Vigilancia sindrómica de la gripe en atención primaria, un instrumento complementario a las redes centinelas para períodos de elevada incidencia de gripe / Syndromic surveillance of Influenza-like illness in primary care: a complement to the sentinel surveillance network for periods of increased incidence of Influenza

Objetivo: La información epidemiológica de Influenza es básica para la gestión de recursos en los períodos de mayor incidencia en la población. Pero no siempre resulta accesible en tiempo real. El objetivo del presente estudio fue valorar el uso de un sistema de vigilancia sindrómica para la gripe en atención primaria (ILIsPC) y su grado de acuerdo con los datos epidemiológicos de la Red Centinela de Gripe. Emplazamiento: Centros de salud y servicios de urgencias extrahospitalarios de toda la Comunidad Autónoma de las Illes Balears. Participantes: Se incluyeron datos de 122 semanas epidemiológicas para cada uno de los sistemas valorados. Mediciones principales: Se compararon datos entre el 1 de enero de 2007 y el 31 de enero de 2010. Las tasas de ILIsPC se obtuvieron de los diagnósticos registrados en las consultas de atención primaria y en los servicios de urgencias extrahospitalarios, las de Red Centinela de los informes epidemiológicos. Se realizó el coeficiente de correlación intraclase y la representación gráfica de Bland y Altman. Resultados: Se observó un muy buen grado de acuerdo entre ambas medidas, con coeficiente de correlación intraclase de 0,88 (IC 95%: 0,83-0,91). Tras aplicar la representación gráfica de Bland y Altman se apreció una mayor precisión entre ambas tasas en los momentos de mayor incidencia de gripe. Conclusiones: Creemos que un sistema de vigilancia sindrómica, basado en la historia electrónica de atención primaria, permite acceder en tiempo real a la información, muy útil especialmente en los períodos de elevada incidencia de gripe como los períodos epidémicos o la pasada pandemia(AU)

Objective: Epidemiological data on influenza is essential for resource management when the incidence of the disease in the population is very high, but not easily available in real-time. The objective of this study was to evaluate the use of a syndromic surveillance system for influenza-like illness in Primary Care (ILIsPC) and assess its level of agreement with the epidemiological data from the Influenza Sentinel Network. Localization: Health centres and deputising medical services in the Balearic Islands. Participants: Data from 122 epidemiological weeks for each system were included. Main measures: Data from January 1, 2007 to January 31, 2010 were compared. ILIsPC rates were obtained from the diagnoses registered in electronic health records of Primary Care clinics and deputising medical services. Data from Sentinel Network were obtained from weekly epidemiological reports. Intraclass correlation coefficient was calculated and Bland - Altman plot constructed. Results: There was good agreement between both measures, with an intraclass correlation coefficient of 0.88 (95% CI: 0.83-0.91). After constructing a Bland-Altman plot, the precision between both rates was greater during the periods of the highest influenza incidence. Conclusions: We believe that the syndromic surveillance system ILIsPC, provides access to very useful data in real-time, especially during periods of high influenza incidence, such as during epidemics or the recent pandemic(AU)

[Syndromic surveillance of Influenza-like illness in primary care: a complement to the sentinel surveillance network for periods of increased incidence of Influenza]. / Vigilancia sindrómica de la gripe en atención primaria, un instrumento complementario a las redes centinelas para períodos de elevada incidencia de gripe.

OBJECTIVE: Epidemiological data on influenza is essential for resource management when the incidence of the disease in the population is very high, but not easily available in real-time. The objective of this study was to evaluate the use of a syndromic surveillance system for influenza-like illness in Primary Care (ILIsPC) and assess its level of agreement with the epidemiological data from the Influenza Sentinel Network. LOCALIZATION: Health centres and deputising medical services in the Balearic Islands. PARTICIPANTS: Data from 122 epidemiological weeks for each system were included. MAIN MEASURES: Data from January 1, 2007 to January 31, 2010 were compared. ILIsPC rates were obtained from the diagnoses registered in electronic health records of Primary Care clinics and deputising medical services. Data from Sentinel Network were obtained from weekly epidemiological reports. Intraclass correlation coefficient was calculated and Bland - Altman plot constructed. RESULTS: There was good agreement between both measures, with an intraclass correlation coefficient of 0.88 (95% CI: 0.83-0.91). After constructing a Bland-Altman plot, the precision between both rates was greater during the periods of the highest influenza incidence. CONCLUSIONS: We believe that the syndromic surveillance system ILIsPC, provides access to very useful data in real-time, especially during periods of high influenza incidence, such as during epidemics or the recent pandemic.

