Summary
The relation between age and mortality after hip fracture was analyzed in elderly patients. 5.5% of the 31,884 patients died. Compared to those 65–74 years old, the multivariate OR for ...mortality for those 75–84 and ≥85 were 2.11 (95% CI: 1.61–2.77) and 4.10 (95% CI: 3.14–5.35).
Purpose
To analyze the impact of Elixhauser comorbidities on the relation between age and mortality after hip fracture in elderly patients.
Methods
Cross-sectional study of the population ≥65 years old hospitalized in Spain in 2013 with a diagnosis of fall-related hip fracture in the Basic Minimum Set Data (BMSD). The impact of Elixhauser comorbidities on the association between mortality and age groups (65–74, 75–84, ≥85) was analyzed by logistic regression models with progressive adjustment for demographic variables and comorbidities introduced individually.
Results
We identified 31,884 patients, 5.5% of which died during hospitalization. Compared with those 65–74 years old, the multivariate OR of mortality for those 75–84 and ≥85 years old decreased from 2.23 (95% CI: 1.71–2.90) and 4.57 (95% CI: 3.54–5.90) to 2.11 (95% CI: 1.61–2.77) and 4.10 (95% CI: 3.14–5.35), respectively after adjustment for comorbidities. The OR of mortality for men was 1.77 (95% CI: 1.58–1.98) compared to women. The comorbidities with higher OR for mortality were congestive heart failure (OR: 3.88; 95% CI: 3.42–4.41), metastasis (OR: 3.44; 95% CI: 2.27–5.20), fluid and electrolyte disorders (OR: 2.95; 95% CI: 2.47–3.52), coagulation deficiencies (OR: 2.87; 95% CI: 2.08–3.96), and liver disease (OR: 2.40; 95% CI: 1.82–3.17).
Conclusions
The association between age and mortality after hip fracture remains after adjusting for numerous comorbidities. However, some potentially controllable disorders are associated with an increased risk for mortality, thus, improving their management could benefit survival.
Hepatitis C is an important public health problem about which there is currently scarce epidemiological information. The objective of this study is to describe and analyse the demographic and ...epidemiological characteristics of hospitalized cases of hepatitis C in the Spanish population between 2004 and 2013.
The study uses the Hospital Discharge Records Database of the Spanish National Health System. It is a retrospective descriptive epidemiological study. The variables analysed were year of infection, age, sex, diagnostic category, days admitted and co-morbidity.
There have been a total of 351,996 hospitalizations; 225,138 men (64%) and 126,858 women (36%). They are divided between acute hepatitis 8161 (2.3%); chronic hepatitis 325,185 (92.4%) and unspecified hepatitis 18,650 (5.3%). The mean age for men is 53.7 (+/-15.2) and for women 62.3 (+/-17.3). 22.8% also present with an Human immunodeficiency virus (HIV) disease coinfection, and 14.7% with opioid dependencies. The trend is for a gradual increase in cases without statistical significance.
The Hepatitis C cases hospitalized had high levels of chronicity, which entails two distinct patterns of illness in men and women - who are affected in different age ranges.
In 2005 and 2006 an outbreak of disease associated with border disease virus (BDV) infection caused high mortality in the Pyrenean chamois (
Rupicapra pyrenaica) in the Catalan Pyrenees (NE Spain). ...The aim of this study was to determine values for different haematological and serum biochemical analytes in 32 free-ranging Pyrenean chamois affected by the disease and to compare them with those obtained from healthy chamois.
In the affected chamois red blood cell counts, haemoglobin concentrations, packed cell volumes, mean corpuscular volumes and lymphocyte counts were all lower, while the neutrophil and platelet counts were higher. Glucose, lactate, triglycerides, creatinine, total protein concentrations and alkaline phosphatase activity were also lower, in contrast to the concentrations of total bilirubin, urea and aspartate aminotransferase activity, which were higher.
Most of the observed changes could be associated with cachexia and inflammation in the affected chamois. Lymphopenia could be directly related to the BDV, which would lead to immunosuppression and explain the high rate of secondary infection observed in these animals.
•Three out of four persons disabled by road traffic crashes suffer from mild disability.•The moderate/severe disability rate on the Capacity Severity Index is 0.6 per thousand for ages >16 years, ...decreasing to 0.4 per thousand on the Performance Severity Index.•Mental and nervous system impairments are associated with greater severity of disability.•The majority of moderately/severely/completely disabled persons need technical aids, personal assistance and family support.•Having moderate/severe disability leads to a fourfold increase in the probability of being retired/unfit for work.
The severity of disability related to road traffic crashes has been little studied, despite the significant health and socio-economic impacts that determine victims’ quality of life.
To estimate the consequences of road traffic crashes on the severity of disability, in terms of individuals’ capacity to execute activities and perform tasks in their current environment, using aids.
Cross-sectional study conducted on community-dwelling participants in the “2008 National Survey of Disability”, with data on 91,846 households having 20,425 disabled persons, 443 of whom had disability due to road traffic crashes. We measured severity using two indicators, i.e., the Capacity (CSI) and Performance (PSI) Severity Indices.
