Corrigendum: Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis.

[This corrects the article DOI: 10.3389/fpubh.2023.1175482.].

Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis.

Background: Disseminated tuberculosis is frequently associated with delayed diagnosis and a poorer prognosis. Objectives: To describe case series of disseminated TB and diagnosis delay in a low TB burden country during the COVID-19 period. Methodology: We consecutively included all patients with of disseminated TB reported from 2019 to 2021 in the reference hospital of the Northern Crown of the Metropolitan Area of Barcelona. We collected socio-demographic information, clinical, laboratory and radiological findings. Results: We included all 30 patients reported during the study period-5, 9, and 16 in 2019, 2020, and 2021 respectively-20 (66.7%) of whom were male and whose mean age was 41 years. Twenty-five (83.3%) were of non-EU origin. The most frequent system involvement was central nervous system (N = 8; 26.7%) followed by visceral (N = 7; 23.3%), gastro-intestinal (N = 6, 20.0%), musculoskeletal (N = 5; 16.7%), and pulmonary (N = 4; 13.3%). Hypoalbuminemia and anemia were highly prevalent (72 and 77%). The median of diagnostic delay was 6.5 months (IQR 1.8-30), which was higher among women (36.0 vs. 3.5 months; p = 0.002). Central nervous system involvement and pulmonary involvement were associated with diagnostic delay among women. We recorded 24 cured patients, two deaths, three patients with post-treatment sequelae, and one lost-to-follow up. We observed a clustering effect of patients in low-income neighborhoods (p < 0.001). Conclusion: There was a substantial delay in the diagnosis of disseminated TB in our study region, which might impacted the prognosis with women affected more negatively. Our results suggest that an increase in the occurrence of disseminated TB set in motion by diagnosis delay may have been a secondary effect of the COVID-19 pandemic.

Lesiones óseas en enfermedad de Erdheim-Chester / Bone lesions in Erdheim-Chester disease

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Short-term foot complications in Charcot neuroarthropathy: A retrospective study in tertiary care centres in Spain / Complicaciones a corto plazo en el pie en la neuroartropatía de Charcot: estudio retrospectivo en centros de atención terciaria en España

Objectives: To assess the clinical characteristics of patients with Charcot neuroarthropathy (CN) in Spain and to identify predictors for CN-related complications. Patients and methods: A retrospective study was conducted at five tertiary hospitals with diabetic foot care units in Spain. Data were collected from 83 patients, including demographic profiles, foot factors, diabetes characteristics, and presence of microvascular and macrovascular comorbidity, and a podiatric examination was also performed. Logistic regression analyses were used to determine significant predictors of the predefined clinical events. Results: Signs of diabetic neuropathy were found in almost all patients (98.9%) at the initial assessment, approximately half of them had diabetic retinopathy or nephropathy (61.5% and 51.8%, respectively), and peripheral artery disease was uncommon (8.6%). Thirty-eight patients (47.5%) experienced one or more relevant clinical events: 22 (27.5%) a new foot ulcer; 7 (8.7%) a major amputation; 20 (25%) were admitted to hospital; and 4 (5%) died. Only the presence of diabetic nephropathy was independently associated to development of any of the complications studied (p = 0.009; odds ratio = 3.37; 95% CI: 1.12-10.1). Conclusions: Almost half the patients with CN attending specialised foot care units in tertiary hospitals experienced short-term CN-associated complications, and the risk was 3 times higher in those with a history of diabetic nephropathy

