Short-Term Effect of a Health Promotion Intervention Based on the Electronic 12-Hour Dietary Recall (e-12HR) Smartphone App on Adherence to the Mediterranean Diet Among Spanish Primary Care Professionals: Randomized Controlled Clinical Trial.

BACKGROUND: The World Health Organization has called for addressing the growing burden of noncommunicable diseases (NCDs) by promoting healthy lifestyles among the population. Regarding patient health, primary care professionals (PCPs) are the first line of care who can positively influence patients' behavior and lifestyle habits. However, a significant percentage of PCPs do not lead a healthy lifestyle. Therefore, addressing their health behaviors may be the key to substantially increasing health promotion advice in general practice. The Mediterranean diet has been extensively studied, and there is strong evidence of it being a dietary pattern for the prevention of NCDs, in addition to its significant environmental, sociocultural, and local economics benefits. OBJECTIVE: This study focused only on the dietary aspect of the PCPs' lifestyle. The primary objective was to evaluate the effect of using the Electronic 12-Hour Dietary Recall (e-12HR) smartphone app to improve diet, specifically to promote adherence to the Mediterranean diet (AMD), among PCPs. The secondary objectives were to establish the usability of the e-12HR app and to determine AMD among PCPs. METHODS: An individual-level randomized, controlled, and single-blind clinical trial was conducted with 2 parallel groups: a control group (CG), using the nonfeedback version of the e-12HR app, and an intervention group (IG), using the feedback version of the e-12HR app. The level of human involvement was fully automated through the use of the app. There was a 28-day follow-up period. Participants were PCPs (medicine or nursing) recruited offline at one of the selected primary care centers (Andalusia, Spain, Southern Europe), of both sexes, over 18 years old, possessing a smartphone, and having smartphone literacy. RESULTS: The study response rate was 73% (71 of 97 PCPs), with 27 (38%) women and 44 (62%) men: 40 (56%) PCPs in the CG and 31 (44%) in the IG. At baseline, AMD was medium (mean Mediterranean Diet Serving Score [MDSS] index 9.45, range 0-24), with 47 (66%) PCPs with a medium/high MDSS index. There were significant statistical improvements (CG vs IG, in favor of the IG) at week 4 (no significant statistical differences at baseline): +25.6% for the MDSS index (P=.002) and +213.1% for the percentage with a medium/high MDSS index (P=.001). In relation to specific food groups, there were significant statistical improvements for fruits (+33.8%, P=.02), vegetables (+352%, P=.001), nuts (+184%, P=.02), and legumes (+75.1%, P=.03). The responses to the usability rating questionnaire were satisfactory. CONCLUSIONS: The results support recommending the use of the e-12HR app as a tool to contribute to improving diet and preventing NCDs among PCPs, while positively influencing patient dietary behavior and preventing diet-related NCDs among patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT05532137; https://clinicaltrials.gov/study/NCT05532137.

Temporal Evolution and Associated Factors of Adherence to Mammography Screening among Women in Spain: Results from Two National Health Surveys (2017-2020).

Ensuring equity in cancer screening is recommended by the European Commission. Despite the fact that breast cancer screening is a free population-based program in Spain, there remains considerable variation in the adherence to screening rate among population groups. This study was designed to describe the adherence of breast cancer screening in women in Spain, to evaluate the evolution in the period from 2017 to 2020, and to determine the variables that influence choosing to undergo breast cancer screening. A nationwide cross-sectional study with 7220 females aged 50-69 years from the 2017 Spanish National Health Survey and the 2020 European Health Survey for Spain was performed. We investigated mammography uptake rates, with socio-demographic factors, lifestyle habits, and health-related characteristics as independent variables. Multivariable logistic regression was used to identify the associated factors of mammography adherence. Of the women, 78% had undergone mammography in the previous two years, and there was a significant decrease in the uptake rate for breast cancer screening from 2017 (81.23%) to 2020 (74.68%) (p < 0.001). Educational level, marital status, residential location, nationality, smoking status, alcohol consumption, and leisure-time physical activity were all associated factors of mammography uptake.

Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial.

There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these technologies. The objective is to evaluate the effectiveness of an app (e-12HR) at improving AMD in a sample of Spanish university students and different strata. The study method was a controlled and randomized clinical trial over a four-week follow-up period and involving 385 participants (76.9% women). The participants were in two parallel groups: the control group (CG) and the intervention group (IG), with only the IG receiving feedback to improve their AMD. There were significant statistical improvements (with higher values in the IG) at week four, after no significant statistical differences at baseline (Week One): in the whole sample: +25.7% AMD index and +74.5% percentage with moderate/high AMD index. In the subgroups, seven of eight subgroups, ranging in AMD index from +17.8% (≥20 years) to +33.0% (<20 years); and for males, in weeks two (+27.9%) and three (+23.9%), but not at week four. In conclusion, e-12HR could improve AMD among university students (in the total sample and all subgroups, except ≥25 kg/m2).

Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study.

Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence to the MD (AMD) in university students. This study was a controlled, randomized, and multicentric clinical trial with two parallel groups (control group (CG) and intervention group (IG)), a 28-day follow-up period, and 286 participants (74.1% women). There were two versions of e-12HR: 'feedback' e-12HR (IG) and 'non-feedback' e-12HR (CG). Only the 'feedback' e-12HR had two specific automatic functions: 1. Evaluation of the user's AMD; 2. Identification of the food groups for which the user has not fulfilled the MD recommendations. Both versions of the application allowed the collection of data on dietary intake in order to calculate the AMD. When comparing CG and IG at 14-, 21-, and 28-days follow-up (no significant statistical differences at baseline), there were significant statistical improvements in favor of IG in AMD index (0.71, 1.56, and 1.43 points, respectively), and in the percentage of participants with medium/high AMD index (14.4%, 20.6%, and 23.7%, respectively). In conclusion, e-12HR could improve AMD among university students.

Weekend-Weekday Differences in Adherence to the Mediterranean Diet among Spanish University Students.

Daily routines may influence eating patterns; however, differences in intake on weekdays and at weekends have rarely been explored. Furthermore, these differences have not been analyzed among university students (a particularly interesting group among the younger generations). The aim of the study was to evaluate weekend−weekday variation in the Mediterranean diet among Spanish university students, while investigating the potential influence of age, gender, studies, body mass index, smoking status and physical activity status. A repeated-measurement 28-day cross-sectional observational study with self-reported dietary intake collected using the e12HR app was conducted. There were 361 participants: average age 20.6 years; 72.9% women; 58.2% students of Pharmacy; average BMI 21.9 kg/m2; 91.4% nonsmokers; 77.6% performed ≥150 min/week of physical activity. Outcome measurements were adherence to the Mediterranean diet (AMD) index and percentage of participants meeting recommendations for each food group on weekdays and at weekends. In all subgroups, Spanish university students' global diet was associated with low AMD, with poorer diet quality (>12% reductions in mean scores of AMD index and >26% reductions in adequate adherence scores (≥9)) at weekends. In conclusion, weekend health behaviors of Spanish university students displayed less favorable eating behavior, making the weekend an important target for public health interventions aiming to improve dietary intake.

Relative Validity of a Method Based on a Smartphone App (Electronic 12-Hour Dietary Recall) to Estimate Habitual Dietary Intake in Adults.

