Características clínicas y sociosanitarias en mayores de 65 años asistidos en atención primaria. Estudio PYCAF / Clinical and socio-sanitary characteristics in adults older than 65 years attended in the Primary Care setting. The PYCAF study

OBJETIVO: Describir las características clínicas y sociosanitarias de los pacientes mayores de 65 años atendidos en consultas de atención primaria. MATERIAL Y MÉTODOS: El estudio PYCAF (Prevalencia Y Características del Anciano Frágil) es un estudio descriptivo, transversal y multicéntrico. Se incluyeron de manera consecutiva sujetos mayores de 65 años, atendidos en las consultas de atención primaria de toda España en condiciones de práctica clínica habitual. RESULTADOS: Se analizaron un total de 2.461 pacientes (edad media de 76,0+/-6,9 años; 57,9% mujeres). La coexistencia de factores de riesgo cardiovascular y comorbilidades fue frecuente, siendo las más prevalentes: hipertensión arterial (73,7%), dislipidemia (58,3%), artrosis (56,4%), obesidad (34,0%) y diabetes (28,9%). El 13,4% de los pacientes tenían algún grado de deterioro cognitivo. Las mujeres mostraron un mayor grado de fragilidad (61,0% vs.51,8%; p < 0,001). El 47,4% de los pacientes tomaban más de 6 fármacos, siendo mayor el consumo en las mujeres (44,2% vs.49,8%; p = 0,047). El 49,5% de los pacientes realizaron más de 10 visitas a atención primaria, el 25,9% 4 o más visitas a atención especializada y un 22,3% estuvieron ingresados en el último año. CONCLUSIONES: El estudio PYCAF nos muestra que los pacientes ancianos tienen mayor prevalencia de enfermedades crónicas cardiovasculares y no cardiovasculares, lo que conduce a una elevada polimedicación. Esta última tiene consecuencias tanto en la seguridad del paciente como en los costes directos e indirectos sobre el Sistema Nacional de Salud que emanan de la asistencia al paciente mayor de 65 años. La prevalencia de fragilidad alcanza a la mitad de la muestra

OBJECTIVE: To describe the clinical and socio-sanitary characteristics of adults older than 65 years attended in a Primary Care setting. MATERIAL AND METHODS: The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a descriptive, cross-sectional and multicentre study, in which patients older than 65 years attended in clinical practice in Primary Care in Spain were consecutively included. RESULTS: A total of 2,461 patients (mean age 76.0+/-6.9 years, 57.9% women) were included in the study. The coexistence of cardiovascular risk factors and comorbidities was frequent, with arterial hypertension (73.7%) being the most prevalent, followed by dyslipidaemia (58.3%), arthrosis (56.4%), obesity (34.0%), and diabetes (28.9%). Some degree of cognitive impairment was observed in 13.4% of patients. Women had higher rates of frailty (61.0% vs.51.8%; P<.001). Just under half (47.4%) of subjects were taking more than 6 drugs, with the prescription being higher in women (44.2% vs.49.8%; P=.047). Just under half (49.5%) of patients made more than 10 visits to Primary Care, 25.9% of patients 4 or more visits to the specialist, and 22.3% of patients were admitted to hospital in the last year. CONCLUSIONS: The PYCAF study shows that elderly patients have a higher prevalence of chronic cardiovascular and non-cardiovascular diseases, which leads to high polypharmacy. The latter has consequences both on patient safety and on the direct and indirect costs of the National Health System that emanate from the care of patients over 65 years of age. Half the sample has fragility

[Clinical and socio-sanitary characteristics in adults older than 65 years attended in the Primary Care setting. The PYCAF study]. / Características clínicas y sociosanitarias en mayores de 65 años asistidos en atención primaria. Estudio PYCAF.

OBJECTIVE: To describe the clinical and socio-sanitary characteristics of adults older than 65 years attended in a Primary Care setting. MATERIAL AND METHODS: The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a descriptive, cross-sectional and multicentre study, in which patients older than 65 years attended in clinical practice in Primary Care in Spain were consecutively included. RESULTS: A total of 2,461 patients (mean age 76.0±6.9 years, 57.9% women) were included in the study. The coexistence of cardiovascular risk factors and comorbidities was frequent, with arterial hypertension (73.7%) being the most prevalent, followed by dyslipidaemia (58.3%), arthrosis (56.4%), obesity (34.0%), and diabetes (28.9%). Some degree of cognitive impairment was observed in 13.4% of patients. Women had higher rates of frailty (61.0% vs. 51.8%; P<.001). Just under half (47.4%) of subjects were taking more than 6 drugs, with the prescription being higher in women (44.2% vs. 49.8%; P=.047). Just under half (49.5%) of patients made more than 10 visits to Primary Care, 25.9% of patients 4 or more visits to the specialist, and 22.3% of patients were admitted to hospital in the last year. CONCLUSIONS: The PYCAF study shows that elderly patients have a higher prevalence of chronic cardiovascular and non-cardiovascular diseases, which leads to high polypharmacy. The latter has consequences both on patient safety and on the direct and indirect costs of the National Health System that emanate from the care of patients over 65 years of age. Half the sample has fragility.

