ABSTRACT
INTRODUCTION AND OBJECTIVES: To help to illustrate the trends in isolated surgical aortic valve replacement (SAVR) in Spain, we performed a national-level analysis to investigate the changes from 1998 to 2017 in a) SAVR volume, b) patients' risk profiles, c) in-hospital mortality, and d) types of aortic valve prostheses. METHODS: We included all episodes of patients undergoing isolated SAVR from January 1998 to December 2017 recorded in the Minimum Basic Data Set (Ministry of Health, Consumer Affairs, and Social Welfare, Spain). The study duration was divided into four 5-year periods. We analyzed the trends in SAVR volume, comorbidity prevalence, and in-hospital mortality. Through multivariate logistic regression, we identified factors associated with mortality and type of prosthesis. The risk-adjusted mortality rate was compared over the study period. RESULTS: In total, 73 668 patients underwent an isolated SAVR from 1998 to 2017. The annual volume of procedures increased from 16 363 between 1998 and 2002 to 22 685 between 2013 and 2017. The prevalence of all investigated comorbidities increased, except for history of previous myocardial infarction and unplanned admission. The Charlson comorbidity index worsened from 1998-2002 (2.3; SD, 1.4) to 2013-2017 (3.6; SD, 1.7) (P <.001). In-hospital mortality decreased from 7.2% to 3.3% (P <.001) while the risk-adjusted mortality index improved from 1.3 to 0.7. The proportion of bioprostheses increased from 20.7% (1998-2002) to 59.6% (2013-2017) (P <.001). CONCLUSIONS: We detected an increase in the annual SAVR volume in Spain, with more patients receiving bioprostheses. Despite an increased risk profile of the patients, in-hospital mortality substantially reduced.
Subject(s)
Aortic Valve Stenosis , Heart Valve Prosthesis Implantation , Transcatheter Aortic Valve Replacement , Aortic Valve/surgery , Aortic Valve Stenosis/surgery , Hospital Mortality , Humans , Risk Factors , Spain/epidemiology , Treatment OutcomeABSTRACT
La ludopatía es considerada como una patología, una adicción que altera ostensiblemente el comportamiento del individuo con consecuencias negativas en la propia persona, su entorno y la sociedad. Objetivo: Establecer la relación entre los niveles de integración familiar y la práctica de juegos de azar en población de 12 a 64 años. Métodos: Análisis secundario de la III Encuesta Nacional de Consumo de Drogas en la Población General de Perú 2006 (Comisión Nacional para el Desarrollo y Vida sin Drogas - DEVIDA). Se incluyó a las personas entre 12 y 64 años de edad residentes habituales de zonas urbanas del país. La práctica de juegos de azar se caracterizó analizando el módulo XV de la encuesta (preguntas 122 a 125). La integración familiar se analizó a partir del módulo V de la encuesta (preguntas 12 a 18). Resultados: El promedio de edad en la muestra estudiada fue 34.2±14.4 años. Predominó el sexo femenino (56.8%); el estado civil más frecuente fue soltero (42.7%); con secundaria completa o incompleta (49.9%); la mayoría de entrevistados vivía en una vivienda con un solo hogar (90.3%). El 50.5% percibe su integración familiar como media y el 25.6% considera que su integración familiar es baja. La prevalencia de vida de práctica de juegos de azar en la muestra estudiada fue 37.5% y la prevalencia de año el 19.6%. Los indicadores de riesgo de dependencia a los juegos de azar, figuran el jugar para ganar dinero y poder pagar deudas (11.3%), el terminar jugando a pesar de tener la intención de no hacerlo (11.2%) y tener la urgencia de volver a jugar para ganar más después de haber ganado dinero en el juego (10.2%). Las personas con alta integración familiar presentan 19% menos probabilidad de haber practicado alguna vez en su vida juegos de azar, en comparación a quienes presentan una integración familiar media (OR= 0.810, IC95% 0.806 a 0.815), y 32% menos probabilidad en comparación a quienes presentan una integración familiar...