Objetivos: Determinar las características clínicas de pacientes con neuroartropatía de Charcot (NC) en España e identificar predictores de complicaciones relacionadas. Materiales y métodos: Estudio retrospectivo llevado a cabo en 5 hospitales terciarios de España con unidad de pie diabético. Se recopilaron datos de 83 pacientes incluyendo perfil demográfico, datos provenientes de la exploración podológica, características de la diabetes y presencia de comorbilidad micro y macro vascular. Para determinar los predictores significativos de acontecimientos clínicos predefinidos se utilizaron análisis de regresión logística. Resultados: Casi todos los pacientes (98,9%) tenían signos de neuropatía diabética en la evaluación inicial, aproximadamente la mitad tenían retinopatía o nefropatía diabética (61,5 y 51,8%, respectivamente) y la enfermedad arterial periférica era infrecuente (8,6%). Treinta y ocho pacientes (47,5%) experimentaron uno o más acontecimientos clínicos relevantes: 22 (27,5%) una nueva úlcera en el pie, 7 (8,7%) una amputación mayor, 20 (25%) fueron hospitalizados y 4 (5%) murieron. Solamente la presencia de nefropatía diabética se encontró independientemente asociada al desarrollo de alguna de las complicaciones estudiadas (p = 0,009; odds ratio = 3,37; 95% CI: 1,12-10,1). Conclusiones: Casi la mitad de los pacientes con NC atendidos en unidades de cuidado del pie diabético en hospitales terciarios experimentaron complicaciones asociadas a NC a corto plazo, y el riesgo entre aquellos sujetos con historia de úlcera previa era 3 veces mayor

Short-term foot complications in Charcot neuroarthropathy: A retrospective study in tertiary care centres in Spain.

OBJECTIVES: To assess the clinical characteristics of patients with Charcot neuroarthropathy (CN) in Spain and to identify predictors for CN-related complications. PATIENTS AND METHODS: A retrospective study was conducted at five tertiary hospitals with diabetic foot care units in Spain. Data were collected from 83 patients, including demographic profiles, foot factors, diabetes characteristics, and presence of microvascular and macrovascular comorbidity, and a podiatric examination was also performed. Logistic regression analyses were used to determine significant predictors of the predefined clinical events. RESULTS: Signs of diabetic neuropathy were found in almost all patients (98.9%) at the initial assessment, approximately half of them had diabetic retinopathy or nephropathy (61.5% and 51.8%, respectively), and peripheral artery disease was uncommon (8.6%). Thirty-eight patients (47.5%) experienced one or more relevant clinical events: 22 (27.5%) a new foot ulcer; 7 (8.7%) a major amputation; 20 (25%) were admitted to hospital; and 4 (5%) died. Only the presence of diabetic nephropathy was independently associated to development of any of the complications studied (p = 0.009; odds ratio = 3.37; 95% CI: 1.12-10.1). CONCLUSIONS: Almost half the patients with CN attending specialised foot care units in tertiary hospitals experienced short-term CN-associated complications, and the risk was 3 times higher in those with a history of diabetic nephropathy.

Value of bone SPECT-CT to predict chronic pain relief after percutaneous vertebroplasty in vertebral fractures.

BACKGROUND CONTEXT: Longer life span has resulted in increased risk of vertebral osteoporotic fractures. Among minimally invasive procedures, percutaneous vertebroplasty (PV) has shown excellent results in the treatment of chronic vertebral pain. The role of preintervention bone single photon emission computed tomography-computed tomography (SPECT-CT) has not been clearly established for the management of these patients. PURPOSE: To determine the value of bone SPECT-CT in patient selection, treatment planning, and prediction of response to PV. A comparison with magnetic resonance imaging (MRI) was also aimed. STUDY DESIGN: Prospective consecutive series. PATIENT SAMPLE: We studied the performance of bone SPECT-CT on 33 consecutive patients with chronic pain because of vertebral fracture intended for PV. OUTCOME MEASURES: Improvement of clinical status was based on comparison of preprocedure and postprocedure outcome measurements of pain, mobility, and analgesic use. METHODS: Bone SPECT was done using a dual-detector variable-angle gamma camera coupled with a two-slice CT scanner (Symbia T2 System; Siemens, Munich, Germany). Magnetic resonance imaging was done using a magnet of 1.5 T (Giroscan System ACS NT Intera; Philips, Amsterdam, The Netherlands). RESULTS: Of the 33 patients, 24 finally underwent PV. Positive SPECT-CT images predicted clinical improvement in 91% (21 of 23) of them. Agreement between SPECT-CT and MRI was 80% (20 of 25). Single photon emission computed tomography-computed tomography images showed an alternative cause of pain in some cases, such as new fractures or multiple coexisting fractures, persisting bone remodeling in a previous cemented vertebra, and facet or discal degenerative disease. Single photon emission computed tomography-computed tomography was mandatory in eight patients that could no receive MRI, all of whom improved after PV. CONCLUSIONS: Positive bone SPECT-CT seems a good predictor of postprocedural response. It also adds valuable information as to the cause of back pain and facilitates complete patient evaluation in patients that can not receive MRI.

