSION: Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.

Association of Sitting Time With All-Cause and Cardiovascular Mortality: How Does Frailty Modify This Association?

To investigate how frailty modifies the association of sitting time with all-cause and cardiovascular mortality in Chilean adults. This prospective study included 2,604 participants aged ≥35 from the Chilean National Health Survey 2009-2010. Sitting time was self-reported, while frailty was assessed using a 36-item Frailty Index. Sitting time was categorized as low, medium, and high. Cox proportional hazard models were used to estimate the risk of mortality stratified for the sitting time categories. Over a median follow-up of 8.9 years, 311 participants died, 28% of them due to cardiovascular events. Frail people with prolonged sitting time were at higher risk of all-cause and cardiovascular mortality (hazard ratio 3.13; 95% confidence interval [2.06, 4.71] and hazard ratio 2.41; 95% confidence interval [1.50, 3.64], respectively). The observed risk was higher in women than men. Public health and individual strategies should be implemented to decrease sitting time across the population, with special attention on frail people.

Multimorbidity and 11-year mortality in adults: a prospective analysis using the Chilean National Health Survey.

Research on morbidity and mortality often emphasizes individual diseases over the cumulative effects of multimorbidity, especially in low- and middle-income countries. This study aimed to analyze the association between multimorbidity and all-cause mortality in a representative sample of the Chilean population. This longitudinal study used data from 3701 subjects aged ≥15 years who participated in the Chilean National Health Survey conducted between 2009 and 2010. We included 16 self-reported highly prevalent morbidities. All-cause mortality data from an 11-year follow-up were collected from the Chilean Civil Registry. The Cox proportional hazard model, adjusted for confounders, determined the association between multimorbidity categories and all-cause mortality. Of the total sample, 24.3% reported no morbidity, while 50.4% two or more. After adjustment, participants with four or more morbidities had a 1.66 times higher mortality risk [95% confidence interval (CI): 1.03-2.67] than those without morbidities. The mortality risk increased by 10% for each additional morbidity [HR: 1.09 (CI: 1.04-1.16)]. Multimorbidity was common in the Chilean population and increased the mortality risk, which greatly challenges the health system to provide an integral and coordinated approach to healthcare.

Latent class analyses of multimorbidity and all-cause mortality: A prospective study in Chilean adults.

Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009-2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others.

[Association between oral health and cognitive decline in older Chileans]. / Asociación entre salud oral y deterioro cognitivo en personas mayores chilenas.

OBJECTIVE: To identify the association between oral health and suspected cognitive impairment in older adults in Chile. METHOD: Cross-sectional study including 1826 people ≥60 years who participated in the National Health Survey of Chile, 2016-2017. Oral health was evaluated by the number of teeth, presence of caries, use of dental prostheses, self-reported oral health, and pain and/or discomfort in the oral cavity. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). The association was evaluated by logistic and linear regression, adjusted for sociodemographic and lifestyle variables. RESULTS: Compared with people without suspicion of cognitive impairment, people with suspected impairment had five fewer teeth (13.4 vs. 8.5 teeth), a much higher difference in women than in men, and a higher frequency of oral pain. Edentulism and fewer teeth were associated with a higher likelihood of suspected cognitive impairment, associations that were not maintained in adjusted models. Oral pain was associated with a higher likelihood of suspected impairment even in the most adjusted model (odds ratio: 1.99; 95% confidence interval [95%CI]: 1.09-3.63). In linear models, an increase of 2% (95%CI: 0.01-0.05) in the MMSE score was observed for each additional tooth. CONCLUSIONS: Poor oral health, particularly tooth loss and the presence of pain, was associated with cognitive impairment in older adults in Chile.

Frailty Index as a Predictor of Mortality in Middle-Aged and Older People: A Prospective Analysis of Chilean Adults.

We aimed to investigate the association between frailty status and all-cause mortality in middle-aged and older people. We included 2661 individuals aged ≥ 35 from the Chilean National Health Survey 2009−2010. Mortality was determined through linkage with the Chilean Civil Registry and Identification. A 36-item frailty index (FI) was used to assess the frailty status. Associations between frailty status and all-cause mortality were assessed using Kaplan−Meier and Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. A non-linear association was investigated using penalized cubic splines fitted in the Cox models. During an 8.9 median follow-up (interquartile range of 8.6−9.0), 308 individuals died (11.5%). Lower survival rates were observed in frail individuals compared to pre-frail and robust people (log-rank < 0.001). Compared with robust individuals, frail people had a higher mortality risk (HR: 2.35 [95% CI: 1.57 to 3.51]). Frail middle-aged individuals had a higher risk of dying independently of major risk factors.