Anamnesis del tabaquismo y consejo antitabaco en 200 informes de alta sucesivos de los servicios médicos. Comparación de dos hospitales. Años 2003-2004 / Smoking anamnesis and counseling to stop smoking in 100 successive discharge reports of the medical services. Comparison of two hospitals. Year 2003-2004

Objetivo: El objetivo de este trabajo es conocer el interés de los médicos hospitalarios en general por el tabaquismo en los pacientes que ingresan, evaluando la anamnesis y el consejo médico del informe de alta. Pacientes y métodos: Hicimos un trabajo retrospectivo de 200 informes de alta de pacientes ingresados en 14 servicios médicos del HUCA (100) y en el Hospital Comarcal de Gandía (Comunidad Valenciana)(100), y se estudiaron parámetros epidemiológicos, de anamnesis y consejo antitabaco. Posteriormente, se hicieron comparaciones estadísticas utilizando la χ2, la odds ratio y los intervalos de confianza. Resultados: Los informes de alta de los 200 pacientes correspondían a 108 varones, de los cuales 47 pertenecían al HUCA y 61 al Hospital de Gandia; y 92 mujeres, 53 del HUCA y 39 del Hospital de Gandia y una edad media de 64,69 ± 17,69 años sin diferencias estadísticamente significativas entre ambos hospitales. La anamnesis de tabaquismo se realizó en un 40% de los informes. (HUCA 49%, H de Gandia 31%) con d.e.s. (χ2 = 6,750; p < 0,007) En el HUCA, había 49 pacientes con anamnesis, de los cuales 18 eran no fumadores, 16 fumadores y 24 exfumadores. En el Hospital de Gandía había un total de 31 pacientes a los que se les había hecho anamnesis2 eran no fumadores, 20 fumadores y 9 exfumadores. La diferencia era estadísticamente significativa (χ2 = 11,265) habiendo mayor proporción de fumadores en Gandía. De los 16 fumadores del HUCA 6 recibieron consejo, y en el Hospital de Gandía de 20 fumadores, 8 recibieron consejo, sin diferencias significativas. La mitad de los diagnósticos (49,5%) estaban relacionados etiologicamente con el tabaquismo sin diferencia entre ambos hospitales. Ninguno de los pacientes fumadores fue remitido a la consulta especializada de tabaquismo en ninguno de los 2 hospitales. Conclusiones: Dada la importancia etiológica del tabaquismo en estos pacientes, la anamnesis y el consejo antitabaco deberían de ser mejorados en ambos hospitales (AU)

Objective: This study aims to know the interest of the hospital physicians in general about smoking in the patients admitted to hospital, evaluating the anamnesis and medical counseling of the discharge report. Patients and methods: We conducted a retrospective study of 200 discharge reports of patients admitted to 14 medical departments of the HUCA (100) and in the Regional Hospital of Gandia (Valencian Community) (100) and studied epidemiological, anamnesis and antismoking counseling parameters. Subsequently, statistical comparisons were made using the χ2, odds ratio and confidence intervals. Results: The discharge reports of 200 patients corresponded to 108 men, 47 of whom belonged to the HUCA and 61 to the Hospital of Gandia and 92 women, 53 from the HUCA and 39 from the Hospital of Gandia with mean age of 64.69±17.69 years without statistically significant differences between both hospitals. The smoking anamnesis was conducted in 40% of the reports (HUCA 49%, Hospital of Gandia 31%) con with S.D. (χ2 = 6.750; p< 0.007) There were 49 patients in the HUCA with anamnesis, 18 of whom did not smoke, 16 who smoked and 24 who were ex-smokers. In theHospital of Gandia, there was a total of 31 patients in whom anamnesis was made: 2 were non-smokers, 20 smoked and 9 ex-smokers. The difference was statistically significant (χ2 = 11.265), there being a greater proportion of smokers in Gandia. Six of the 16 smokers in the HUCA received counseling and 8 of the 20 smokers in the Hospital of Gandia received counseling, without significant differences. Half of the diagnoses (49.5%) were etiologically related with smoking, without any difference between both hospitals. None of the patients who smoked were referred to the specialized tobacco consultation in either of the 2 hospitals. Conclusions: Given the etiological importance of smoking in these patients, the anamnesis and anti-smoking counseling should be improved in both hospitals (AU)