The REGICOR-calibrated function provides a better classification of high-risk patients on statin treatment in the Spanish population than the Framingham or SCORE classifications.

INTRODUCTION AND OBJECTIVES: To determine which cardiovascular risk function is best for classifying high-risk individuals on statins. METHODS: Descriptive cross-sectional study of 804 randomly selected patients aged 35-74 years. Variables studied included statin treatment, high cardiovascular risk according to Framingham-REGICOR (10-year risk >or=10%), Framingham-Wilson (10-year risk >or=20%) and SCORE (10-year risk >or=5%) functions, age, sex, cardiovascular risk factors, and total and high-density lipoprotein (HDL) cholesterol. RESULTS: Overall, 83 patients (10.3%) were taking statins. The prevalence of hypercholesterolemia was 25.6%. When high-risk patients were compared with low- and medium-risk patients, the SCORE function only found a significant difference in HDL-cholesterol level (difference, 5.1 mg/dl; P< .001), whereas the Framingham-REGICOR and Framingham-Wilson functions showed that hypercholesterolemia was more prevalent (at 41% and 37.8%, respectively), the total cholesterol level was higher (difference, 15 mg/dl and 12.5 mg/dl, respectively), and the HDL-cholesterol level was lower (difference, 11.9 mg/ dl and 12 mg/dl, respectively; all P< .001). The percentage of patients on statins classified as high-risk by each function was 16% for Framingham-REGICOR (odds ratio [OR]=1.81; 95% confidence interval [CI], 1.01-3.27), 13.4% for Framingham-Wilson (OR=1.47; 95% CI, 0.87-2.47) and 10.6% for SCORE (OR=1.09; 95% CI, 0.50-2.37). Statin use was also significantly associated with hypertension (OR=1.89; 95% CI, 1.20-2.99) and hypercholesterolemia (OR=11.01; 95% CI, 6.55-18.53), and inversely associated with age in patients <65 years (OR=0.51; 95% CI, 0.32-0.81). CONCLUSIONS: The Framingham-REGICOR function was better at classifying high-risk patients on statins than the Framingham-Wilson or SCORE functions. Statin use was associated with hypercholesterolemia and hypertension and inversely with age in patients <65 years.

La función calibrada REGICOR mejora la clasificación de los pacientes de alto riesgo tratados con estatinas respecto a Framingham y SCORE en la población española / The REGICOR-calibrated function provides a better classification of high-risk patients on statin treatment in the Spanish population than the Framingham or SCORE classifications

Introducción y objetivos. Estudiar qué función de riesgo cardiovascular clasifica mejor a los pacientes con riesgo cardiovascular alto que toman estatinas. Métodos. Estudio descriptivo transversal que incluye a 804 pacientes de 35-74 años, seleccionados aleatoriamente. Se estudiaron las variables tratamiento con estatinas, riesgo cardiovascular alto con las ecuaciones de Framingham-REGICOR (≥ 10% a 10 años), Framingham-Wilson (≥ 20% a 10 años) y SCORE (≥ 5% a 10 años), edad, sexo, colesterol total, colesterol de las lipoproteínas de alta densidad (cHDL) y factores de riesgo cardiovascular. Resultados. Tomaban estatinas 83 (10,3%) pacientes. La prevalencia de hipercolesterolemia fue del 25,6%. Comparando a los pacientes de bajo y medio riesgo con los de alto riesgo, SCORE sólo halló diferencias significativas en el cHDL más bajo (diferencia: 5,1 mg/dl; p < 0,001), mientras que Framingham-REGICOR y Framingham-Wilson mostraron (p < 0,001) mayor prevalencia de hipercolesterolemia (el 41 y el 37,8% respectivamente), colesterol total más elevado (diferencia, 15 y 12,5 mg/dl respectivamente) y cHDL más bajo (diferencia, 11,9 y 12 mg/dl respectivamente). Tomaba estatinas el 16% de pacientes de alto riesgo con Framingham-REGICOR (odds ratio [OR] = 1,81; intervalo de confianza [IC] del 95%, 1,01-3,27), el 13,4% con Framingham-Wilson (OR = 1,47; IC del 95%, 0,87-2,47) y el 10,6% con SCORE (OR = 1,09; IC del 95%, 0,50-2,37). Se asociaron significativamente al uso de estatinas la hipertensión (OR = 1,89; IC del 95%, 1,20-2,99) y la hipercolesterolemia (OR = 11,01; IC del 95%, 6,55-18,53), con una relación inversa con la edad < 65 años (OR = 0,51; IC del 95%, 0,32-0,81). Conclusiones. La función Framingham-REGICOR clasifica mejor que Framingham-Wilson y SCORE a los pacientes de riesgo alto que reciben tratamiento con estatinas. La prescripción se asoció al diagnóstico de hipercolesterolemia y HTA y fue menor en pacientes < 65 años (AU)