Asociación entre salud oral y deterioro cognitivo en personas mayores chilenas / Association between oral health and cognitive decline in older Chileans

Objetivo: Identificar la asociación entre salud oral y sospecha de deterioro cognitivo en personas mayores chilenas. Método: Estudio transversal con 1826 participantes ≥60 años de la Encuesta Nacional de Salud de Chile, 2016-2017. La salud oral fue evaluada por el número de dientes, la presencia de caries, el uso de prótesis dental y el autorreporte de salud oral y dolor en la cavidad oral. La sospecha de deterioro cognitivo fue evaluada mediante el Mini-Mental State Examination (MMSE). Se empleó regresión logística y lineal, ajustada por variables sociodemográficas y de estilos de vida. Resultados: En comparación con personas sin sospecha de deterioro cognitivo, aquellas con sospecha de deterioro cognitivo presentaron cinco dientes menos (13,4 vs. 8,5 dientes), diferencia muy superior en mujeres que en hombres, y mayor frecuencia de dolor oral. El edentulismo y el menor número de dientes se asociaron a mayor probabilidad de sospecha de deterioro cognitivo, asociaciones que no se mantuvieron en modelos ajustados. El dolor oral se asoció a mayor probabilidad de sospecha de deterioro cognitivo (odds ratio: 1,99; intervalo de confianza del 95% [IC95%]: 1,09-3,63). Por cada diente adicional se observó un aumento del 2% (IC95%: 0,01-0,05) en la puntuación del MMSE. Conclusiones: La mala salud oral, en particular la pérdida de dientes y la presencia de dolor, se asociaron con deterioro cognitivo en personas mayores chilenas. (AU)

Objective: To identify the association between oral health and suspected cognitive impairment in older adults in Chile. Method: Cross-sectional study including 1826 people ≥60 years who participated in the National Health Survey of Chile, 2016-2017. Oral health was evaluated by the number of teeth, presence of caries, use of dental prostheses, self-reported oral health, and pain and/or discomfort in the oral cavity. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). The association was evaluated by logistic and linear regression, adjusted for sociodemographic and lifestyle variables. Results: Compared with people without suspicion of cognitive impairment, people with suspected impairment had five fewer teeth (13.4 vs. 8.5 teeth), a much higher difference in women than in men, and a higher frequency of oral pain. Edentulism and fewer teeth were associated with a higher likelihood of suspected cognitive impairment, associations that were not maintained in adjusted models. Oral pain was associated with a higher likelihood of suspected impairment even in the most adjusted model (odds ratio: 1.99; 95% confidence interval [95%CI]: 1.09-3.63). In linear models, an increase of 2% (95%CI: 0.01-0.05) in the MMSE score was observed for each additional tooth. Conclusions: Poor oral health, particularly tooth loss and the presence of pain, was associated with cognitive impairment in older adults in Chile. (AU)

Association of Co-Living and Age on the Type of Sports Practiced by Older People.

Introdution: The environment and the type of co-living of older people are crucial to understanding how the nature of their context influences a healthy lifestyle. However, no studies have investigated to what extent their type of co-living may be associated with the sports and the profile practice according to their age. Objective: This study aimed to assess the association between the types of co-living and the age of the physically active elderly and the sports they practice. Hypothesis: It is thought that the age, situation, and satisfaction with the way of living in physically active older people differ according to the type of sport they practice. Methods: Cross-sectional study. We included 358 individuals aged between 61 and 93 years old (M = 69.66, SD = 4.74). Type of co-living was classified as living alone or living with others. The sports activities evaluated were: gym, dance, water activities, and yoga/pilates. Differences in the type of co-living and sports practiced were evaluated by ANOVA or Chi2. Results: Among the elderly who practice gymnastics, most of them live alone and in a tight core (p < 0.001) (Phi = 0.244). Furthermore, those who practice aquatic activities are more frequently the youngest (p < 0.001) (Phi = 0.198). Conclusion: Older people who do gymnastics have smaller living groups, those under 69 opt for gymnastics and aquatic activities, while those aged 70 and over prefer dance, yoga, and pilates.

Functional and radiologic results of the crimson duvet procedure in rotator cuff treatment: a randomized controlled clinical trial.

