Prevención de la enfermedad cardiovascular en atención primaria: comparación de la función SCORE para países europeos de bajo riesgo con la tabla calibrada para España / Prevention of cardiovascular disease in primary care: a comparison of the function SCORE for low risk European countries with the calibrated SCORE for Spain

Introducción. Estudio comparativo de 2 ecuaciones de valoración del riesgo de mortalidad cardiovascular (RCV): función SCORE para países europeos de bajo riesgo y función SCORE calibrada para España, para conocer el perfil de riesgo de los pacientes de nuestro centro de salud y valorar las diferencias entre ambos métodos. Material y métodos. Estudio descriptivo transversal, de un cupo de pacientes de un centro de salud, seleccionándose los de edades comprendidas entre los 35-74 años y sin evento cardiovascular (n=398 pacientes). Se calculó el RCV mediante las 2 ecuaciones, se evaluaron las diferencias de clasificación obtenidas con ambas tablas de manera continua y la distribución de pacientes en cada grupo de riesgo. Resultados. La muestra estudiada presenta un perfil global de RCV bajo. Ambos métodos de estimación de riesgo presentaron una buena correlación (coeficiente de Pearson de 0,975, p<0,001). El RCV promedio estimado por la función SCORE calibrada para España fue superior al RCV estimado por la función SCORE europea (2,04 frente a 1,46%, p<0,001). El SCORE calibrado para España clasificó con un riesgo alto (mortalidad ≥ 5% en 10 años) al 12,9% de los pacientes (frente al 7% del SCORE europeo de países de bajo riesgo). Conclusiones. Aunque ambos métodos de estimación de RCV presentan buena correlación, el SCORE calibrado para España clasifica a los pacientes con un RCV un 28% superior al SCORE europeo. Deben realizarse más estudios de poblaciones locales para una correcta estimación del RCV (AU)

Introduction. This is a comparative Study of two cardiovascular risk (CVR) functions; the SCORE for European countries of low risk and the calibrated SCORE for Spain and the objective is to determine the risk profile and evaluate the differences between both methods. Material and methods. This is a descriptive cross-sectional study of a group of patients in our healthcare area. We selected those with ages between 35-74 years and without any previous cardiovascular event (n=398 patients). The CVR was calculated by both equations, evaluating the differences of classification obtained with both methods. Results. The studied sample had a low CVR profile. Both methods of estimation of risk correlated well (Pearson's coefficient of 0.975, P<.001). The average CVR estimated by the function SCORE calibrated for Spain was higher than the CVR estimated by the European SCORE (2.04 vs. 1.46%, P<.001). The Spanish calibrated SCORE predicted a high risk (mortality risk ≥5% in 10 years) for 12.9% of the patients (vs. 7% of the European SCORE). Conclusions. Although both methods of CVR estimation had a good correlation, the calibrated SCORE for Spain obtained a CVR 28% higher than the European SCORE. More studies of local populations must be performed for a correct estimation of the CVR (AU)

[Audit of clinical records: clinico-microbiologic study of urinary infections in a team of primary care]. / Auditoría de historias clínicas: estudio clinicomicrobiológico de infecciones urinarias en un equipo de atención primaria.

To carry out an audit of clinical records in our center for the evaluation of the quality of care before the introduction of protocols, several prevalent conditions were selected, and among them urinary tract infections (UTI). Another aim of the study was to evaluate the autochthonous flora responsible for UTI and its resistence to commonly used antimicrobials. A series of acceptable criteria and standards were set as quality controls, and the real index was found below the preselected one in all cases. The most commonly isolated organism was E. coli, followed by Proteus, which were resistent to trimetoprim-sulfamethoxazole in 56% and 71.4% of cases, respectively. Problems of organization and knowledge, and a high resistence rate to common antimicrobials were detected; the following were suggested as measures for improvement: introduction of a protocol, need for continuing education, reduction in the care demand, health education and improvement in the antibiotic policy.