BACKGROUND: Accurate dietary assessment is key to understanding nutrition-related outcomes and for estimating the dietary change in nutrition-based interventions. When researching the habitual consumption of selected food groups, it is essential to be aware of factors that could possibly affect reporting accuracy. OBJECTIVE: This study aimed to evaluate the relative validity of the current-day dietary recall, a method based on a smartphone app called electronic 12-hour dietary recall (e-12HR), to categorize individuals according to habitual intake, in the whole sample of adults and in different strata thereof. METHODS: University students and employees over 18 years recorded the consumption of 10 selected groups of food using e-12HR during 28 consecutive days. During this period, they also completed 4 dietary records. Once the period was finished, the subjects then completed a food frequency questionnaire (FFQ) and a usability-rating questionnaire for e-12HR. The food group intakes estimated by the e-12HR app, the dietary records, and the FFQ were categorized into sextiles: less than once a week, once or twice a week, 3-4 times a week, 5-6 times a week, once or twice a day, and 3 or more times a day. The 10 selected groups with e-12HR were compared with 4 dietary records and an FFQ reference method, in the whole sample and in different strata thereof: age (years): <25 and ≥25; gender: females and males; occupation: students and employees; smoking: no and yes; physical activity (minutes/week): ≥150 and <150; and body mass index (kg/m2): <25 and ≥25. The association between the different methods was assessed using Spearman correlation coefficient (SCC). Cross-classification and kappa statistic were used as a measure of agreement between the different methods. RESULTS: In total, 203 participants completed the study (56.7% [115/203] women, and 43.3% [88/203] men). For all food groups and all participants, the mean SCC for e-12HR versus FFQ was 0.67 (≥0.62 for all strata). On average, 50.7% of participants were classified into the same category (≥47.0% for all strata) and 90.2% within the nearest category (≥88.6% for all strata). Mean weighted kappa was 0.49 (≥0.44 for all strata). For e-12HR versus RDs, mean SCC was 0.65 (≥0.57 for all strata). On average, 50.0% of participants were classified into the same category (≥47.0% for all strata) and 88.2% within the nearest category (≥86.1% for all strata). Mean weighted kappa was 0.50 (≥0.44 for all strata). CONCLUSIONS: The results indicate that e-12HR generated categories of dietary intake highly comparable with the 2 reference methods in the whole sample and in different strata thereof. The inclusion of photographs to facilitate estimation of the servings consumed generated correlation/agreement data between e-12HR and the FFQ that were similar to a previous study using an older version of the app, which did not include photographs.

Electronic 12-Hour Dietary Recall (e-12HR): Comparison of a Mobile Phone App for Dietary Intake Assessment With a Food Frequency Questionnaire and Four Dietary Records.

BACKGROUND: One of the greatest challenges in nutritional epidemiology is improving upon traditional self-reporting methods for the assessment of habitual dietary intake. OBJECTIVE: The aim of this study was to evaluate the relative validity of a new method known as the current-day dietary recall (or current-day recall), based on a smartphone app called 12-hour dietary recall, for determining the habitual intake of a series of key food and drink groups using a food frequency questionnaire (FFQ) and four dietary records as reference methods. METHODS: University students over the age of 18 years recorded their consumption of certain groups of food and drink using 12-hour dietary recall for 28 consecutive days. During this 28-day period, they also completed four dietary records on randomly selected days. Once the monitoring period was over, subjects then completed an FFQ. The two methods were compared using the Spearman correlation coefficient (SCC), a cross-classification analysis, and weighted kappa. RESULTS: A total of 87 participants completed the study (64% women, 56/87; 36% men, 31/87). For e-12HR versus FFQ, for all food and drink groups, the average SCC was 0.70. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 51.5%; exact agreement + adjacent was 91.8%, and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.51. For e-12HR versus the four dietary records, for all food and drink groups, the average SCC was 0.63. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 47.1%; exact agreement + adjacent was 89.2%; and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.47. CONCLUSIONS: Current-day recall, based on the 12-hour dietary recall app, was found to be in good agreement with the two reference methods (FFQ & four dietary records), demonstrating its potential usefulness for categorizing individuals according to their habitual dietary intake of certain food and drink groups.