[Apache III score: a prognostic factor in pressure ulcer development in an intensive care unit]. / La escala APACHE III: un factor pronóstico en la aparición de úlceras por presión en una Unidad de Cuidados Intensivos.

UNLABELLED: OBJECTIVE. To analyze total APACHE III score association to pressure ulcers development in patients hospitalized in an intensive care unit (ICU). MATERIAL AND METHODS: Prospective cohort study conducted in an intensive care unit of the Hospital General de VIC. All the patients hospitalized between January 2001 to December 2001 were enrolled. Age, gender, length of stay, total Norton and APACHE III score and pressure sore development were collected. RESULTS: Pressure sore incidence was 12.5% of the patients. The factors were significantly associated with the appearance of pressure sores in those patients with a length of stay in the intensive care unit, total Norton and severity of the disease measured by the APACHE III score. Patients having the greatest risk of pressure ulcers development were those whose Norton score was less than or equal to 14, and an APACHE III score higher than or equal to 50 (Odds Ratio: 37.9, 95% CI 11.16-128.47) CONCLUSION: The severity of the diseases measured with the APACHE III scale showed a relationship with the appearance of in-hospital pressure ulcers. The joint use of the APACHE III and Norton scale could be a good strategy to detect patients with very high risk of suffering pressure sores.

La escala APACHE III: un factor pronóstico en la aparición de úlceras por presión en una Unidad de Cuidados Intensivos / Apache III Score: A prognostic factor in pressure ulcer development in an Intensive Care Unit

Objetivo. Analizar la asociación de la gravedad de la enfermedad, medida mediante laescala APACHE III, en el desarrollo de úlceras por presión (UPP) en pacientes hospitalizadosen una Unidad de Cuidados Intensivos (UCI).Material y método. Estudio prospectivo de cohortes en la UCI Polivalente del HospitalGeneral de Vic. Se incluyeron todos los pacientes ingresados entre enero y diciembre de2001. Se recogieron los datos referentes a edad, sexo, días de estancia, puntuación en laescala Norton y en la escala APACHE III, y aparición de UPP intrahospitalarias.Resultados. Aparecieron UPP en el 12,5% de los pacientes. Los factores significativamenteasociados con la aparición de UPP en estos pacientes fueron: días de estancia en laUCI, puntuación en la escala Norton y la gravedad de la enfermedad medida mediante laescala APACHE III. El grupo de pacientes que presentó mayor probabilidad de desarrollarUPP fueron aquellos con una puntuación Norton inferior o igual a 14 y un APACHE III superioro igual a 50 (odds ratio: 37,9, intervalo de confianza al 95% 11,16-128,47).Conclusión. La gravedad de la enfermedad medida mediante la escala APACHE III demostróestar relacionada con la aparición de UPP intrahospitalarias. La utilización conjuntade la escala APACHE III y la escala Norton podría ser una buena estrategia para detectarlos pacientes con un riesgo muy elevado de padecer UPP(AU)

Objective. To analyze total APACHE III score association to pressure ulcers developmentin patients hospitalized in an intensive care unit (ICU).Material and methods. Prospective cohort study conducted in an intensive care unit ofthe Hospital General de VIC. All the patients hospitalized between January 2001 toDecember 2001 were enrolled. Age, gender, length of stay, total Norton and APACHE IIIscore and pressure sore development were collected.Results. Pressure sore incidence was 12.5% of the patients. The factors were significantlyassociated with the appearance of pressure sores in those patients with a length of stayin the intensive care unit, total Norton and severity of the disease measured by theAPACHE III score. Patients having the greatest risk of pressure ulcers development werethose whose Norton score was less than or equal to 14, and an APACHE III score higherthan or equal to 50 (Odds Ratio: 37.9, 95% CI 11.16-128.47)Conclusion. The severity of the diseases measured with the APACHE III scale showed arelationship with the appearance of in-hospital pressure ulcers.The joint use of the APACHE III and Norton scale could be a good strategy to detectpatients with very high risk of suffering pressure sores(AU)