The highest proportion of disability was mild (CSI=70.5%; PSI=80.8%), while 7.6% (CSI) and 4.9% (PSI) was severe/complete respectively. The moderate/severe disability rate was 0.6 per thousand on the CSI, decreasing to 0.4 per thousand on the PSI. No differences were observed by age or sex. Moderate/severely disabled persons had a fourfold higher probability of being retired or unfit for work. Mental and nervous system impairments were more closely related to moderate/severe/complete problems of capacity and performance (p<0.001), disability for carrying out general tasks and demands, and interpersonal interactions and relationships (p<0.001). Being permanently bedridden (p<0.001), receiving aids (p<0.001), family support (p<0.05) and moving home (p<0.05) increased with an increase in the level of severity.
Road traffic crashes mainly cause mild disability. Moderate/severe disability is associated with lower work capacity, greater functional dependence, and increased need of aids, moving home and family support.
In the original publication, all the collaborator names were incorrectly tagged and published online. The correct given and family names for the collaborators names should list as follows.
Background and importanceThe response and the toxicity profile associated with capecitabine treatment shows great interindividual variability. The study of genetic polymorphisms of genes involved in ...the metabolism of capecitabine could help to predict the response and toxicity to breast cancer treatment.Aim and objectivesTo evaluate both the response and toxicity of patients with breast cancer treated with capecitabine, as well as its relation to some genetic polymorphisms of genes involved in the metabolism of capecitabine (UMPS, TYMP and UPB1).Material and methodsA prospective observational study was conducted during 2021 in a third-level hospital. The study had been approved by the Ethics and Clinical Research Committee of the Hospital with the prior informed consent of the patients for their inclusion in the study. Clinical and demographic characteristics were obtained by reviewing the clinical history of the patients. The response was evaluated according to the RECIST 1.1 criteria and toxicities were categorised according to version 5.0 of the CTCAE. A DNA extraction was performed from swabs with saliva samples using a QIAamp DNA Mini Kit. Genetic markers were analysed via OpenArray by QuantStudio 12K Flex System using the ‘TaqMan PGx Express’ array. The relation between demographic and clinical variables and polymorphisms with response and toxicity to treatment with capecitabine were studied using bivariate analysis with R software 4.1.1 version.Results63 patients were treated in 2021. The evaluation of the response (n=38) resulted in complete response: 13.16% (n=5), partial response: 10.53% (n=4), stable disease: 10.53% (n=4) and progessive disease: 65.79% (n=25). An association was observed between the nulliparity (p=0.037, OR 7.2, IC95% 0.96 to 67.19) of the patients and the response to capecitabine, as well as between estrogen (p=0.024, OR 4.11, IC95% 1.15 to 15.22) and progesterone (p=0.006, OR 5.71, IC95% 1.62 to 23.84) receptors with the appearance of toxicity after treatment. No association was found between any of the studied polymorphisms with response or toxicity to capecitabine therapy.Conclusion and relevanceThe results suggest that there is no relevant relation between the genetic variants analysed with the response and toxicity to capecitabine therapy. However, this result partly resembles that reflected by other studies. A larger study with a bigger patient cohort is required in order to obtain meaningful results.References and/or acknowledgementsNoneConflict of interestNo conflict of interest
Background and ImportanceAtopic dermatitis (AD) is a chronic inflammatory skin disease characterised by severe pruritus, eczema and xerosis. A systemic treatment option for moderate-severe AD is ...tralokinumab, a human monoclonal antibody targeting IL-13.Aim and ObjectivesThe aim of the study is to evaluate the effectiveness and safety of tralokinumab in patients with moderate-severe AD in three tertiary hospitals.Material and MethodsObservational, retrospective, multicentred study of patients treated with tralokinumab from April 2022 to September 2023. Variables collected: age, sex, previous treatments, initiation and duration of treatment, adverse effects (AE) and the severity of AD was analysed using the scales: Eczema Area and Severity Index (EASI) and Body Surface Area (BSA).Effectiveness was evaluated assessing the number of patients with a reduction of at least 50% or 75% in the values of EASI (EASI50 and EASI75, respectively) and number of patients with a reduction in BSA, during week 16 approximately. Sources of information: application of electronic prescription Prisma® and computerised clinical history Diraya®.ResultsWe included 39 patients, of whom 32 (18 women, 14 men) had reached week 16 of treatment or higher, with an average age of 37.63 years (range 16–66 years) and with a median follow-up of 26.6 weeks. All received previous treatment with topical corticosteroids and cyclosporine, 11 had received treatment with dupilumab and 6 with JAK inhibitors.The basal medium of EASI was 27.05 and after the assessment carried out, 33% (13/39) achieved EASI50 and 23% (9/39) EASI75. With a median dermatologist assessment of 20 weeks, the number of patients remaining on EASI50 was 11 and on EASI75 9. The basal median of BSA was 21, where 3 (8%) patients suffered an increase and 17 (44%) reduced it, reaching 7 of them to values of 0–1. 15 patients (38%) discontinued treatment, 14 due to lack of efficacy and 1 due to AE.Four patients with AD were reported: syncope, respiratory infection, headache and conjunctivitis together with generalised xerosis, whose patient had to discontinue treatment.Conclusion and RelevanceTralokinumab is an innovative alternative in patients with moderate-severe AD refractory to other therapies. More data on long-term efficacy and safety are needed.References and/or AcknowledgementsConflict of InterestNo conflict of interest.
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