Epidemiología de los accidentes en una cohorte de adultos mayores de 64 años de la Comunidad Autónoma del País Vasco / Epidemiology of accidents in a cohort of adults over 64 years old in the Autonomous Community of the Basque Country

Introducción. Los accidentes son un problema importante de salud para las personas mayores. El objetivo de este estudio ha sido valorar la incidencia de accidentes en la población mayor de 64 años y describir las características que se asocian a la accidentalidad. Material y métodos. Estudio descriptivo de una cohorte de 15.192 personas mayores de 64 años, no institucionalizadas, realizado a través de Red Vigía de la CAPV y durante el periodo de un año. Por cada accidente se realizó una encuesta. Se calcularon las tasas de accidentalidad y los riesgos por grupos de edad y sexo. Resultados. La tasa de accidentalidad fue 46,52 y 81,87 por 1.000 hombres y mujeres, respectivamente. El tipo de accidente más frecuente fue la caída (92%), la lesión más severa la fractura (17%) con un riesgo significativamente superior para las mujeres y los mayores de 75 años. Conclusiones. Los datos presentados confirman la importante dimensión de los accidentes no intencionados en la población mayor de 64 años en la CAPV. El accidente más frecuente ha sido la caída, que constituye un fenómeno de gran transcendencia en los adultos mayores ya que son una de las principales causas de lesiones, incapacidad e institucionalización (AU)

Introduction. Accidents represent a significant health problem for elderly people. The objective of this study was to assess the incidence of accidents in over-64-year-olds in the Basque Country population, and to describe the clinical-epidemiological features leading to them. Material and methods. This was a prospective cohort study of 15,192 non-institutionalised individuals over 64 years of age, conducted under the auspices of the Basque Sentinel Practice Network (Red Vigía) over one year. A questionnaire was completed for each accident. The rates and risks of accidents were calculated by sex and age group of the individuals who had the accidents. Results. The rates of accidents were 46.52 and 81.87 per 1000 men and women, respectively. The most common type of accident was a fall (92%), and the most severe injuries were fractures (17%), with the risk of an accident being significantly higher in women and in the over-75-year-olds. Conclusions. These data reflect the scale of accidents in over-64-year-olds in the Basque Country. The most frequent accident was the fall, which represents a dramatic event among the elderly, being one of the main causes of injury, disability and institutionalisation among this population group (AU)

[Epidemiology of accidents in a cohort of adults over 64 years old in the Autonomous Community of the Basque Country]. / Epidemiología de los accidentes en una cohorte de adultos mayores de 64 años de la Comunidad Autónoma del País Vasco.

INTRODUCTION: Accidents represent a significant health problem for elderly people. The objective of this study was to assess the incidence of accidents in over-64-year-olds in the Basque Country population, and to describe the clinical-epidemiological features leading to them. MATERIAL AND METHODS: This was a prospective cohort study of 15,192 non-institutionalised individuals over 64 years of age, conducted under the auspices of the Basque Sentinel Practice Network (Red Vigía) over one year. A questionnaire was completed for each accident. The rates and risks of accidents were calculated by sex and age group of the individuals who had the accidents. RESULTS: The rates of accidents were 46.52 and 81.87 per 1000 men and women, respectively. The most common type of accident was a fall (92%), and the most severe injuries were fractures (17%), with the risk of an accident being significantly higher in women and in the over-75-year-olds. CONCLUSIONS: These data reflect the scale of accidents in over-64-year-olds in the Basque Country. The most frequent accident was the fall, which represents a dramatic event among the elderly, being one of the main causes of injury, disability and institutionalisation among this population group.

Estudio comparativo de QuantiFERON ®-TB Gold IT frente a tuberculina para el diagnóstico de la infección tuberculosa latente en estudios de contactos / Comparative performance of QuantiFERON ®-TB Gold IT versus Tuberculin Skin Test among contact investigations for latent tuberculosis infection

