Influencia del código postal en las hospitalizaciones pediátricas en Sevilla / Influence of postcode on paediatric admissions in Seville

Introducción: El lugar de vivienda es un indicador del nivel socioeconómico que influye en la morbimortalidad y utilización de recursos sanitarios. Los objetivos de este estudio fueron analizar este efecto en las hospitalizaciones pediátricas y describir las tasas de hospitalización de los diagnósticos principales más frecuentes en la ciudad de Sevilla. Material y métodos: Estudio observacional y transversal con 2 unidades de análisis: «ingresos hospitalarios» en los hospitales públicos de Sevilla de menores de 15 años (n = 2.660) y «distritos de Sevilla» (n = 11). La variable independiente de estudio fue la residencia en distritos con o sin «zonas de necesidad de transformación social», obtenida del código postal. El análisis de las características hospitalarias se realizó mediante los test de la chi2, Fisher y t de Student, y la descripción de tasas mediante el cálculo de tasas cruda y específica, y del índice de tasas. Resultados: Los ingresos pediátricos procedentes de distritos con menor nivel socioeconómico se produjeron a una edad media 7 meses menor (p < 0,001) y con carácter urgente en mayor proporción (p < 0,001). No se detectaron diferencias en la estancia media ni en la mortalidad intrahospitalaria. El índice de la tasa bruta de hospitalización fue superior en los distritos con menor nivel socioeconómico (1,8), con una mayor diferencia en las tasas específicas de hospitalización por asma, infecciones respiratorias, hernia inguinal y epilepsia/convulsiones. Conclusiones: Las tasas de hospitalización de los diagnósticos principales más frecuentes fueron mayores en distritos con menor nivel socioeconómico. Sus ingresos se produjeron a edades más tempranas y con mayor carácter urgente (AU)

Introduction: The postcode (where the home is situated) is an indicator of socioeconomic status and is associated with morbidity, mortality, and the use of health services. The aim of this study was to analyse its effects on paediatric admissions and to determine the rates of the most common causes of paediatric admissions in Seville. Matherial and methods: An observational cross-sectional study with two analysis units: under 15 year-old "admissions" in public hospitals in Seville (n = 2,660) and "city districts" of Seville (n = 11). The independent variable analysed was whether the postcode of the admitted patients was within a Regional Government designated "area with social transformation needs". The analysis of the admissions was performed using X2-test, Fisher test and Student-t test, with the description of rates using the calculation of crude and specific rates, and by rate ratio. Results: Children living in districts with a lower socioeconomic status were on average 7 months younger (P < .001), and they were significantly more likely to be admitted via the emergency department (P < .001). There was no statistical difference detected in either the length of hospital stay or mortality. The crude admission rate ratio was higher in districts with a lower socioeconomic status (1.8), with a higher specific rate ratio detected in admissions due to asthma, respiratory infections, inguinal hernia, and epilepsy/convulsions. Conclusions: Paediatric hospital admission rates of the main diagnoses were higher in districts with a lower socioeconomic status. Children living in these districts were more likely to be admitted younger and via the emergency department (AU)

[Influence of postcode on paediatric admissions in Seville]. / Influencia del código postal en las hospitalizaciones pediátricas en Sevilla.

INTRODUCTION: The postcode (where the home is situated) is an indicator of socioeconomic status and is associated with morbidity, mortality, and the use of health services. The aim of this study was to analyse its effects on paediatric admissions and to determine the rates of the most common causes of paediatric admissions in Seville. MATHERIAL AND METHODS: An observational cross-sectional study with two analysis units: under 15 year-old "admissions" in public hospitals in Seville (n=2,660) and "city districts" of Seville (n=11). The independent variable analysed was whether the postcode of the admitted patients was within a Regional Government designated "area with social transformation needs". The analysis of the admissions was performed using X2-test, Fisher test and Student-t test, with the description of rates using the calculation of crude and specific rates, and by rate ratio. RESULTS: Children living in districts with a lower socioeconomic status were on average 7 months younger (P<.001), and they were significantly more likely to be admitted via the emergency department (P<.001). There was no statistical difference detected in either the length of hospital stay or mortality. The crude admission rate ratio was higher in districts with a lower socioeconomic status (1.8), with a higher specific rate ratio detected in admissions due to asthma, respiratory infections, inguinal hernia, and epilepsy/convulsions. CONCLUSIONS: Paediatric hospital admission rates of the main diagnoses were higher in districts with a lower socioeconomic status. Children living in these districts were more likely to be admitted younger and via the emergency department.

Serum cystatin C levels in preterm newborns in our setting: Correlation with serum creatinine and preterm pathologies.