BACKGROUND: Rotator cuff tears are one of the more frequent pathologies of the shoulder. Arthroscopic techniques and biologic augmentation have been developed to improve the rate and quality of healing. The crimson duvet procedure (CDP) theoretically provides mesenchymal stem cells through microfracture treatment of the footprint. The aim of this research was to evaluate the effect of CDP in patients who had undergone arthroscopic surgery for complete rotator cuff repair. METHODS: A prospective randomized clinical trial was performed in a total of 123 patients, consisting of 59 women and 64 men, with a mean age of 58 years. We included patients with a clinical and radiologic diagnosis of a complete rotator cuff tear. All patients were treated with arthroscopic rotator cuff repair. In group 1, the surface of the footprint was débrided; in group 2, the footprint underwent microfracture. The primary outcome was the nonhealing rate, which was detected by magnetic resonance imaging (MRI) or ultrasonography, and the secondary outcome was the functional result. A Sugaya classification of I to III was considered to indicate healing. For clinical evaluation, the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Constant scores were evaluated, along with the range of motion. The functional evaluation was performed preoperatively and at 6 months and 1 year postoperatively. The radiologic (MRI or ultrasonography) evaluation was performed at 6 months. Neither the patients nor the radiologists and physical therapists who performed the postoperative evaluations were informed of the random selection. RESULTS: We observed a healing rate of 85.11% in the control group and 93.7% in the CDP group, which was not significant (P = .19). However, a significant improvement in function was observed in all patients. The ASES score improved from 68.9 (SD 13.8) preoperatively to 92.2 at 6 months and to 96.4 (SD 6.2) at 12 months (P < .05), but no difference was observed between the groups. A similar level of improvement was observed in the Constant score. CONCLUSION: The arthroscopic repair of complete rotator cuff tears presents good and excellent clinical results in most patients. Nevertheless, nonhealing occurs at a rate that depends mainly on the age of the patient and the size of the tear. The addition of CDP did not improve the functional results or the healing rate.

Arthroscopic-assisted latissimus dorsi transfer for irreparable posterosuperior cuff tears: Clinical outcome of 15 patients.

OBJECTIVE: We analyzed the clinical and functional results of patients with irreparable posterosuperior rotator cuff tears treated with arthroscopic-assisted latissimus dorsi transfer and the clinical relevance of the addition of partial repair of the remaining cuff to the transfer. METHODS: This was a prospective cohort study that included patients diagnosed with irreparable massive rotator cuff tears treated by arthroscopic-assisted latissimus dorsi transfer between 2015 and 2018. Demographic characteristics, clinical and functional outcomes (Constant-Murley (CS) score and subjective shoulder value (SSV)), and the incidence of complications were evaluated. Clinical outcomes were compared between patients treated with transfer alone and transfer with partial cuff repair. RESULTS: Fifteen patients were included, with an average follow-up of 37 ± 16 months. The median duration of symptoms before surgery was 66 weeks (24-208). A significant increase in forward elevation of 52° (p < 0.003) and abduction of 48° (p < 0.001) was obtained. The CS score increased by 48 points (p < 0.001), and the SSV changed from 29% preoperatively to 70% postoperatively (p < 0.001), with a significant decrease in the visual analog pain score from 7 to 1 (p < 0.001). In 10 patients, partial repair of the rotator cuff was also performed. No statistically significant differences were found in these patients compared with patients treated with transfer alone. Two patients presented complications, including transient sensitive neuropraxia of the axillary nerve and seroma, which were managed conservatively and did not affect the outcomes. CONCLUSION: Arthroscopic-assisted latissimus dorsi transfer is a safe technique that significantly improves clinical and functional outcomes in selected patients. Longer follow-up and comparison with other treatment options are needed to confirm these excellent results in this group of difficult-to-treat patients. LEVEL OF EVIDENCE IV: Nil.

There is direct relationship between bone bridge length and coracoclavicular fixation resistance to failure: Biomechanical study in a porcine model.

BACKGROUND: This study aims to evaluate the relation between coracoclavicular resistance to failure and the distance between clavicular tunnels. The hypothesis is that a greater clavicular bone bridge between tunnels achieves a stronger coracoclavicular fixation. METHODS: Descriptive Laboratory Study. Thirty-six (36) coracoclavicular models were constructed utilizing porcine metatarsals. Coracoclavicular stabilizations were performed using a subcoracoid loop fixation configuration through two clavicular tunnels, tied at the clavicle's superior cortex using a locking knot. Models were randomly assigned to 1 of 3 experimental groups of variable bone bridge length between clavicular tunnels: 5 mm, 10 mm, and 15 mm. Each group had 12 models. Fixation resistance was assessed through the ultimate failure point under an axial load to failure trial. Failure patterns were documented. A one-way ANOVA test was used, and a Tukey post hoc as needed (P < 0.05). FINDINGS: Mean strength per bone bridge length: 5 mm = 312 N (Range: 182-442 N); 10 mm = 430 N (Range: 368-595 N); 15 mm = 595 N (Range: 441-978 N). The 15 mm group had a significantly higher ultimate failure point than the other two groups: 5 mm (P < 0.001) and 10 mm (P < 0.001). All fixations systematically failed by a superior cortex clavicle fracture at the midpoint between tunnels. INTERPRETATION: A direct relationship between bone bridge length and coracoclavicular resistance to failure was demonstrated, being the 15 mm length a significantly higher strength construct in a tied loop model.