Introduction and objectives. To determine which cardiovascular risk function is best for classifying high-risk individuals on statins. Methods. Descriptive cross-sectional study of 804 randomly selected patients aged 35-74 years. Variables studied included statin treatment, high cardiovascular risk according to Framingham-REGICOR (10-year risk ≥10%), Framingham-Wilson (10-year risk ≥20%) and SCORE (10-year risk ≥5%) functions, age, sex, cardiovascular risk factors, and total and high-density lipoprotein (HDL) cholesterol. Results. Overall, 83 patients (10.3%) were taking statins. The prevalence of hypercholesterolemia was 25.6%. When high-risk patients were compared with low- and medium-risk patients, the SCORE function only found a significant difference in HDL-cholesterol level (difference, 5.1 mg/dl; P < .001), whereas the Framingham-REGICOR and Framingham-Wilson functions showed that hypercholesterolemia was more prevalent (at 41% and 37.8%, respectively), the total cholesterol level was higher (difference, 15 mg/dl and 12.5 mg/dl, respectively), and the HDL-cholesterol level was lower (difference, 11.9 mg/ dl and 12 mg/dl, respectively; all P < .001). The percentage of patients on statins classified as high-risk by each function was 16% for Framingham-REGICOR (odds ratio [OR]=1.81; 95% confidence interval [CI], 1.01-3.27), 13.4% for Framingham-Wilson (OR=1.47; 95% CI, 0.87-2.47) and 10.6% for SCORE (OR=1.09; 95% CI, 0.50-2.37). Statin use was also significantly associated with hypertension (OR=1.89; 95% CI, 1.20-2.99) and hypercholesterolemia (OR=11.01; 95% CI, 6.55-18.53), and inversely associated with age in patients <65 years or 95 ci 0 32-0 81 conclusions the framingham-regicor function was better at classifying high-risk patients on statins than framingham-wilson score functions statin use associated with hypercholesterolemia and hypertension inversely age in <65 years (AU)

[Ostearticular tuberculosis. Study of 53 cases]. / Tuberculosis osteoarticular: estudio de 53 casos.

BACKGROUND AND OBJECTIVE: To analyze the characteristics of bone and joint tuberculosis in a Spanish university hospital. PATIENTS AND METHOD: Retrospective study (1984-2006) in a university hospital. All patients had microbiologically and/or histologically proved osteoarticular tuberculosis. Patients with clinical and radiological criteriae, positive tuberculin test responding to antituberculous treatment were not excluded despite negative cultures. RESULTS: We attended 53 patients with osteoarticular tuberculosis (35 males/18 females; mean age: 52 years). Bone tuberculosis involved axial skeleton in 37 patients (71%), peripheral distribution in 12 (21%) and both locations in 4 (8%). Mean time to diagnosis was 8 months. Most common involved joints were knee and ankle. An extraarticular involvement was found in 12 patients (22%) and multifocal bone infection in 6 (11%). Risk factors were present in 22 patients (42%), and 15% were immigrants. The diagnosis was established by a positive culture in 40 cases (75%), and 33 (62%) had suggestive histology. Complications of tuberculosis included medullar compression (9.4%), abscess (12%) and fistulae (9.4%). Spine involvement required surgical intervention in 27% and peripheral involvement in 56%. Curation was achieved in 33 patients (62.3%), curation with secuelae in 19 cases (35.9%) and no consolidation of arthrodesis in one case. CONCLUSIONS: Bone and joint tuberculosis is still common in our area and should be particularly considered in immigrants. Diagnosis delay is remarkable. Complications are present in one third of patients. Surgical treatment is often required.

