Características sociodemográ cas y su relación con las recaídas al año en una cohorte de fumadores / No disponible

Objetivos: Analizar la relación entre las recaídas que sufren un grupo de fumadores y las características sociodemográ - cas, de consumo y entorno de los mismos. Material y métodos: Estudio descriptivo prospectivo sobre 1.503 pacientes atendidos en una consulta especializada en tabaquismo durante 10 años, realizando un seguimiento durante 12 meses consecutivos. El programa de tratamiento consistió en una combinación de tratamiento farmacológico y tratamiento conductual. El tratamiento se desarrolló en 7 sesiones individuales: una visita inicial y seis de seguimiento. Resultados: 1503 fumadores, siendo 47,7% hombres (n=716) y 52,3% mujeres (n=787), con una edad media de 49,6 años (DE=11,6). Sufren recaídas, el 71,2% del total, siendo las mujeres (74,9%) las que signi cativamente (p=0,022) presentan más recaídas que los hombres (67,5%). Conclusiones: Son los factores sociodemográ cos por encima de los factores de consumo, entorno o motivacionales, los que determinan y condicionan las recaídas en el proceso de deshabituación tabáquica (AU)

Objective: Analyze the relationship between smokers relapse and sociodemographical, consumptional and environmental characteristics. Patients and methods: Prospective study in 1503 patients who attended a smoking cessation service for along 10 years, and who were followed up during 12 consecutive months. The programe consisted in combination of pharmacological treatment and cognitive-behavioural treatment. This treatment was developed in 7 individual sessions: 1 basal session and 6 follow up visit. Results: 1503 patients were studied.47,7% men (n=716) and women 52,3% (n=787). Mean age 49,6 years (DE=11,6). Suffer relapse 71,2%, and it was the women group which showed signi cativaly more relapse. Conclusions: The sociodemographical factors determine, over consumption and environmental ones, more relapse during smoking cessation (AU)

Influence of prior pneumococcal and influenza vaccination on outcomes of older adults with community-acquired pneumonia.

OBJECTIVES: To determine whether prior pneumococcal and seasonal influenza vaccination improves outcomes in older adults hospitalized for community-acquired pneumonia (CAP). DESIGN: Prospective, observational, multicenter study. SETTING: Five public hospitals providing universal free care to the whole population in three Spanish regions. PARTICIPANTS: Individuals aged 65 and older admitted to the hospital with CAP through the emergency department. MEASUREMENTS: Pneumococcal and influenza vaccination status. The primary study outcomes were intensive care unit (ICU) admission, length of hospital stay (LOS), and overall case-fatality rate. Outcome variables of individuals vaccinated with both vaccines were compared with outcomes of those who were unvaccinated. RESULTS: Two hundred thirty-eight individuals had received 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccination and were compared with 195 unvaccinated individuals. No differences were found with respect to combined antibiotic therapy between groups (38.0% vs 39.7%; P = .80). Similar percentages of vaccinated and unvaccinated individuals required ICU admission (7.2% vs 8.2%; P = .69). Mean LOS was significantly shorter in vaccinated individuals (9.9 vs 12.4 days; P = .04). Overall case-fatality rates were similar in both groups (5.9% vs 5.1%; P = .73). After adjustment, LOS, risk of ICU admission, and overall case-fatality rate were not associated with prior pneumococcal and seasonal influenza vaccination. CONCLUSION: The clinical outcomes of vaccinated older adults hospitalized with CAP were not better than those observed in unvaccinated individuals.

Influence of socioeconomic status on community-acquired pneumonia outcomes in elderly patients requiring hospitalization: a multicenter observational study.

BACKGROUND: The associations between socioeconomic status and community-acquired pneumonia outcomes in adults have been studied although studies did not always document a relationship.The aim of this multicenter observational study was to determine the association between socioeconomic status and community-acquired pneumonia outcomes in the elderly, in the context of a public health system providing universal free care to the whole population. METHODS: A total of 651 patients aged > or =65 years hospitalized due to community-acquired pneumonia through the emergency departments of five Spanish public hospitals were recruited and followed up between May 2005 and January 2007. The primary outcomes studied were: length of stay, intensive care unit admission, overall mortality and readmission. Socioeconomic status was measured using both individual and community data: occupation [categorized in six social groups (I, II, III, IVa, IVb and V)], educational level (< or = primary level or > or = secondary level) and disposable family income of the municipality or district of residence [>12,500 euro (high municipality family income) and < or =12,500 euro (low municipality family income)]. The six social groups were further categorized as upper/middle social class (groups I-IVb) and lower class (group V).Bivariate and multivariate analyses were performed. OR and their 95% confidence intervals were calculated. All statistical tests were two tailed and statistical significance was established as p < 0.05. RESULTS: 17.7% of patients lived in a municipality or district with a high municipality family income and 63.6% were upper/middle social class (I-IVb). Only 15.7% of patients had a secondary education. The adjusted analysis showed no association between pneumonia outcomes and social class, educational level or municipality family income. However, length of stay increased significantly in patients in whom the factors, living alone and being a smoker or ex-smoker coincided (p < 0.001). CONCLUSIONS: We measured socioeconomic status using both individual and community data and found no association between social class, educational level or municipality family income and the variables of pneumonia outcomes. The lack of differences between social classes supports the provision of universal, equitable health care by the public health system.

Validity of self-reported pneumococcal vaccination status in the elderly in Spain.

The objective of this study was to evaluate the validity of information reported by the elderly on 23-valent pneumococcal polysaccharide vaccine (23vPPV) vaccination status. A cross-sectional, observational study was carried out in patients aged >or=65 years admitted to five Spanish hospitals. Data on 23vPPV vaccination history were obtained through interview of the patient or close relative and review of written medical information. The validity of the patient self-report was compared to the written medical information by calculation of the sensitivity, specificity, concordance, positive predictive value (PPV) and negative predictive value (NPV). A total of 2484 patients were initially included of whom 1814 patients (73%) responded about their vaccination status. The global sensitivity of the patient self-report was 0.74 and the specificity 0.95. The PPV was 0.92, the NPV 0.84 and the concordance 87. Vaccination cards and centralized vaccination registries in primary health care centres and hospitals should be potentiated in order to ensure that neither more nor less vaccinations are administered than are necessary.