BACKGROUND: Cystatin C (CysC) is a renal function marker that is not as influenced as creatinine (Cr) by endogenous or exogenous agents, so it is therefore proposed as a marker in preterm infants. OBJECTIVES: To determine serum CysC values in preterm infants during the first week of life, compared to Cr. To analyze alterations caused by prematurity diseases. METHOD: The design involved a longitudinal, observational study of prospective cohorts. Groups were based on gestational age (GA): Group A (24-27 weeks), Group B (28-33 weeks), Group C (34-36 weeks). Blood samples were collected at birth, within 48-72hours and after 7 days of life. STATISTICS: SPSS v.20 software was used. The statistical methods applied included chi-squared test and ANOVA. RESULTS: A total of 109 preterm infants were included in the study. CysC levels were: 1.54mg/L (±0.28) at birth; 1.38mg/L (±0.36) within 48-72hours of life; 1.50mg/L (±0.31) after 7 days (p<0.05). Cr levels were: 0.64mg/dL (±0.17) at birth; 0.64mg/dL (±0.28) within 48-72hours; 0.56mg/dL (±0.19) after 7 days (P<.05). CysC values were lower in hypotensive patients and those with a respiratory disease (P<.05), and no alterations associated with other diseases were observed. There were no differences in Cr levels associated with any disease. Creatinine levels were higher in patients ≤1.500g (P<.05). CONCLUSIONS: Serum CysC decreased within 48-72hours of life, and this decline showed significance (P<.05). The levels increased after 7 days in all 3 GA groups, and there was no difference in CysC levels among the groups. More studies in preterm infants with hypotension and respiratory disease are required. CysC is a better glomerular filtration (GF) marker in ≤1.500g preterm infants.

Valores de cistatina C sérica en recién nacidos pretérmino en nuestro medio. Relación con valores de creatinina sérica y patologías de la prematuridad / Serum cystatin C levels in preterm newborns in our setting: Correlation with serum creatinine and preterm pathologies

Antecedentes: La cistatina C (CisC) es un marcador de función renal no tan influenciado como la creatinina (Cr) por agentes endógenos o exógenos, por lo que se propone como marcador en el pretérmino. Objetivos: Determinar valores de CisC sérica en pretérminos en la primera semana de vida, comparándola con la Cr. Analizar modificaciones por patologías de la prematuridad. Método: Estudio longitudinal, observacional, de cohortes prospectivo. Grupos por edad gestacional (EG): grupo A (24-27 semanas), grupo B (28-33 semanas), grupo C (34-36 semanas). Se recogieron muestras de sangre al nacimiento, a las 48-72h y a los 7días. Estadística: Programa SPSS v.20. Métodos estadísticos utilizados χ2 y ANOVA. Resultados: N=109 pretérminos. CisC al nacimiento: 1,54mg/l (±0,28), a las 48-72h de vida: 1,38mg/l (±0,36), a los 7días: 1,50mg/l (±0,31) (p<0,05). Cr al nacimiento: 0,64mg/dl (±0,17), a las 48-72h: 0,64mg/dl (±0,28), a los 7días: 0,56mg/dl (±0,19) (p<0,05). Valores de CisC más bajos en pacientes con patología respiratoria e hipotensos (p<0,05) sin modificación según patologías restantes. No diferencias en valores de Cr según patología. Valores de creatinina más altos en pacientes ≤1.500g (p<0,05). Conclusiones: Descenso de CisC sérica a las 48-72h de vida, siendo esta caída en el tiempo significativa (p<0,05), ascenso a los 7días, en los 3 grupos de EG y sin diferencias en valores de CisC entre los grupos. Se requieren más estudios en pretérminos con patología respiratoria y situaciones de hipotensión. En ≤1.500g la CisC es mejor marcador de filtrado glomerular (FG) (AU)

Background: Cystatin C (CysC) is a renal function marker that is not as influenced as creatinine (Cr) by endogenous or exogenous agents, so it is therefore proposed as a marker in preterm infants. Objectives: To determine serum CysC values in preterm infants during the first week of life, compared to Cr. To analyze alterations caused by prematurity diseases. Method: The design involved a longitudinal, observational study of prospective cohorts. Groups were based on gestational age (GA): Group A (24-27 weeks), Group B (28-33 weeks), Group C (34-36 weeks). Blood samples were collected at birth, within 48-72hours and after 7 days of life. Statistics: SPSS v.20 software was used. The statistical methods applied included chi-squared test and ANOVA. Results: A total of 109 preterm infants were included in the study. CysC levels were: 1.54mg/L (±0.28) at birth; 1.38mg/L (±0.36) within 48-72hours of life; 1.50mg/L (±0.31) after 7 days (p<0.05). Cr levels were: 0.64mg/dL (±0.17) at birth; 0.64mg/dL (±0.28) within 48-72hours; 0.56mg/dL (±0.19) after 7 days (P<.05). CysC values were lower in hypotensive patients and those with a respiratory disease (P<.05), and no alterations associated with other diseases were observed. There were no differences in Cr levels associated with any disease. Creatinine levels were higher in patients ≤1.500g (P<.05). Conclusions: Serum CysC decreased within 48-72hours of life, and this decline showed significance (P<.05). The levels increased after 7 days in all 3 GA groups, and there was no difference in CysC levels among the groups. More studies in preterm infants with hypotension and respiratory disease are required. CysC is a better glomerular filtration (GF) marker in ≤1.500g preterm infants (AU)