Epidemiología y factores de riesgo para cuidados intensivos y mortalidad en pacientes hospitalizados por COVID-19 / Epidemiology and risk factors for intensive care and mortality in COVID-19 hospitalized patients

INTRODUCCIÓN: El Complejo Hospitalario Universitario Nuestra Señora de Candelaria (CHUNSC) ha sido el hospital con más ingresos COVID-19 de Canarias. OBJETIVO: determinar factores de riesgo de ingreso en Unidad de Cuidados Intensivos (UCI) y mortalidad. MATERIAL Y MÉTODOS: Estudio observacional analítico retrospectivo de pacientes con COVID-19 confirmado, ingresados entre 25 febrero y 31 mayo 2020 en el CHUNSC. RESULTADOS: Ingresaron 264 pacientes, 56,8% hombres, edad media 65,3 años. Tasa de letalidad 15,2%. Factores de riesgo asociados con ingreso en UCI: neumonía (OR 2,22, IC 95% 1,08-4,55, p = 0,029) y síndrome de distrés respiratorio agudo (SDRA) (OR 4,94, IC 95% 1,46-16,68; p = 0,010). Factores asociados con mortalidad: edad ≥ 60 años (OR 3,94, IC 95% 1,21-12,82, p = 0,023), neumonía (OR 3,38, IC 95% 1,35-8,47, p = 0,009), SDRA (OR 5,84, IC 95% 1,60-21,24, p = 0,007) y enfermedad renal crónica (ERC) (OR 3,74, IC 95% 1,40-9,98, p = 0,009). CONCLUSIONES: Neumonía y SDRA se asociaron con ingreso en UCI. Neumonía, SDRA, edad ≥ 60 años y ERC se asociaron con mayor riesgo de mortalidad

INTRODUCTION: Complejo Hospitalario Universitario Nuestra Señora de Candelaria (CHUNSC) had the highest number of COVID-19 admissions in the Canary Islands. Aim of the study was to determine the risk factors for admission to the Intensive Care Unit (ICU) and mortality. METHODS: Retrospective analytical longitudinal study of patients with confirmed COVID-19, hospitalized between February 25 and May 31, 2020, at CHUNSC. RESULTS: In the study period, 264 patients were admitted, 56.8% men, mean age 65.3 years. Most frequent symptoms: cough (67%) and fever (59.8%), most frequent comorbidities: cardiovascular disease (60.6%) and diabetes (26.5%). Global Case Fatality Rate (CFR) 15.2%. Risk factors associated with ICU admission: Pneumonia (OR 2.22, 95%CI 1.08-4.55, p = 0.029) and Acute Respiratory Distress Syndrome (ARDS) (OR 4.94, 95%CI 1.46-16.68; p = 0.010). Risk factors associated with mortality: age ≥ 60 years (OR 3.94, 95%CI 1.21-12.82, p = 0.023), pneumonia (OR 3.38, 95%CI 1.35-8.47, p = 0.009), ARDS (OR 5.84, 95%CI 1.60-21.24, p = 0.007) and chronic kidney disease (CKD) (OR 3.74, 95%CI 1.40-9.98, p = 0.009). CONCLUSION: Pneumonia and ARDS were associated with ICU admission. Pneumonia, ARDS, age ≥ 60 years and CKD were associated with mortality

Factores asociados al conocimiento y el control de la hipertensión arterial en Canarias / Factors associated with knowledge and control of arterial hypertension in the Canary Islands