Valoración de la ingesta dietética mediante la aplicación e-EPIDEMIOLOGÍA: comparación con un cuestionario de frecuencia de consumo de alimentos en una muestra de trabajadores / Evaluation of dietary intake using the e-EPIDEMIOLOGY app: comparison with a food frequency questionnaire in a sample of workers

Antecedentes: Las nuevas tecnologías abren nuevas posibilidades para mejorar los métodos convencionales de determinación de la dieta. Objetivos: Comparar los datos de ingesta habitual obtenidos con una aplicación para teléfono móvil (e-EPIDEMIOLOGÍA) con los recogidos mediante un cuestionario de frecuencia de consumo de alimentos (CFCA) previamente validado. Material y métodos: Trabajadores andaluces de 26-68 años usaron e-EPIDEMIOLOGÍA durante 28 días y rellenaron un CFCA (en papel) al final del periodo de estudio. El grado de acuerdo entre las categorías de consumo habitual para los alimentos/bebidas estudiados fue evaluado mediante coeficiente de correlación de Spearman (CCS), análisis de clasificación cruzada e índice kappa ponderado (K). Resultados: 68 participantes completaron el estudio. CCS mostró alta La cita de este artículo es: O A Reyes et al. Valoración de la ingesta dietética mediante la aplicación e-EPIDEMIOLOGÍA: comparación con un cuestionario de frecuencia de consumo de alimentos en una muestra de trabajadores asociación (0,63). Análisis de clasificación cruzada mostró que el 87,8% de los sujetos estaban clasificados correctamente (misma categoría o categoría adyacente). K indicó una concordancia aceptable (0,46). Discusión: Los resultados indican que e-EPIDEMIOLOGÍA presenta buen acuerdo con el CFCA (AU)

Background: New technologies open up new possibilities for improving conventional methods for determining dietary intake. Objectives: To compare the usual intake data obtained with a mobile phone application (e-EPIDEMIOLOGY) with those collected using a previously validated Food Consumption Frequency Questionnaire (CFCA). Material and methods: Andalusian workers aged 26-68 used e-EPIDEMIOLOGY for 28 days and filled out a CFCA (paper) at the end of the study period. The degree of agreement between the categories of habitual consumption for the foods/drinks studied was evaluated using Spearman’s correlation coefficient (SCC), cross-classification analysis and weighted kappa index (K). Results: 68 participants completed the study. SCC showed high association (0.63). Cross-classification analysis showed that 87.8% of the subjects were correctly classified (same category or adjacent category). K indicated an acceptable concordance (0.46). Discussion: The results indicate that e-EPIDEMIOLOGY has a good agreement with the CFCA (AU)

Is there any alternative to traditional food frequency questionnaire for evaluating habitual dietary intake?

INTRODUCTION: Dietary assessment methods are an important instrument for nutrition research. Food frequency questionnaires (FFQs) have been the most frequently used dietary assessment tool in epidemiological and intervention studies. There is a great necessity for new methods of determination of habitual dietary intake that overcome the limitations of these traditional methods. OBJECTIVES: The objectives of the present study were to develop a new method, based on an application for mobile phones called e-EPIDEMIOLOGY, designed to record individual consumption data about a short series of foods/drinks, and to compare data collected using this tool with those obtained from a previously validated short paper FFQ. METHODS: University students over 18 years recorded the consumption of certain foods/drinks using e-EPIDEMIOLOGY during 28 consecutive days and then filled out a short paper FFQ at the end of the study period. To evaluate the agreement between both methods, Spearman's correlation coefficient, cross-classification analysis and a weighted kappa statistic were used. RESULTS: One hundred and nineteen participants completed the study (71.4% female and 28.6% male). The mean Spearman's correlation coefficients for food/drink group intake between the two methods was 0.73. The mean percentage of participants cross-classified into categories of "exact agreement + adjacent" was 91.6%. The average weighted kappa statistic was 0.60. CONCLUSIONS: The results indicate that e-EPIDEMIOLOGY has good agreement with the previously validated FFQ short paper. However, it was noted that further testing of e-EPIDEMIOLOGY is required to establish its wider utility.