Tuberculosis osteoarticular: estudio de 53 casos / Ostearticular tuberculosis. Study of 53 cases

Fundamento y objetivo: Analizar las características de la tuberculosis osteoarticular en un hospital universitario. Pacientes y método: Se ha realizado un estudio retrospectivo (1984-2006) de los pacientes con tuberculosis osteoarticular atendidos en el Hospital Universitario Germans Trias i Pujol de Badalona (Barcelona). Se incluyó a todos los pacientes con diagnóstico microbiológico y/o histológico, y también a los que tenían criterios clínicos y radiológicos indicativos, prueba de la tuberculina positiva (derivado proteico purificado) y respuesta favorable al tratamiento antituberculoso. Resultados: Se recogieron 53 casos de tuberculosis osteoarticular (35 eran varones). La edad media de los pacientes era de 52 años. La localización de la infección tuberculosa fue: esqueleto axial en 37 casos (71%), periférica en 12 (21%) y mixta en 4 (8%). El tiempo medio transcurrido hasta el diagnóstico fue de 8 meses. Las articulaciones más afectadas fueron la rodilla y el tobillo. Se halló simultáneamente otra localización extraarticular activa en 12 pacientes (22%) e infección ósea multifocal en 6 (11%). En 22 casos (42%) se observó algún factor de riesgo. El 15% eran inmigrantes. El diagnóstico se estableció por el resultado positivo del cultivo en 40 casos (75%) y 33 (62%) tuvieron histología compatible. Las complicaciones más frecuentes fueron la compresión medular (9,4%) y la formación de abscesos (12%) y fístulas (9,4%). Se intervino quirúrgicamente al 27% de los pacientes con afectación vertebral y al 56% de aquéllos con formas periféricas. Se obtuvo curación en 33 casos (62,3%), curación con secuelas en 19 (35,9%) y mala consolidación de la artrodesis en uno. Conclusiones: La tuberculosis osteoarticular es una infección prevalente en nuestro entorno y debe tenerse especialmente en cuenta en la población inmigrante. La demora hasta el diagnóstico es importante y sus complicaciones condicionan que más de la tercera parte de los pacientes precise tratamiento quirúrgico

Background and objective: To analyze the characteristics of bone and joint tuberculosis in a Spanish university hospital. Patients and method: Retrospective study (1984-2006) in a university hospital. All patients had microbiologically and/or histologically proved osteoarticular tuberculosis. Patients with clinical and radiological criteriae, positive tuberculin test responding to antituberculous treatment were not excluded despite negative cultures. Results: We attended 53 patients with osteoarticular tuberculosis (35 males/18 females; mean age: 52 years). Bone tuberculosis involved axial skeleton in 37 patients (71%), peripheral distribution in 12 (21%) and both locations in 4 (8%). Mean time to diagnosis was 8 months. Most common involved joints were knee and ankle. An extraarticular involvement was found in 12 patients (22%) and multifocal bone infection in 6 (11%). Risk factors were present in 22 patients (42%), and 15% were immigrants. The diagnosis was established by a positive culture in 40 cases (75%), and 33 (62%) had suggestive histology. Complications of tuberculosis included medullar compression (9.4%), abscess (12%) and fistulae (9.4%). Spine involvement required surgical intervention in 27% and peripheral involvement in 56%. Curation was achieved in 33 patients (62.3%), curation with secuelae in 19 cases (35.9%) and no consolidation of arthrodesis in one case. Conclusions: Bone and joint tuberculosis is still common in our area and should be particularly considered in immigrants. Diagnosis delay is remarkable. Complications are present in one third of patients. Surgical treatment is often required

Seudopodagra séptica por Streptococcus agalactia / Septic pseudopodagra by Streptococcus agalactiae

