Changing trends in the epidemiology of hip fracture in Spain.

UNLABELLED: Temporal trends in hip fracture incidence have recently been reported in some developed countries. Such data in Spain has previously been incomplete; this study reports the stratified incidence of hip fractures in people over 65 in Spain during the last 14 years. INTRODUCTION: The main objective is to establish whether temporal trends in hip fracture incidence in Spain exist. METHODS: Ecological study with data from hospital discharges nationwide. The study includes patients aged ≥ 65 years during a 14-year period (1997-2010). The analysis compares two periods of four years: 1997-2000 (P1) and 2007-2010 (P2). RESULTS: There were 119,857 fractures in men and 415,421 in women. Comparing periods (P1 vs P2) over 10 years, the crude incidence rate/100,000 inhabitant/year increased an average of 2.3%/year in men and 1.4% in women. After adjustment, the rate increased an average of 0.4%/year in men (p < 0.0001), but decreased 0.2%/year in women (p < 0.0001). In men, younger than 85, the decrease was not significant except in 70-74 years, and from 80 years, the adjusted rate increases significantly (p < 0.0001). In women under 80 years of age, the decrease in adjusted rate was significant; there was no change in 80-84 years, and the adjusted rate increased significantly in individuals 85 years and older (p < 0.0001). Mortality rates declined by 22% in both sexes, and the index of overaging population rises 30.1 % in men and 25.2% in women. CONCLUSIONS: This study supports other international studies by showing changes in the incidence of hip fractures after age-population adjustment, which denotes a decrease in the younger age groups and among women and shows an increase in both groups over 85 years. The increase in the crude incidence rate of hip fracture in Spain reflects changes in population structure.

[Prevalence of chronic renal failure in primary care]. / Prevalencia de insuficiencia renal crónica en atención primaria.

OBJECTIVE: To determine the prevalence of chronic renal failure (CRF) without replacement treatment (RT), and to describe the primary renal diseases and associated risk factors that might favour its evolution to terminal renal failure. Design. Cross-sectional, descriptive study. SETTING: Population attended at a primary care centre (PCC). PARTICIPANTS: Over-14s with a clinical history opened at the Bon Pastor PCC. RESULTS: Between the 1st of January 1997 and the 1st of December 1997, 12241 clinical histories were reviewed. 64 patients were identified who satisfied criteria of CRF without RT, a prevalence of 5228 patients per million inhabitants (95% CI, 3,950-6,510). 71.9% were men, and mean age was 72 (SD, 13.5). The most recent plasma creatinine averaged 2 mg/dl (SD, 0.66). Frequency according to kind of nephropathy was: 3 (4.7%) glomerular, 5 (7.8%) diabetic, 3 (4.7%) interstitial, 41 (64.1%) vascular (hypertension), 2 (3.1%) indeterminate and 10 (15.6%) unclassifiable. Associated risk factors in these patients were: 47 (73.4%) with hypertension, 16 (25%) diabetic, 26 (40.6%) with hypercholesterolaemia, 20 (31.3%) chronic consumers of analgesics, and 10 (15.6%) smokers. 51.6% of the patients suffered other cardiovascular illnesses. CONCLUSIONS: The estimated prevalence in the population of CRF without RT is 5,228 per million inhabitants. Hypertension is the risk factor most closely associated with this pathology.

Prevalencia de insuficiencia renal crónica en atención primaria / Prevalence of chronic renal failure in primary care

Objetivo. Determinar la prevalencia de insuficiencia renal crónica (IRC) sin tratamiento sustitutivo (TSR), describir el tipo de enfermedades renales primarias y los factores de riesgo asociados que pueden favorecer su evolución hacia la insuficiencia renal terminal. Diseño. Estudio descriptivo, transversal. Emplazamiento. Población atendida por un centro de atención primaria. Participantes. Mayores de 14 años con historia clínica abierta en el CAP Bon Pastor. Resultados. Durante el período 1-I-1997 hasta 1-XII-1997 se revisaron 12.241 historias clínicas. Se identificaron 64 pacientes que cumplían criterios de IRC sin TSR; prevalencia, 5.228 pacientes por millón de habitantes (pmp) (IC del 95 por ciento, 3.950-6.510 pmp). Un 71,9 por ciento era varón, la edad media era de 72 años (DE, 13,5). La media de la última creatinina plasmática fue de 2 mg/dl (DE, 0,66). La frecuencia según tipo de nefropatía fue: glomerular, 3 (4,7 por ciento); diabética, 5 (7,8 por ciento); intersticial, 3 (4,7 por ciento); vascular (HTA), 41 (64,1 por ciento); indeterminada, 2 (3,1 por ciento), e inclasificable, 10 (15,6 por ciento). Los factores de riesgo asociados en estos pacientes fueron: hipertensos, 47 (73,4 por ciento); diabéticos, 16 (25 por ciento); hipercolesterémicos, 26 (40,6 por ciento); consumidores crónicos de analgésicos, 20 (31,3 por ciento), y 10 (15,6 por ciento), fumadores. Un 51,6 por ciento de los pacientes presentaba otras enfermedades cardiovasculares. Conclusiones. La prevalencia estimada de IRC sin TRS en la población es de 5.228 pmp, y la hipertensión es el factor de riesgo más frecuente asociado a esta patología (AU)

[Prevalence of hepatitis C virus infection and cohabiting contacts]. / Estudio de la prevalencia de infección por el virus de la hepatitis C y estudio de contactos convivientes.

OBJECTIVES: Study of the prevalence of Hepatitis C infection and of cohabiting contacts. DESIGN: A descriptive crossover study. SETTING: Health District. PATIENTS: There were a total of 13,500 people with histories opened at our centre. The histories of patients attending for general medical consultations between January 1995 and December 1996 were reviewed for Ac+ to the Hepatitis C (HC) virus. RESULTS: 145 patients were found to be Ac positive for HC (1.07%; CI, 0.9-1.2). 135 were index cases and 10 contacts. The most important items of history were intravenous drug use in 33 carriers (23%), transfusion in 22 (15%), contact with non-disposable material in 97 (67%) and surgery in 119 (82%). 115 (79%) of those infected had Transaminase disorder (< x10). CONCLUSIONS: The 1.07% prevalence found was similar to other studies. Previous surgery stood out among the factors causing risk of infection. Prevalence among cohabitants was 7%, half through sexual contacts. Since there was a higher prevalence of HC+ among family members (50% sexual partners), we believe the study should be extended and followed up in the family environment.