First evaluation steps of a new method for dietary intake estimation regarding a list of key food groups in adults and in different sociodemographic and health-related behaviour strata.

OBJECTIVE: A new method known as 'current-day dietary recall' (current-day recall) is based on an application for mobile phones called 'electronic 12 h dietary recall' (e-12HR). This new method was designed to rank participants into categories of habitual intake regarding a series of key food groups. The present study compared current-day recall against a previously validated short paper FFQ. DESIGN: Participants recorded the consumption of selected food groups using e-12HR during twenty-eight consecutive days and then filled out a short paper FFQ at the end of the study period. To evaluate the association and agreement between both methods, Spearman's correlation coefficients (SCC), cross-classification analysis and weighted kappa statistics (κ w) were used. SETTING: Andalusia, Spain, Southern Europe. SUBJECTS: University students and employees over the age of 18 years. RESULTS: One hundred and eighty-seven participants completed the study (64·2 % female, 35·8 % male). For all particpants, for all food group intakes, the mean SCC was 0·70 (SCC≥0·62 were observed for all strata); the mean percentage of participants cross-classified into categories of 'exact agreement+adjacent' was 90·1 % (percentages≥87·8 % were observed for all strata); and the mean κ w was 0·55 (κ w≥0·53 in ten of the twelve strata). CONCLUSIONS: For the whole sample and for all strata thereof, the current-day recall has good agreement with the previously validated short paper FFQ for assessing food group intakes, rendering it a useful method for ranking individuals.

Is there any alternative to traditional food frequency questionnaire for evaluating habitual dietary intake? / ¿Hay alguna alternativa al tradicional cuestionario de frecuencia de consumo de alimentos para la evaluación de la ingesta alimentaria habitual?

Introduction: Dietary assessment methods are an important instrument for nutrition research. Food frequency questionnaires (FFQs) have been the most frequently used dietary assessment tool in epidemiological and intervention studies. There is a great necessity for new methods of determination of habitual dietary intake that overcome the limitations of these traditional methods. Objectives: The objectives of the present study were to develop a new method, based on an application for mobile phones called e-EPIDEMIOLOGY, designed to record individual consumption data about a short series of foods/drinks, and to compare data collected using this tool with those obtained from a previously validated short paper FFQ. Methods: University students over 18 years recorded the consumption of certain foods/drinks using e-EPIDEMIOLOGY during 28 consecutive days and then filled out a short paper FFQ at the end of the study period. To evaluate the agreement between both methods, Spearman’s correlation coefficient, cross-classification analysis and a weighted kappa statistic were used. Results: One hundred and nineteen participants completed the study (71.4% female and 28.6% male). The mean Spearman’s correlation coefficients for food/drink group intake between the two methods was 0.73. The mean percentage of participants cross-classified into categories of «exact agreement + adjacent» was 91.6%. The average weighted kappa statistic was 0.60. Conclusions: The results indicate that e-EPIDEMIOLOGY has good agreement with the previously validated FFQ short paper. However, it was noted that further testing of e-EPIDEMIOLOGY is required to establish its wider utility (AU)