La seudopodagra es una causa infrecuente de artritis de primera metatarsofalángica (MTF). Entre sus múltiples causas, siempre hay que descartar la posible causa infecciosa. Se presenta un caso de seudopodagra séptica por Streptococcus agalactiae en un paciente con hepatopatía crónica en el que se retrasó el diagnóstico por su curso indolente. Recibió tratamiento antibiótico intravenoso con buena evolución y sin secuelas funcionales. Se realiza una revisión de los casos de seudopodagra descritos en la bibliografía, con especial atención en los de causa infecciosa(AU)

Pseudopodagra is an unusual cause of first metatarsophalangeal arthritis. There are multiple causes, and an infectious cause always has to be excluded. We report a septic pseudopodagra by Streptococcus agalactiae in a patient with chronic hepatopathy with an indolent evolution and a consequent delay in diagnosis. Antibiotic treatment was installed with a favourable outcome without functional sequelae. The pseudopodagra reports in the bibliography are reviewed with special attention on those of infectious aetiology(AU)

[Septic pseudopodagra by Streptococcus agalactiae]. / Seudopodagra séptica por Streptococcus agalactiae.

Pseudopodagra is an unusual cause of first metatarsophalangeal arthritis. There are multiple causes, and an infectious cause always has to be excluded. We report a septic pseudopodagra by Streptococcus agalactiae in a patient with chronic hepatopathy with an indolent evolution and a consequent delay in diagnosis. Antibiotic treatment was installed with a favourable outcome without functional sequelae. The pseudopodagra reports in the bibliography are reviewed with special attention on those of infectious aetiology.

Comparación de los modelos SCORE y REGICOR para el cálculo del riesgo cardiovascular en sujetos sin enfermedad cardiovascular atendidos en un centro de salud de Barcelona / Comparison of the SCORE and REGICOR Models for Calculating Cardiovascular Risk in Cardiovascular Disease-Free Individuals at a Healthcare Center in Barcelona, Spain

Fundamento: No se dispone de estudios que hayan comparadoSCORE, REGICOR y Framingham. El objetivo de este trabajo esestudiar cómo clasifican el riesgo cardiovascular las funcionesREGICOR y SCORE, su correlación y concordancia respecto a Framingham(1998) y si presentan diferencias respecto a los factores deriesgo cardiovascular en los casos de riesgo alto.Métodos: Estudio descriptivo transversal realizado en atención primaria.Se incluyó a 851 personas entre 35-74 años, libres de enfermedadescardiovasculares y seleccionadas por muestreo aleatorio simple.Se estudió la proporción de pacientes de riesgo alto con Framingham(³20% a 10 años), SCORE (³5% a 10 años) y REGICOR con puntos decorte ³20%, ³15%, ³10% y ³5% a 10 años, ya que con REGICOR³20% apenas hay casos con riesgo alto. Se comparó la correlación (r dePearson) y concordancia (coeficiente Kappa) de las personas de riesgoalto de REGICOR y SCORE respecto a Framingham.Resultados: Presentaron riesgo alto 23,3% con Framingham,15,2% con SCORE y un 1,4%, 5,8%, 17,6% y 57,0% con REGICORcon los puntos de corte descritos, respectivamente. REGICOR tuvouna correlación de 0,99 y SCORE de 0,78. REGICOR ³10% tuvomejor concordancia (Kappa 0,83) que SCORE (Kappa 0,61). Alcomparar los factores de riesgo cardiovascular de los casos con riesgoalto (³20% Framingham, ³5% SCORE y ³10% REGICOR), elsegundo presentó mayor prevalencia de diabetes y menor de hipercolesterolemia(p<0,05).Conclusiones: REGICOR presentó una buena correlación conFramingham. Con el punto de corte ³10% clasifica como riesgo altoa un número de personas similar a SCORE e inferior a Framingham.El modelo SCORE trataría con hipolipemiantes a un número parecidode pacientes que el modelo REGICOR ³10%, pero con menorevidencia de efectividad del tratamiento

