Manchas de Roth y endocarditis infecciosa / Roth's spots and infective endocarditis

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Tendencia y características de la hospitalización por insuficiencia cardiaca en un marco poblacional durante el periodo 2003-2013 / Trends and Characteristics of hospitalization for heart failure in a population setting from 2003 to 2013

Introducción y objetivos: Estudios poblacionales llevados a cabo en otros países indican una disminución de las tasas estandarizadas de hospitalización por insuficiencia cardiaca (IC); sin embargo, en España se carece de datos poblacionales. Métodos: A partir del Conjunto Mínimo Básico de Datos de todos los hospitales de la Región de Murcia, se obtuvieron los episodios asistenciales por tarjeta sanitaria individual con un diagnóstico principal de IC entre 2003-2013 (n = 27.158). Para cada año se estudiaron las tasas de hospitalización por 1.000 habitantes (‰), bruta y estandarizada por edad y sexo, variables clínicas y administrativas. Las tendencias temporales se analizaron con regresión de joinpoint. Resultados: La tasa de hospitalización aumentó un 76,7%, pasando del 1,28 a 2,26‰ (bruta) y del 1,06 a 1,77‰ (estandarizada); el porcentaje de cambio anual medio (PCA) fue 8,2% hasta 2007 y posteriormente 1,9% (p < 0,05). Las personas mayor o igual 75 años duplicaron su tasa, hasta 19,9‰ en 75-84 años (PCA, 5,4%) y 32,5‰ en mayor o igual 85 años (PCA, 11,7%), mientras que en < 75 años no se modificó. La tasa de hospitalización en mujeres fue un 36% mayor, pero se equiparó tras estandarizar por edad y no presentó variaciones. El índice de comorbilidad de Elixhauser aumentó casi 1 punto y los episodios > 6 puntos se duplicaron. La estancia y mortalidad hospitalarias no cambiaron. Conclusiones: Entre 2003-2013 persiste un incremento sostenido de la hospitalización por IC, que afecta a la población mayor o igual 75 años y está asociado al aumento de comorbilidad. Son necesarias estrategias específicas dirigidas a esta población (AU)

Introduction and objectives: Population-based studies in other countries have reported a reduction of standardized rates of hospitalization for heart failure (HF) but data from a well-defined population are lacking in Spain. Methods: All hospitalizations with a principal diagnosis of HF between 2003 and 2013 were obtained from the Minimum Basic Data Set, which includes all hospitals in the Region of Murcia. Health care episodes were identified by the individual health card (27 158 episodes). For each year, we studied the following parameters: crude, age-standardized and sex-standardized hospitalization rates for HF, length of stay, mortality, clinical variables, and the Elixhauser index. Time trends were analyzed using joinpoint regression. Results: Hospitalization rates increased by 76.7%, from 1.28% to 2.26% (crude) and 1.06% to 1.77% (standardized); the mean annual percentage of change (APC) was 8.2% until 2007 and was subsequently 1.9% (P < .05). Rates doubled in persons 75 years, reaching 19.9% in those aged 75 to 84 years (APC, 5.4%) and 32.5% in those aged 85 years (APC, 11.7%) but were unchanged in persons aged < 75 years. The hospitalization rate was 36% higher in women than in men but was equal after age-standardization and showed no temporal change. The Elixhauser comorbidity index increased by almost 1 point during the study period and episodes > 6 points increased by 2-fold. Length of stay and mortality were unchanged during the study period. Conclusions: Between 2003 and 2013, there was a sustained increase in standardized rates of hospitalization for HF, which affected persons 75 years and was associated with a rise in comorbidity. There is a need for strategies focused on this population (AU)

Trends and Characteristics of Hospitalization for Heart Failure in a Population Setting From 2003 to 2013.

INTRODUCTION AND OBJECTIVES: Population-based studies in other countries have reported a reduction of standardized rates of hospitalization for heart failure (HF) but data from a well-defined population are lacking in Spain. METHODS: All hospitalizations with a principal diagnosis of HF between 2003 and 2013 were obtained from the Minimum Basic Data Set, which includes all hospitals in the Region of Murcia. Health care episodes were identified by the individual health card (27 158 episodes). For each year, we studied the following parameters: crude, age-standardized and sex-standardized hospitalization rates for HF, length of stay, mortality, clinical variables, and the Elixhauser index. Time trends were analyzed using joinpoint regression. RESULTS: Hospitalization rates increased by 76.7%, from 1.28‰ to 2.26‰ (crude) and 1.06‰ to 1.77‰ (standardized); the mean annual percentage of change (APC) was 8.2% until 2007 and was subsequently 1.9% (P < .05). Rates doubled in persons ≥ 75 years, reaching 19.9‰ in those aged 75 to 84 years (APC, 5.4%) and 32.5‰ in those aged ≥ 85 years (APC, 11.7%) but were unchanged in persons aged < 75 years. The hospitalization rate was 36% higher in women than in men but was equal after age-standardization and showed no temporal change. The Elixhauser comorbidity index increased by almost 1 point during the study period and episodes > 6 points increased by 2-fold. Length of stay and mortality were unchanged during the study period. CONCLUSIONS: Between 2003 and 2013, there was a sustained increase in standardized rates of hospitalization for HF, which affected persons ≥ 75 years and was associated with a rise in comorbidity. There is a need for strategies focused on this population.