ABSTRACT
INTRODUCTION: Addressing suicide requires an understanding of regional patterns of epidemiology, with health variables being central. However, the clinical profile of people who commit suicide has received little attention. The objectives of this study were to analyze the sociodemographic, clinical, and forensic characteristics of persons who committed suicide in Galicia between 2013 and 2016, analyze suicide mortality rates, and identify trajectories of hospitalizations and associated variables. MATERIAL AND METHODS: A population study was carried out on the 1354 people who died by suicide in Galicia. RESULTS: The most common profile was a retired man, 57.9 years old (SD=18.5), from an urban and inner area. 43.6% had been previously hospitalized, 41.6% had been diagnosed with physical disorders, and 26.8% with mental disorders. 48.2% had been prescribed psychiatric medications and 29.6% had received outpatient psychiatric care. The highest prevalence of death by suicide (27.5%) was in 2014, with the predominant method being hanging (59.1%). The average raw rate was 12.3/100,000. Three trajectories of hospitalizations emerged: 94.83% had experienced few hospitalizations; 2.95% an increasing pattern; and 2.22% a decreasing pattern. These trajectories were associated with number of psychiatric appointments, prescription of psychiatric medications, and diagnoses of physical and mental disorders. CONCLUSIONS: These findings are crucial for detection and prevention.
Subject(s)
Mental Disorders , Suicide , Male , Humans , Middle Aged , Suicide/psychology , Mental Disorders/epidemiology , Hospitalization , Research DesignABSTRACT
OBJECTIVES: To know the impact of COVID-19 in incidence and lethality in nursing homes in Galicia. METHODS: This is a descriptive study of nursing homes residents and workers with confirmed COVID-19. The analysis spanned from March 1, 2020 to March 27, 2022, stratified into 6 periods (one per wave). The impact on incidence (attack rate, number of outbreaks, reinfections, sex, age, and diagnostic technique) and lethality (by sex, age, place of death, and number of centers with deaths) was analyzed. RESULTS: There were 15,819 people affected, 51.9% of the jobs and 47.0% of the workers. The attack rate in residents was: 5.8% in the first wave, 10.4% in the second, 6.3% in the third, 0.1% in the fourth, 2.1% in the fifth and 27.3% in the sixth. In the sixth wave, there were 11.3% reinfections and the number of outbreaks in was 3 times higher than in the second. The case fatality in residents was higher during the first wave (21.8%) and lower during the sixth (2.4%). He only had one worker in relation to COVID-19. CONCLUSIONS: Surveillance of COVID-19 in nursing homes was essential to understand the dynamics of the disease. The sixth wave was the one with the highest incidence and the lowest lethality. Lethality was higher in the first wave. The fourth and fifth waves had a lower incidence due to the effects of vaccination.
Subject(s)
COVID-19 , Male , Humans , COVID-19/epidemiology , Pandemics , Spain/epidemiology , Incidence , SARS-CoV-2 , Reinfection , Nursing HomesABSTRACT
Objetivos: Conocer el impacto de la COVID-19 en incidencia y letalidad en los centros residenciales de mayores (CRM) de Galicia. Métodos: Se trata de un estudio descriptivo en residentes y trabajadores de los CRM con COVID-19 confirmada. El análisis abarcó del 1 de marzo de 2020 al 27 de marzo de 2022 y se estratificó en 6 períodos (uno por ola). Se analizó el impacto en incidencia (tasa de ataque, número de brotes, reinfecciones, sexo, edad y técnica diagnóstica) y letalidad (por sexo, edad, lugar de fallecimiento y número de centros con fallecidos). Resultados: Hubo 15.819 personas afectadas, el 51,9% de las plazas y el 47% de los trabajadores. La tasa de ataque en residentes fue: 5,8% en la primera ola, 10,4% en la segunda, 6,3% en la tercera, 0,1% en la cuarta, 2,1% en la quinta y 27,3% en la sexta ola. En la sexta ola hubo un 11,3% de reinfecciones y el número de brotes fue 3 veces mayor que en la segunda. La letalidad en residentes fue mayor durante la primera ola (21,8%) y menor durante la sexta (2,4%). Solo falleció un trabajador en relación con la COVID-19. Conclusiones: La vigilancia de la COVID-19 en CRM fue fundamental para conocer la dinámica de la enfermedad. La sexta ola fue la de mayor incidencia y la de menor letalidad. La letalidad fue superior en la primera ola. La cuarta y la quinta ola tuvieron menor incidencia debido a los efectos de la vacunación. (AU)
Objectives: To know the impact of COVID-19 in incidence and lethality in nursing homes in Galicia. Methods: This is a descriptive study of nursing homes residents and workers with confirmed COVID-19. The analysis spanned from March 1, 2020 to March 27, 2022, stratified into 6 periods (one per wave). The impact on incidence (attack rate, number of outbreaks, reinfections, sex, age, and diagnostic technique) and lethality (by sex, age, place of death, and number of centers with deaths) was analyzed. Results: There were 15,819 people affected, 51.9% of the jobs and 47.0% of the workers. The attack rate in residents was: 5.8% in the first wave, 10.4% in the second, 6.3% in the third, 0.1% in the fourth, 2.1% in the fifth and 27.3% in the sixth. In the sixth wave, there were 11.3% reinfections and the number of outbreaks in was 3 times higher than in the second. The case fatality in residents was higher during the first wave (21.8%) and lower during the sixth (2.4%). He only had one worker in relation to COVID-19. Conclusions: Surveillance of COVID-19 in nursing homes was essential to understand the dynamics of the disease. The sixth wave was the one with the highest incidence and the lowest lethality. Lethality was higher in the first wave. The fourth and fifth waves had a lower incidence due to the effects of vaccination. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Pandemics , Coronavirus Infections/epidemiology , Nursing Homes , Coronavirus Infections/mortality , Severe acute respiratory syndrome-related coronavirus , Health Services for the Aged , Aging , Incidence , Epidemiology, DescriptiveABSTRACT
Background: To plan end-of-life care it is essential to ascertain where patients die. There is very little information on the place of death of chronic obstructive pulmonary disease (COPD) patients. Accordingly, this study set out to describe the place of death of all COPD-related deaths in a Spanish region across the period 2009-2017, taking into account the sex and age of the deceased. Methods: We analyzed COPD deaths, codes J41-44 of the International Classification of Diseases-10th revision, in the Galician Autonomous Region from 2009 to 2017. Using death certificate data furnished by the Galician Mortality Registry, information was extracted on place of death, categorized as "hospital", "nursing home", "patient's home", "other" or "not shown". Results: There were 10,274 deaths, with a male:female ratio of 2.52; 39.0% of deaths occurred in hospital and 41.4% at home, with these data varying according to sex and age. Across the study period, no reduction was observed in the number of deaths that occurred in hospital. For all the period analyzed, deaths among women occurred mostly at home, with an increase being seen in the number of deaths in nursing homes over the course of the study. Patients aged under 70 years tended to die more frequently in hospital, and those over this age died more frequently at home or in nursing homes. Conclusion: A very high percentage of COPD patients still die in hospital, a trend that has shown no decline in recent years. Even so, there are important variations by sex and age on the place of death of these patients.