Background: No studies have been published to date comparingSCORE, REGICOR and Framingham models. This study isaimed at analyzing how the REGICOR and SCORE functions classifycardiovascular risk, their correlation and concordance withFramingham (1998) and whether any differences exist among themwith regard to the cardiovascular risk factors in high-risk groups.Methods: Descriptive cross-sectional study conducted in primarycare. A total of 851 individuals within the 35-74 age range, freeof cardiovascular diseases and selected by simple random samplingwere included. A study was made of the percentage of high-riskpatients with Framingham (³20% ten-year risk), SCORE (³5% tenyearrisk) and REGICOR with cutoff points ³20%, ³15%, ³10% and³5% at 10 years, given that with REGICOR ³20% there are hardlyany high-risk cases. A comparison was drawn between the correlation(Pearson´s r) and concordance (Kappa index) of the REGICORand SCORE high-risk individuals as compared to Framingham.Results: The high-risk percentages respectively found were:23.3% with Framingham; 15.2%; with SCORE; and 1.4%, 5.8%,17.6% and 57.0% with REGICOR with the cutoff points described.REGICOR has a 0.99 correlation, SCORE a 0.78 correlation. REGICOR³10% showed a better concordance (Kappa 0.83) than SCORE(Kappa 0.61). On comparing the cardiovascular risk factors of thehigh-risk cases (³20% Framingham, ³5% SCORE and ³10% REGICOR),SCORE showed higher prevalence of diabetes and a lowerprevalence of hypercholesterolemia (p<0.05).Conclusions: REGICOR showed a good correlation with Framingham.With the ³10% cutoff point, it classifies a number of individualsas high-risk similar to SCORE and fewer than Framingham.The SCORE model would treat a number of patients similar to theREGICOR ³10% model with hypolipemiant drugs, however showinglesser evidence of effectiveness of the treatment

[Comparison of the SCORE and REGICOR models for calculating cardiovascular risk in cardiovascular disease-free individuals at a healthcare center in Barcelona, Spain]. / Comparación de los modelos SCORE y REGICOR para el cálculo del riesgo cardiovascular en sujetos sin enfermedad cardiovascular atendidos en un centro de salud de Barcelona.

BACKGROUND: No studies have been published to date comparing SCORE, REGICOR and Framingham models. This study is aimed at analyzing how the REGICOR and SCORE functions classify cardiovascular risk, their correlation and concordance with Framingham (1998) and whether any differences exist among them with regard to the cardiovascular risk factors in high-risk groups. METHODS: Descriptive cross-sectional study conducted in primary care. A total of 851 individuals within the 35-74 age range, free of cardiovascular diseases and selected by simple random sampling were included. A study was made of the percentage of high-risk patients with Framingham (> or = 20% ten-year risk), SCORE (> or = 5% ten-year risk) and REGICOR with cutoff points > or = 20%, > or = 15%, > or = 10% and > or = 5% at 10 years, given that with REGICOR > or = 20% there are hardly any high-risk cases. A comparison was drawn between the correlation (Pearson's r) and concordance (Kappa index) of the REGICOR and SCORE high-risk individuals as compared to Framingham. RESULTS: The high-risk percentages respectively found were: 23.3% with Framingham; 15.2%; with SCORE; and 1.4%, 5.8%, 17.6% and 57.0% with REGICOR with the cutoff points described. REGICOR has a 0.99 correlation, SCORE a 0.78 correlation. REGICOR > or = 10% showed a better concordance (Kappa 0.83) than SCORE (Kappa 0.61). On comparing the cardiovascular risk factors of the high-risk cases (> or = 20% Framingham, > or = 5% SCORE and > or = 10% REGICOR), SCORE showed higher prevalence of diabetes and a lower prevalence of hypercholesterolemia (p<0.05). CONCLUSIONS: REGICOR showed a good correlation with Framingham. With the > or = 10% cutoff point, it classifies a number of individuals as high-risk similar to SCORE and fewer than Framingham. The SCORE model would treat a number of patients similar to the REGICOR > or =10% model with hypolipemiant drugs, however showing lesser evidence of effectiveness of the treatment.

REGICOR mejor que Framingham en el cálculo del riesgo coronario: una buena noticia para nuestros pacientes / REGICOR better than Framingham coronary risk function in Spain: good news for our patients

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