Introducción y objetivos. Analizar los factores asociados al conocimiento y el control de la hipertensión arterial en la población adulta de Canarias. Métodos. Se reclutó aleatoriamente una muestra de población general adulta (18-75 años). Se consideró hipertensión la presión arterial sistólica/diastólica >= 140/90mmHg; hipertensión conocida, la declaración de padecerla e hipertensión controlada, valores < 140/90mmHg. La asociación bivariable del conocimiento y el control de la hipertensión con edad, sexo, antropometría, lípidos séricos y estilo de vida se ajustó posteriormente por edad y sexo en un modelo logístico multivariable. Resultados. Se incluyó a 6.675 participantes. Entre los varones hay mayor prevalencia de hipertensión (el 40 frente al 31%; p < 0,001), pero menos frecuencia de tratamiento y control. El sexo femenino (p < 0,001), la edad ≥ 55 años (p < 0,001), la obesidad (p < 0,001) y la diabetes mellitus (p < 0,001) se asocian directamente con la hipertensión conocida. Los factores modificables que, pese al tratamiento, incrementaban el riesgo de mal control son consumo de alcohol (odds ratio [OR] = 2,4 si alcohol > 30g/día [p < 0,001]; OR = 2 si 15 < alcohol ≤ 30g/día [p = 0,009]; OR = 1,83 si 5 < alcohol ≤ 15g/día [p = 0,004]), obesidad (OR = 2 si índice masa corporal >= 30 [p = 0,003]; OR = 1,7 si 24,9 < índice masa corporal < 30 [p = 0,024]), colesterol sérico > 250mg/dl (OR = 1,6; p = 0,006) y frecuencia cardiaca elevada (OR = 1,45 si frecuencia > 80 lat/min [p = 0,045]; OR = 1,36 si 70 < frecuencia <= 80 lat/min [p = 0,038]). Conclusiones. El conocimiento de la hipertensión aumenta con la frecuentación del sistema sanitario y los factores asociados a ello: sexo femenino, edad y sufrir problemas de salud. Los factores modificables que incrementan el mal control de la hipertensión conocida son: consumo de alcohol, obesidad, frecuencia cardiaca elevada e hipercolesterolemia (AU)

Introduction and objectives. To analyze the factors associated with knowledge and control of hypertension in the adult population of the Canary Islands (18-75 years). Methods. We recruited a random sample of the general population aged ≥18 years. Hypertension was defined as systolic/diastolic blood pressure >=140/90mmHg or known hypertension (self-declared, or controlled hypertension <140/90mmHg). The bivariate association of known and controlled hypertension with age, sex, anthropometry, serum lipids, medication, and lifestyle was corroborated by adjusting a multivariate logistic model. Results. We included 6675 participants. The prevalence of hypertension was higher in men (40% vs 31%, P<.001), who also had a lower frequency of treated and controlled hypertension. Female sex (P<.001), age ≥55 years (P<.001), obesity (P<.001), and diabetes (P<.001) were associated with known hypertension. The modifiable factors that, in spite of treatment, increased the risk of poor control of hypertension were alcohol consumption (>30g/day, odds ratio [OR]=2.4, P<.001; >15-≤30g/day, OR=2, P=.009; >5-≤15, g/day, OR=1.83, P=.004), obesity (body mass index ≥30, OR=2, P=.003; >24.9-<30, OR=1.7, P=.024), serum cholesterol >250mg/dL (OR=1.6, P=.006) and elevated heart rate (>80 bpm, OR=1.45, P=.045; >70-<=80 bpm, OR=1.36, P=.038). Conclusions. The awareness of hypertension increases with frequent use of the health system and with factors associated with known hypertension: female sex, age, underlying health problems. The modifiable factors associated with poor control of known hypertension are alcohol consumption, obesity, elevated heart rate, and hypercholesterolemia (AU)

Factors associated with knowledge and control of arterial hypertension in the Canary Islands.

INTRODUCTION AND OBJECTIVES: To analyze the factors associated with knowledge and control of hypertension in the adult population of the Canary Islands (18-75 years). METHODS: We recruited a random sample of the general population aged ≥18 years. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mmHg or known hypertension (self-declared, or controlled hypertension <140/90 mmHg). The bivariate association of known and controlled hypertension with age, sex, anthropometry, serum lipids, medication, and lifestyle was corroborated by adjusting a multivariate logistic model. RESULTS: We included 6675 participants. The prevalence of hypertension was higher in men (40% vs 31%, P<.001), who also had a lower frequency of treated and controlled hypertension. Female sex (P<.001), age ≥55 years (P<.001), obesity (P<.001), and diabetes (P<.001) were associated with known hypertension. The modifiable factors that, in spite of treatment, increased the risk of poor control of hypertension were alcohol consumption (>30 g/day, odds ratio [OR]=2.4, P<.001; >15-≤30 g/day, OR=2, P=.009; >5-≤15, g/day, OR=1.83, P=.004), obesity (body mass index ≥30, OR=2, P=.003; >24.9-<30, OR=1.7, P=.024), serum cholesterol >250 mg/dL (OR=1.6, P=.006) and elevated heart rate (>80 bpm, OR=1.45, P=.045; >70-≤80 bpm, OR=1.36, P=.038). CONCLUSIONS: The awareness of hypertension increases with frequent use of the health system and with factors associated with known hypertension: female sex, age, underlying health problems. The modifiable factors associated with poor control of known hypertension are alcohol consumption, obesity, elevated heart rate, and hypercholesterolemia.