Evaluation and Management of Glenohumeral Instability With Associated Bone Loss: An Expert Consensus Statement Using the Modified Delphi Technique.

PURPOSE: To establish an international expert consensus, using the modified Delphi technique, on the evaluation and management of glenohumeral instability with associated bone loss. METHODS: A working group of 6 individuals generated a list of statements related to history and physical examination, imaging and specialized diagnostic tests, bone loss quantification and classification, treatment outcomes and complications, and rehabilitation for the management of glenohumeral instability associated with bone loss to form the basis of an initial survey for rating by a group of experts. The expert group (composed of 22 high-volume glenohumeral instability experts) was surveyed on 3 occasions to establish a consensus on the statements. Items with over 70% agreement and less than 10% disagreement achieved consensus. RESULTS: After a total of 3 rounds, 31 statements achieved consensus. Eighty-six percent of the experts agreed that a history of multiple dislocations and failed soft-tissue surgery should raise suspicion about the possibility of an associated bone deficit. Ninety-five percent of the experts agreed that 3-dimensional (3D) computed tomography (CT) is the most accurate diagnostic method to evaluate and quantify bone loss. Eighty-six percent of the experts agreed that any of the available methods to measure glenoid bone deficiency is adequate; however, 91% of the experts thought that an en face view of the glenoid using 3D CT provides the most accurate method. Ninety-five percent of the experts agreed that Hill-Sachs lesions are poorly quantified and classified by current imaging systems. Ninety percent of the experts agreed that in cases with a glenoid bone deficit greater than 20%, glenoid bone graft reconstruction should be performed and any of the available options is valid. There was no consensus among experts on how Hill-Sachs injuries should be managed or on how postoperative rehabilitation should be carried out. CONCLUSIONS: The essential statements on which the experts reached consensus included the following: A history of multiple dislocations and failed soft-tissue surgery should make surgeons consider the possibility of an associated bone deficit. Three-dimensional CT is the most accurate diagnostic method to evaluate and quantify bone loss. Although any of the available methods to measure glenoid bone deficiency is adequate, an en face view of the glenoid using 3D CT provides the most accurate method. Hill-Sachs lesions are poorly quantified and classified by current imaging systems. Finally, in cases with a glenoid bone deficit greater than 20%, glenoid bone graft reconstruction should be performed. LEVEL OF EVIDENCE: Level V, consensus statement.

Transferencia artroscópica del trapecio inferior en pacientes con rotura irreparable del manguito rotador posterosuperior. Resultados preliminares de ocho pacientes / Arthroscopically assisted lower trapezius transfer in patients with irreparable posterosuperior rotator cuff tears. Preliminary outcomes in eight patients

Introducción: El objetivo de este trabajo es evaluar resultados clínicos y funcionales de pacientes con una rotura irreparable del manguito rotador posterosuperior, sometidos a una transferencia artroscópica del trapecio inferior. Materiales y métodos: estudio de una cohorte retrospectiva de pacientes con roturas irreparables del manguito rotador, en quienes se realizó una transferencia del trapecio inferior asistida por artroscopía. Se evaluó la evolución clínica mediante la ganancia del rango de movilidad del hombro y la disminución del dolor. Del mismo modo, se evaluó la evolución funcional usando el índice de Constant-Murley y la valoración subjetiva del hombro (SSV, por sus siglas en inglés). Resultados: se incluyeron ocho pacientes, con un seguimiento promedio de veintidós meses. Obtuvimos una ganancia estadísticamente significativa de rotación externa de 32°, disminución de 5 puntos en la escala del dolor, aumento de 31 puntos en el score de Constant y un aumento de 38% del SSV. Se registró un aumento de 12° de elevación, sin embargo, este no fue estadísticamente significativo. Dos pacientes presentaron un seroma en el sitio de la cosecha del trapecio, que se resolvió con manejo conservador. Conclusión: la transferencia del trapecio inferior con asistencia artroscópica, en pacientes con rotura irreparable del manguito rotador posterosuperior, es una técnica segura que mejora significativamente la rotación externa y los índices funcionales en este grupo de pacientes. Tipo de estudio: Serie de casos IV