Pathological gambling is considered a disease, an addiction that alters individual behavior ostensibly with negative consequences on one's person, his environment and society. Objective: To establish the relationship between levels of family integration and practice of gambling population aged 12 to 64 years. Methods: Secondary analysis of the Third National Survey on Drug Use in General Population of Peru 2006 (Comisión Nacional para el Desarrollo y Vida sin Drogas - DEVIDA). The study included people between 12 and 64 years of age habitually resident in urban areas of the country. The practice of gambling was characterized by analyzing the module XV of the survey (questions 122 to 125). Family integration was analyzed from the module V of the survey (questions 12 to 18). Results: The average age in this sample was 34.2 ± 14.4 years. Women were 56.8%, the most common marital status was single (42.7%), with complete or incomplete secondary education (49.9%), most respondents lived in a home with a single household (90.3%). 50.5% perceived their family integration on average and 25.6% said their family integration is low. The lifetime prevalence of practice of gambling in this sample was 37.5% and the year prevalence was 19.6%. Risk indicators of dependence on gambling include playing to earn money to pay debts (11.3%), not ending game despite having the intention to do so (11.2%) and having the urge to return play to earn more money after winning the game (10.2%). People with high family integration were 19% less likely to have practiced gambling some time in his life, compared to those with an average family integration (OR = 0.810, 95% from 0,806 to 0815), and 32% less likely compared to those with low family integration (OR = 0.681, 95% from 0,677 to 0684). Conclusions: There is an inverse relationship between the level of family integration and practice of gambling in the peruvian population 12 to 64 years old.
Subject(s)
Humans , Male , Adolescent , Adult , Female , Young Adult , Middle Aged , Gambling , Family Relations , PeruABSTRACT
OBJECTIVES: The authors sought to find out whether certain Webometric indexes of a sample of pediatric Web resources, and some tests based on them, could be helpful predictors of their disappearance. METHODS: The authors performed a retrospective study of a sample of 363 pediatric Websites and pages they had followed for 4 years. Main measurements included: number of resources that disappeared, number of inbound links and their annual increment, average daily visits to the resources in the sample, sample compliance with the quality criteria of 3 international organizations, and online time of the Web resources. RESULTS: On average, 11% of the sample disappeared annually. However, 13% of these were available again at the end of follow up. Disappearing and surviving Websites did not show differences in the variables studied. However, surviving Web pages had a higher number of inbound links and higher annual increment in inbound links. Similarly, Web pages that survived showed higher compliance with recognized sets of quality criteria than those that disappeared. A subset of 14 quality criteria whose compliance accounted for 90% of the probability of online permanence was identified. Finally, a progressive increment of inbound links was found to be a marker of good prognosis, showing high specificity and positive predictive value (88% and 94%, respectively). CONCLUSIONS: The number of inbound links and annual increment of inbound links could be useful markers of the permanence probability for pediatric Web pages. Strategies that assure the Web editors' awareness of their Web resources' popularity could stimulate them to improve the quality of their Websites.
Subject(s)
Information Services/statistics & numerical data , Information Storage and Retrieval/statistics & numerical data , Internet/statistics & numerical data , Patient Education as Topic/standards , Pediatrics/standards , Humans , Information Services/standards , Information Storage and Retrieval/standards , Internet/standards , Quality Assurance, Health Care/statistics & numerical data , ROC Curve , Retrospective StudiesABSTRACT
OBJECTIVE: Little is known about the ability of internet users to distinguish the best medical resources online, and how their preferences, measured by usage and popularity indexes, correlate with established quality criteria. Our objective was to analyse whether the number of inbound links and/or daily visits to a sample of paediatric web pages are reliable quality markers of the pages. DESIGN: Two-year follow-up study of 363 web pages with paediatric information. MEASUREMENTS: The number of inbound links and the average number of daily visits to the pages were calculated on a yearly basis. In addition, their rates of compliance with the codes of conduct, guidelines and/or principles of three international organizations were evaluated. RESULTS: The quality code most widely met by the sample web pages was the Health on the Net Foundation Code of Conduct (overall rate, 60.2%). Sample pages showed a low degree of compliance with principles related to privacy, confidentiality and electronic commerce (overall rate less than 45%). Most importantly, we observed a moderate, significant correlation between compliance with quality criteria and the number of inbound links (p < 0.001). However, no correlation was found between the number of daily visits to a page and its degree of compliance with the principles. CONCLUSIONS: Some indexes derived from the analysis of webmasters' hyperlinks could be reliable quality markers of medical web resources.