Introducción: los métodos de evaluación de la dieta son importantes instrumentos para la investigación nutricional. Los cuestionarios de frecuencia de consumo de alimentos (CFCA) han sido los métodos utilizados con mayor frecuencia en los estudios epidemiológicos y de intervención. Hay una gran necesidad de nuevas herramientas que superen las limitaciones de estos métodos tradicionales. Objetivos: los objetivos del presente estudio fueron desarrollar un nuevo método, basado en una aplicación para teléfonos móviles llamada e-EPIDEMIOLOGY, diseñada para registrar los datos de consumo individual de una serie corta de alimentos/bebidas, y comparar estos datos con los obtenidos a partir de un CFCA corto (en papel) validado previamente. Métodos: estudiantes universitarios mayores de 18 años registraron el consumo de ciertos alimentos/bebidas usando e-EPIDEMIOLOGY durante 28 días consecutivos y cumplimentaron un CFCA corto (en papel) al final del periodo de estudio. Para evaluar el acuerdo entre ambos métodos se utilizaron el coeficiente de correlación de Spearman, el análisis de clasificación cruzada y el kappa ponderado. Resultados: un total de 119 participantes completaron el estudio (71,4% mujeres y 28,6% hombres). El coeficiente de correlación de Spearman medio entre ambos métodos fue 0,73. La media del porcentaje de clasificación cruzada en la categoría de «acuerdo exacto + adyacente» fue 91,6%. La media del kappa ponderado fue 0,60. Conclusiones: los resultados indican que e-EPIDEMIOLOGY tiene buena concordancia con el CFCA corto (en papel) previamente validado. Sin embargo, son necesarias más pruebas con e-EPIDEMIOLOGY para establecer su utilidad de forma más amplia (AU)

The e-EPIDEMIOLOGY Mobile Phone App for Dietary Intake Assessment: Comparison with a Food Frequency Questionnaire.

BACKGROUND: There is a great necessity for new methods of evaluation of dietary intake that overcome the limitations of traditional self-reporting methods. OBJECTIVE: The objective of this study was to develop a new method, based on an app for mobile phones called e-EPIDEMIOLOGY, which was designed to collect individual consumption data for a series of foods/drinks, and to compare this app with a previously validated paper food frequency questionnaire (FFQ). METHODS: University students >18 years of age recorded the consumption of certain foods/drinks using e-EPIDEMIOLOGY during 28 consecutive days and then filled out a paper FFQ at the end of the study period. To evaluate the agreement between the categories of habitual consumption for each of the foods/drinks included in the study, cross-classification analysis and a weighted kappa statistic were used. RESULTS: A total of 119 participants completed the study (71% female, 85/119; 29% male, 34/119). Cross-classification analysis showed that 79.8% of the participants were correctly classified into the same category and just 1.1% were misclassified into opposite categories. The average weighted kappa statistic was good (κ=.64). CONCLUSIONS: The results indicate that e-EPIDEMIOLOGY generated ranks of dietary intakes that were highly comparable with the previously validated paper FFQ. However, it was noted that further testing of e-EPIDEMIOLOGY is required to establish its wider utility.

¿Los trastornos por cocaína asociados al infarto agudo de miocardio son lo mismo que el infarto de miocardio asociado al consumo reciente de cocaína?. Respuesta / Is cocaine-associated acute myocardial infarction the same as myocardial infarction associated with recent cocaine consumption?. Response

No disponible

Epidemiología de los efectos clínico-asistenciales asociados al consumo de cocaína. Respuesta / The epidemiology of the clinical and health effects associated with cocaine. Response

No disponible

Trastornos por cocaína e infarto agudo de miocardio, prolongación de estancias y exceso de costes hospitalarios / Cocaine Use Disorders and Acute Myocardial Infarction, Excess Length of Hospital Stay and Overexpenditure