Fundamento y objetivo: Hasta hace poco, la única técnica disponible para diagnosticar la infección tuberculosa latente (ITL) era la tuberculina (PPD). QuantiFERON®-TB Gold In-Tube (QF), al igual que otros métodos diagnósticos basados en la liberación de interferón-γ (IGRA), aparecen como una alternativa a la PPD. El objetivo del estudio es comparar ambas técnicas (PPD y QF) para evaluar la utilidad diagnóstica y factibilidad del uso rutinario de QF en estudios de contactos. Pacientes y método: Estudio descriptivo prospectivo de concordancia entre PPD y QF a partir de contactos de pacientes con tuberculosis confirmada mediante cultivo entre mayo de 2007 y febrero de 2008 en Bizkaia y Araba, estimándose la concordancia mediante el estadístico kappa (κ).Resultados: Se hallaron 376 contactos: 8 niños (edad ≤ 14 años) de alto riesgo, 30 niños de riesgo bajo-medio, 46 adultos (edad > 14 años) de alto riesgo y 270 adultos de riesgo bajo-medio. Un total de 160 contactos (42,5%) fueron PPD+ para PPD ≥ 5mm, 141 (37,5%) para PPD ≥ 10mm y 95 (25,3%) para PPD ≥ 15mm. Mediante QF se obtuvieron 94 positivos, 279 negativos y tres indeterminados. Aunque en conjunto hay buena concordancia para PPD ≥ 10mm (κ=0,53; p < 0,0001), hubo pobre concordancia cuando el caso índice era no bacilífero para PPD ≥ 5mm (κ=0,28; p<0,001) y en contactos de alto riesgo para PPD ≥ 15mm (κ=0,048; p=0,36). Conclusiones: Frente a PPD, los IGRA constituyen una excelente herramienta en Salud Pública para el diagnóstico de la ITL, proporcionando un diagnóstico más específico, reduciendo el número potencial de tratamientos y mejorando el aprovechamiento de recursos sanitarios (AU)

Background and objective: Until recently, the only tool for detection of latent tuberculosis infection (LTI) was the tuberculin skin test (PPD). QuantiFERON®-TB Gold In-Tube (QF), as well as other Mycobacterium tuberculosis-specific interferon-γ release assays (IGRAs), appears to be an alternative or adjunct to the PPD. The goal of the study was to compare QF with PPD to evaluate de accuracy of QF for routinely identifying LTI in contact investigations. Patients and method:We performed a descriptive and prospective study with contacts of culture-confirmed tuberculosis source cases in Bizkaia and Araba from May 2007 through February 2008 who underwent QF and PPD. Concordance between both tests was analyzed using the kappa statistic (κ). Results: 376 contacts were found: 8 were high-risk children (age < 15), 30 low-medium risk children, 46 high-risk adults (age>14) and 270 low-medium risk adults. PPD was positive in 160 subjects (42.5%) at PPD ≥ 5mm, 141 (37.5%) at PPD ≥ 10mm and 95 (25.3%) at PPD ≥ 15mm. In QF analysis 94 subjects were positive, 279 negative and 3 indeterminate. Overall agreement between QF and PPD was good at PPD ≥ 10mm (κ=0.53; p<0.0001) but agreement was poor when the index case had positive baciloscopy at PPD ≥ 5mm (κ=0.28; p<0.001) and high-risk contacts at PPD ≥ 15mm (κ=0.048; p=0.36). Conclusions: IGRAs are an accurate indicator of LTI, providing a more specific way of diagnostic and reducing the number of subjects to be treated. QF appears to be a valuable public health tool with potential advantages over the PPD and improving resources (AU)

[Comparative performance of QuantiFERON(®)-TB Gold IT versus tuberculin skin test among contact investigations for latent tuberculosis infection]. / Estudio comparativo de QuantiFERON(®)-TB Gold IT frente a tuberculina para el diagnóstico de la infección tuberculosa latente en estudios de contactos.

BACKGROUND AND OBJECTIVE: Until recently, the only tool for detection of latent tuberculosis infection (LTI) was the tuberculin skin test (PPD). QuantiFERON(®)-TB Gold In-Tube (QF), as well as other Mycobacterium tuberculosis-specific interferon-γ release assays (IGRAs), appears to be an alternative or adjunct to the PPD. The goal of the study was to compare QF with PPD to evaluate de accuracy of QF for routinely identifying LTI in contact investigations. PATIENTS AND METHOD: We performed a descriptive and prospective study with contacts of culture-confirmed tuberculosis source cases in Bizkaia and Araba from May 2007 through February 2008 who underwent QF and PPD. Concordance between both tests was analyzed using the kappa statistic (κ). RESULTS: 376 contacts were found: 8 were high-risk children (age < 15), 30 low-medium risk children, 46 high-risk adults (age>14) and 270 low-medium risk adults. PPD was positive in 160 subjects (42.5%) at PPD ≥ 5mm, 141 (37.5%) at PPD ≥ 10mm and 95 (25.3%) at PPD ≥ 15 mm. In QF analysis 94 subjects were positive, 279 negative and 3 indeterminate. Overall agreement between QF and PPD was good at PPD ≥ 10mm (κ=0.53; p<0.0001) but agreement was poor when the index case had positive baciloscopy at PPD ≥ 5mm (κ=0.28; p<0.001) and high-risk contacts at PPD ≥ 15 mm (κ=0.048; p=0.36). CONCLUSIONS: IGRAs are an accurate indicator of LTI, providing a more specific way of diagnostic and reducing the number of subjects to be treated. QF appears to be a valuable public health tool with potential advantages over the PPD and improving resources.