Introduction: The purpose of this study is to compare clinical and functional outcomes of patients with irreparable posterosuperior rotator cuff tears treated by arthroscopic assisted lower trapezius transfer. Materials and methods: retrospective cohort design of patients with irreparable rotator cuff tear, treated by arthroscopy-assisted lower trapezius transfer. The clinical evolution was evaluated according to the gain in the range of shoulder movement and the decrease of pain. Functional outcomes were evaluated using the Constant-Murley score and the subjective shoulder value (SSV). Results: eight patients were included, with average follow-up of twenty-two months. We obtained a statistically significant gain in active external rotation of 32°, 5-point decrease in the pain scale (VAS), a 31-point increase in the Constant score, and a 38% increase in SSV. There was a 12° increase in active forward elevation, however this was not statistically significant. Two patients had a seroma at the trapezius harvest site, which resolved with conservative treatment. Conclusion: arthroscopically assisted lower trapezius transfer in patients with irreparable posterosuperior rotator cuff tears were a safe technique that significantly improves external rotation and functional scores in patients. Type of study: Case series IV

Incidencia y letalidad intrahospitalaria por insuficiencia cardiaca en Chile: ¿Existen diferencias por sexo? / Incidence and hospital mortality due to heart failure. Are there any differences by sex?

Background: Gender may influence the incidence, severity and hospital mortality due to heart failure (HF). Aim: To evaluate the influence of sex on the proportion of patients hospitalized due to heart failure, its incidence and hospital mortality. Methods: Analysis of the hospital discharge database of the Chilean Ministry of Health during 2014. All hospital admissions for HF were considered according to ICD-10 codes, including the discharge diagnosis of congestive HF (I500), left ventricular HF (I501) and non-specified HF (I509). Incidence rates, proportion of discharges due to HF and hospital mortality were calculated according to age and sex. Results: During 2014, there were 1,306,431 discharges from Chilean hospitals. Of these, 125,484 were for cardiovascular disease and 10% of these corresponded to HF (12,825). The incidence rate was slightly higher in men than in women (0.71 and 0.70 per 1,000 admissions respectively). Among patients aged 80 years or more, the prevalence of admissions for HF was higher in women (19.1 and 15.9% respectively, p < 0.01). Hospital mortality was also higher in women (9.7 and 8.6% respectively, p = 0.03). The factors associated with a higher hospital mortality were an age over 80 years (Odds Ratio (OR) 2.11; 95% confidence intervals (CI): 1.87-2.40; p < 0.01), a length of stay over seven days (OR 1.13; 95%CI: 1.01-1.29; p = 0.04), being admitted to high complexity facilities (OR 1.29; 95%CI: 1.12-1.50; p = 0.01) and being insured by the public national health fund (OR 1.94; 95%CI: 1.54-2.43; p < 0.01). Conclusions: The incidence of hospital admissions due to HF is similar in men and women. There is high hospital mortality, especially in women.

Galectina-3: experiencia en pacientes chilenos con diagnóstico de insuficiencia cardíaca descompensada / Galectin-3 levels in patients hospitalized for decompensated heart failure

Background: Galectin-3 (Gal-3) is a mediator of myocardial fibrosis involved in cardiac remodeling and a potential new prognosis marker in heart failure (HF). Aim: To measure Gal-3 at the moment of discharge in patients hospitalized for HF and its association with different variables. Material and Methods: Patients hospitalized for decompensated HF from four hospitals between August 2014 and March 2015, were included. Demographic, clinical and laboratory variables were recorded at the time of admission. At discharge, a blood sample was withdrawn to measure Gal-3 and brain natriuretic propeptide (Pro-BNP). Patients were separated in two groups, according to the level of Gal-3 (using a cutoff value of 17.8 ng/mL), comparing clinical and laboratory values between groups. Results: We included 52 patients with HF aged 70 ± 17 years (42% females). Functional capacity was III-IV in 46% of patients and the ejection fraction was 34.9 ± 13.4%. Pro-BNP values at discharge were 5,323 ± 8,665 pg/mL. Gal-3 values were 23.8 ± 16.6 ng/mL. Sixty percent of patients had values over 17.8 ng/mL. Those with elevated Gal-3 levels were older (75 ±16 and 62 ± 15 years, respectively, p = 0.025) and were hypertensive in a higher proportion (90.5% and 57.1% respectively, p = 0.021). Conclusions: In patients hospitalized for HF, Gal-3 levels are higher in older and hypertensive subjects.