Introducción y objetivos Analizar la relación entre la prevalencia de trastornos por cocaína y el infarto agudo de miocardio en pacientes ≥ 18 años y su influencia en la mortalidad, la prolongación de estancias y el exceso de costes de los pacientes con infarto agudo de miocardio. Métodos Estudio retrospectivo de los datos del conjunto mínimo básico de datos de 87 hospitales españoles durante 2008-2010.ResultadosSe estudiaron 5.575.325 ingresos, entre los cuales hubo 24.126 pacientes con trastornos por cocaína y 79.076 casos de infarto agudo de miocardio. La prevalencia de infarto agudo de miocardio entre los pacientes con trastornos por cocaína aumentó con la edad, y fue máxima entre los de 55-64 años de edad (p < 0,0001). El análisis multivariable indicó que los trastornos por cocaína son más prevalentes entre los pacientes con infarto agudo de miocardio (odds ratio = 3,0) e independientemente de edad, sexo, otras adicciones y 30 comorbilidades. Entre los pacientes con infarto agudo de miocardio, aquellos con trastornos por cocaína no presentaron mayor mortalidad, pero sí una prolongación indebida de las estancias hospitalarias (1,5 días) y un exceso de costes (382 euros).Conclusiones Hay una asociación entre los trastornos por cocaína y el infarto agudo de miocardio. Estos trastornos prolongan las estancias hospitalarias y aumentan los costes de los pacientes hospitalizados. La interrupción del uso de la droga debe ser uno de los principales objetivos terapéuticos tras el alta del paciente (AU)

Introduction and objectives To investigate the relationship between the prevalence of cocaine use disorders and acute myocardial infarction in patients aged ≥ 18 years and to estimate the influence of cocaine use disorders on mortality, excess length of stay, and overexpenditure among hospitalized patients with acute myocardial infarction. Methods Retrospective study of the minimum basic data set of 87 Spanish hospitals from 2008 to 2010.ResultsAmong 5 575 325 admissions reviewed, there were 24 126 patients with cocaine use disorders and 79 076 cases of acute myocardial infarction. The incidence of acute myocardial infarction among patients with cocaine use disorders increased with age and reached a peak at 55 years to 64 years (P < .0001). Multivariate analysis showed that cocaine use disorders were more prevalent among patients with acute myocardial infarction independently of age, sex, other addictive disorders, and 30 other comorbidities (odds ratio = 3.0). Among patients with acute myocardial infarction, those with cocaine use disorders did not show an increase of in-hospital death, but did show excess length of hospital stay (1.5 days) and overexpenditure (382 euros). Conclusions Cocaine use disorders are associated with acute myocardial infarction and increase the length of hospital stay and overexpenditure among acute myocardial infarction patients. Cessation of cocaine use among these patients should be one of the primary therapeutic goals after hospital discharge(AU)

Cocaine use disorders and acute myocardial infarction, excess length of hospital stay and overexpenditure.

INTRODUCTION AND OBJECTIVES: To investigate the relationship between the prevalence of cocaine use disorders and acute myocardial infarction in patients aged ≥ 18 years and to estimate the influence of cocaine use disorders on mortality, excess length of stay, and overexpenditure among hospitalized patients with acute myocardial infarction. METHODS: Retrospective study of the minimum basic data set of 87 Spanish hospitals from 2008 to 2010. RESULTS: Among 5 575 325 admissions reviewed, there were 24 126 patients with cocaine use disorders and 79 076 cases of acute myocardial infarction. The incidence of acute myocardial infarction among patients with cocaine use disorders increased with age and reached a peak at 55 years to 64 years (P < .0001). Multivariate analysis showed that cocaine use disorders were more prevalent among patients with acute myocardial infarction independently of age, sex, other addictive disorders, and 30 other comorbidities (odds ratio = 3.0). Among patients with acute myocardial infarction, those with cocaine use disorders did not show an increase of in-hospital death, but did show excess length of hospital stay (1.5 days) and overexpenditure (382 euros). CONCLUSIONS: Cocaine use disorders are associated with acute myocardial infarction and increase the length of hospital stay and overexpenditure among acute myocardial infarction patients. Cessation of cocaine use among these patients should be one of the primary therapeutic goals after hospital discharge.

