Incidencia y mortalidad por infarto agudo de miocardio en la población mayor de 60 años del área de Tarragona / Incidence and mortality of ischaemic stroke among people 60 years or older in the región of Tarragona, Spain

Fundamentos. La información procedente de datos de base poblacional sobre la epidemiología del infarto agudo de miocardio es limitada. Este estudio analizó la incidencia y mortalidad por infarto en la población general mayor de 60 años del área sanitaria de Tarragona. Métodos. Estudio de cohortes que incluyó a 27.204 personas ≥60 años adscritas a 9 Áreas Básicas de Salud en la comarca del Tarragonés. Se realizó un seguimiento prospectivo durante 3 años, en los que se registraron todos los episodios de infarto diagnosticados entre los miembros de la cohorte desde 01/12/2008 a 30/11/2011. Se incluyeron exclusivamente los episodios con diagnóstico validado tras revisión de la historia clínica, se excluyeron los casos sin confirmación electrocardiográfica y por biomarcadores. Resultados: Hubo un total de 359 episodios confirmados de infarto, lo cual supuso una incidencia de 475 episodios por 100.000 personas-año (IC 95%: 428-527). La incidencia en hombres fue de 681 por 100.000 y en mujeres de 311 (p<0,001). Por edad fue 277 en el grupo de 60-69, 632 en el de 70-79 y 690 por 100.000 en los sujetos de ≥80 años (p<0,001). La incidencia en las personas con diagnóstico previo de cardiopatía isquémica fue de 2.844 casos por 100.000 personas-año. La mortalidad a los 30 días tras el diagnóstico alcanzó el 15,3%, en hombres 14,9% y en mujeres 16,0% (p=0,776). Conclusiones: La incidencia fue 2,2 veces mayor en hombres que en mujeres y aumentó considerablemente con la edad. También fue superior entre las personas con diagnóstico previo de cardiopatía isquémica. La mortalidad fue ligeramente más baja en hombres que en mujeres (AU)

Background: Population-based data available about the epidemiology of acute myocardial infarction is limited. This study investigated incidence and mortality from infarction among the general population over 60 years in Tarragona. Methods: Cohort study that included 27,204 individuals ≥60 years assigned to nine Primary Care Centers in the Tarragones county (Catalonia, Spain), who were prospectively followed between 01/12/2008 and 30/11/2011. During follow-up, all presumptive episodes of infarction were recruited among cohort members, but only confirmed cases (electrocardiogram and biomarkers confirmation) were included. Results: There were an amount of 359 confirmed episodes of infarction, which means a global incidence rate of 475 episodes per 100,000 person-years (95% CI: 428-527). Incidence was 681 in men and 311in women (p<0.001). According to age, incidence was 277 in 60-69, 632 in 70-79 and 690 per 100,000 in ≥80 years (p<0.001). Incidence was 2,844 cases per 100,000 person-years among those persons whom had history of prior coronary artery disease. Overall 30-day mortality rate was 15.3%, in male 14.9% and in female 16.0% (p=0.776). Conclusion: Incidence was 2.2 times higher in men than in woman and increased considerable by age. It was greater among patients with prior history of coronary artery disease. Mortality was slightly lower in men than in women (AU)

Influence of chronic illnesses and underlying risk conditions on the incidence of pneumococcal pneumonia in older adults.

OBJECTIVE: To investigate hospitalizations from pneumococcal pneumonia in older adults with specific underlying chronic conditions, evaluating the influence of these conditions in developing pneumonia. METHODS: Population-based cohort study involving 27,204 individuals ≥ 60 years old in Southern Catalonia, Spain. All cases of hospitalization from pneumococcal pneumonia (bacteremic and nonbacteremic) were collected since 01/12/2008 until 30/11/2011. Cox regression was used to calculate hazards ratio (HR) and estimate the association between baseline conditions and the risk of developing pneumococcal pneumonia. RESULTS: Maximum incidences (per 1000 person-years) appeared among patients with history of prior pneumonia (14.6), nursing home residents (12.8), persons with immunodeficiency/asplenia (7.7) and patients with chronic pulmonary disease (7.6). In multivariable analysis, age (HR: 1.05), nursing home residence (HR: 4.59), history of prior pneumonia (HR: 3.58), stroke (HR: 2.50), chronic heart disease (HR: 1.53), chronic pulmonary disease (HR: 4.09), diabetes mellitus (HR: 1.66), smoking (HR: 1.69) and immunosuppressive medication (HR: 1.87) appeared significantly associated with an increased risk of pneumococcal pneumonia. CONCLUSION: Our data support that nursing home residence, chronic pulmonary disease and immunocompromising conditions are the underlying conditions most strongly associated with an increasing risk of pneumococcal pneumonia in older adults. This data underline the need for better prevention strategies among these persons.

[Incidence and mortality of ischaemic stroke among people 60 years or older in the region of Tarragona, Spain]. / Incidencia y mortalidad por infarto agudo de miocardio en la población mayor de 60 años del área de Tarragona.

BACKGROUND: Population-based data available about the epidemiology of acute myocardial infarction is limited. This study investigated incidence and mortality from infarction among the general population over 60 years in Tarragona. METHODS: Cohort study that included 27,204 individuals ≥60 years assigned to nine Primary Care Centers in the Tarragones county (Catalonia, Spain), who were prospectively followed between 01/12/2008 and 30/11/2011. During follow-up, all presumptive episodes of infarction were recruited among cohort members, but only confirmed cases (electrocardiogram and biomarkers confirmation) were included. RESULTS: There were an amount of 359 confirmed episodes of infarction, which means a global incidence rate of 475 episodes per 100,000 person-years (95% CI: 428-527). Incidence was 681 in men and 311in women (p<0.001). According to age, incidence was 277 in 60-69, 632 in 70-79 and 690 per 100,000 in ≥80 years (p<0.001). Incidence was 2,844 cases per 100,000 person-years among those persons whom had history of prior coronary artery disease. Overall 30-day mortality rate was 15.3%, in male 14.9% and in female 16.0% (p=0.776). CONCLUSION: Incidence was 2.2 times higher in men than in woman and increased considerable by age. It was greater among patients with prior history of coronary artery disease. Mortality was slightly lower in men than in women.