Subject(s)
Pulmonary Disease, Chronic Obstructive , Terminal Care , Aged , Female , Hospitals , Humans , Male , Nursing Homes , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/therapy , RegistriesABSTRACT
Objetivo: conocer el estado nutricional de la población de 65 años o más no institucionalizada y autónoma, atendida en Atención Primaria en la zona norte de Galicia e identificar factores asociados al riesgo de malnutrición. Método: estudio descriptivo transversal de la población de 65 años o más, no institucionalizada y autónoma residente en las áreas sanitarias de A Coruña y Lugo. La muestra se seleccionó entre quienes acudieron a consulta (de febrero a diciembre de 2010). Enfermeras entrenadas administraron un cuestionario que incluyó variables sociodemográficas, antropométricas, de comorbilidad, la escala de comorbilidad de Charlson y la escala Mini Nutritional Assessment. Se realizaron índices de estadística descriptiva y modelos de regresión logística multivariante, cuya variable resultado fue la malnutrición y riesgo de malnutrición (MyRM). Resultados: la muestra final fue de 1.196 personas, con una media de edad de 75,2 años (DT 0,2) y un 61% de mujeres (n= 730). La prevalencia de malnutrición fue de 0,17 (IC95%: 0,02-0,60) y de malnutrición y riesgo de malnutrición (MyRM) fue del 15,5% (IC95%:13,4-17,5), similar en ambos sexos. Se encontró un aumento del riesgo (p< 0,05) de padecer MyRM en quienes no preparaban su comida (OR 1,49 (IC95%:1,01-2,21)), comían solos/as (OR 1,83 (IC95%:1,07-3,14)), tenían dos o más patologías (OR 1,58 (IC95%:1,04- 2,41)) o hubiesen estado ingresados en un hospital durante el último año (OR 2,16 (IC95%: 1,30-3,58)). Cada punto de mejoría en la valoración subjetiva del estado de salud realizada por la enfermera supuso disminución del riesgo (OR 0,68 (IC95%:0,60-0,76)). Conclusiones: la población de 65 años o más, no institucionalizada, autónoma y residente en la zona norte de Galicia, presenta un estado nutricional aceptable, aunque tres de cada 20 personas de este colectivo está en riesgo de malnutrición. Esta situación se asocia con factores sociales y clínicos
Objective: to understand the nutritional status of the ≥65-year-old population non-institutionalized and independent, seen at Primary Care in Northern Galicia, and to identify any factors associated with the risk of malnutrition. Method: a descriptive cross-sectional study in the ≥65-year-old population, non-institutionalized and independent, living in the health areas of A Coruña and Lugo. The sample was selected among those persons who came for a consultation (February to December, 2010). Trained nurses administered a questionnaire which included sociodemographical and anthropometric variables, as well as comorbidity, the Charlson comorbidity scale, and the Mini-Nutritional-Assessment scale. Descriptive statistical indexes were conducted, and multivariate logistical regression models, with the outcome variable Malnutrition and Risk of Malnutrition (MandRM). Results: the final sample was of 1.196 persons, with 75.2 years as mean age (TD 0.2); 61% were women (n= 730). The prevalence of malnutrition was 0.17 (CI 95%: 0.02-0.60), and 15.5% for MandRM (CI 95%:13.4-17.5), similar in both genders. It was found that there was an increase in the risk (p< 0.05) of suffering MandRM in those who did not prepare their meals (OR 1.49 (CI 95%:1.01-2.21)), those who ate alone (OR 1.83 (CI 95%:1.07-3.14)), suffered two or more health conditions (OR 1.58 (CI 95%:1.04- 2.41)) or had been hospitalized during the past year (OR 2.16 (CI 95%: 1.30-3.58)). Each point of improvement in the subjective evaluation by the nurse of their health status represented a reduction in risk (OR 0.68 (CI 95%:0.60-0.76)). Conclusions: the ≥65-year-old population, non-institutionalized, independent, and living in the Northern area of Galicia, presented an acceptable nutritional status, even though three of every 20 persons in this group are at risk of malnutrition. This situation is associated with social and clinical factors