Enfermedad celiaca y trastornos por consumo de alcohol: prolongación de estancias, exceso de costes y mortalidad atribuible / Celiac disease and alcohol use disorders: Increased length of hospital stay, overexpenditures and attributable mortality

Antecedentes y objetivos: los trastornos por consumo de alcohol se han asociado a una mayor incidencia de ciertas comorbilidades entre los pacientes con enfermedad celiaca. En la actualidad no disponemos de información sobre si estos trastornos tienen un impacto en la prolongación de las estancias hospitalarias, mayores costes por estancia y un exceso de mortalidad entre estos pacientes. Métodos: Se hizo un estudio de casos y controles a partir de una muestra de pacientes de 18 o más años de edad hospitalizados durante 2008-2010 en 87 hospitales de España. Las estimaciones de prolongación de estancias, exceso de costes y mortalidad atribuible se calcularon mediante un modelo de análisis multivariante de la covarianza que incluyó edad, género, grupo hospitalario, trastornos por alcohol, trastornos por tabaco y 30 comorbilidades. Resultados: los pacientes de enfermedad celiaca con trastornos por alcohol presentaron una prolongación de estancias de 3,1 días en las mujeres y de 1,7 días en los varones, un exceso de costes por estancia de 838,7 euros en las mujeres y de 389,1 euros en los varones, y un exceso de mortalidad atribuible de 15,1 % en las mujeres y de 12,2 % en los varones. Conclusiones: además de una dieta sin gluten y otras medidas asistenciales, en estos pacientes está indicada la prevención del abuso de alcohol, y los hospitalizados que presentan estos trastornos deberían recibir asistencia especializada tras el alta hospitalaria. La detección e intervención precoz debería intentar prevenir el desarrollo de lesiones orgánicas y no centrarse exclusivamente en varones (AU)

Background and objectives: alcohol use disorders are associated with a greater incidence of certain comorbidities in patients with celiac disease. Currently there is no available information about the impact that these disorders may have on length of hospital stays, overexpenditures during hospital stays, and excess mortality in these patients. Methods: a case-control study was conducted with a selection of patients 18 years and older hospitalized during 2008-2010 in 87 hospitals in Spain. Estimations of excess length of stays, costs, and attributable mortality were calculated using a multivariate analysis of covariance, which included age, gender, hospital group, alcohol use disorders, tobacco related disease and 30 other comorbidities. Results: patients who had both celiac disease and alcohol use disorders had an increased length of hospital stay, an average of 3.1 days longer in women, and 1.7 days longer in men. Excess costs per stay ranged from 838.7 euros in female patients, to 389.1 euros in male patients. Excess attributable mortality was 15.1 % in women, 12.2 % in men. Conclusions: apart from a gluten-free diet and other medical measures, the prevention of alcohol abuse is indicated in these patients. Patients hospitalized who present these disorders should receive specialized attention after leaving the hospital. Early detection and treatment should be used to prevent the appearance of organic lesions and should not be solely focused on male patients (AU)

Celiac disease and alcohol use disorders: increased length of hospital stay, overexpenditures and attributable mortality.

BACKGROUND AND OBJECTIVES: alcohol use disorders are associated with a greater incidence of certain comorbidities in patients with celiac disease. Currently there is no available information about the impact that these disorders may have on length of hospital stays, overexpenditures during hospital stays, and excess mortality in these patients. METHODS: a case-control study was conducted with a selection of patients 18 years and older hospitalized during 2008-2010 in 87 hospitals in Spain. Estimations of excess length of stays, costs, and attributable mortality were calculated using a multivariate analysis of covariance, which included age, gender, hospital group, alcohol use disorders, tobacco related disease and 30 other comorbidities. RESULTS: patients who had both celiac disease and alcohol use disorders had an increased length of hospital stay, an average of 3.1 days longer in women, and 1.7 days longer in men. Excess costs per stay ranged from 838.7 euros in female patients, to 389.1 euros in male patients. Excess attributable mortality was 15.1 % in women, 12.2 % in men. CONCLUSIONS: apart from a gluten-free diet and other medical measures, the prevention of alcohol abuse is indicated in these patients. Patients hospitalized who present these disorders should receive specialized attention after leaving the hospital. Early detection and treatment should be used to prevent the appearance of organic lesions and should not be solely focused on male patients.