10 research outputs found

    The use of the capture- recapture method in evaluating the epidemiological meningococcal disease monitoring system in Tenerife, Spain (1999-2000)

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    BACKGROUND: Meningococcal Disease is mainly monitored passively on the Canary Islands, the regular Compulsory Disease Notification channels being used. The objective of this study includes describing the qualitative and quantitative aspects of this system and evaluating the exhaustiveness, by means of the capture-recapture system, of three information sources. METHODS: This study covers the 1999-2001 period in Tenerife. The information was gathered from three sources: the Compulsory Disease Notification System, the Microbiology Laboratories and the hospital Minimum Basic Data Set. The Evaluation Protocols of the Monitoring System of the Atlanta Centers of Disease Control and Prevention were used. A log-linear model was used for estimating the number of cases. The calculations of the exhaustiveness and the 95% confidence intervals were done in the SPSS10 statistics package. RESULTS: The system was found to have an 84.9% sensitivity, and an 80.4% positive predictive value. The delay in notification (timeliness) fell within the 0.5-13-day range, averaging 3 days. The system was found to have a 76.6% overall acceptability. The exhaustiveness value was 98.1%. CONCLUSIONS: This disease is being monitored well, with a degree of sensitivity which would be revealing of a good notification level, also confirmed by its exhaustiveness. Although the positive predictive value is high, this could be indicative of the expeditious starting of antibiotic treatment which would hinder microbiological confirmation. The system is timely, affording the possibility of measures being taken for fast intervention. Fundamento: La vigilancia de la Enfermedad Meningocócica en Canarias es fundamentalmente pasiva, sirviéndose del circuito habitual de las Enfermedades de Declaración Obligatoria. El objetivo de este trabajo incluye describir los atributos cualitativos y cuantitativos del sistema y evaluar la exhaustividad mediante el sistema de captura-recaptura de tres fuentes de información. Métodos: El estudio abarca los años 1999-2001 en Tenerife. La información se obtuvo de tres fuentes: el Sistema de las Enfermedades de Declaración Obligatoria, los Laboratorios de Microbiología y el Conjunto Mínimo Básico de Datos hospitalario. Se aplicaron los Protocolos de Evaluación de un Sistema de Vigilancia de los Centers of Disease Control and Prevention, de Atlanta. Para la estimación del número de casos se usó un modelo log-linear. Los cálculos de la exhaustividad y los intervalos de confianza al 95% se realizaron en el paquete estadístico SPSS10. Resultados: La sensibilidad del sistema resultó ser del 84,9% y el valor predictivo positivo del 80,4%. El retraso en la notificación (oportunidad) osciló entre los 0,5 y 13 días, con una mediana de 3 días. La aceptabilidad global del sistema ha sido del 76,64%. El valor de la exhaustividad fue del 98,1%. Conclusiones: La vigilancia de esta enfermedad es buena, con una sensibilidad que hablaría de un buen nivel de declaración, reafirmada por la exhaustividad. Aunque el valor predictivo positivo es alto, podría apuntar hacia la rápida instauración de tratamiento antibiótico que impediría la confirmación microbiológica. El sistema es oportuno, permitiendo la rápida adopción de medidas de intervención

    Pre-hospital antibiotic treatment and mortality caused by invasive meningococcal disease, adjusting for indication bias

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    <p>Abstract</p> <p>Background</p> <p>Mortality from invasive meningococcal disease (IMD) has remained stable over the last thirty years and it is unclear whether pre-hospital antibiotherapy actually produces a decrease in this mortality. Our aim was to examine whether pre-hospital oral antibiotherapy reduces mortality from IMD, adjusting for indication bias.</p> <p>Methods</p> <p>A retrospective analysis was made of clinical reports of all patients (n = 848) diagnosed with IMD from 1995 to 2000 in Andalusia and the Canary Islands, Spain, and of the relationship between the use of pre-hospital oral antibiotherapy and mortality. Indication bias was controlled for by the propensity score technique, and a multivariate analysis was performed to determine the probability of each patient receiving antibiotics, according to the symptoms identified before admission. Data on in-hospital death, use of antibiotics and demographic variables were collected. A logistic regression analysis was then carried out, using death as the dependent variable, and pre-hospital antibiotic use, age, time from onset of symptoms to parenteral antibiotics and the propensity score as independent variables.</p> <p>Results</p> <p>Data were recorded on 848 patients, 49 (5.72%) of whom died. Of the total number of patients, 226 had received oral antibiotics before admission, mainly betalactams during the previous 48 hours. After adjusting the association between the use of antibiotics and death for age, time between onset of symptoms and in-hospital antibiotic treatment, pre-hospital oral antibiotherapy remained a significant protective factor (Odds Ratio for death 0.37, 95% confidence interval 0.15–0.93).</p> <p>Conclusion</p> <p>Pre-hospital oral antibiotherapy appears to reduce IMD mortality.</p

    Aplicación del método captura-recaptura en la evaluación del sistema de vigilancia epidemiológica de la enfermedad meningocócica en Tenerife (1999-2001)

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    Fundamento: La vigilancia de la Enfermedad Meningocócica en Canarias es fundamentalmente pasiva, sirviéndose del circuito habitual de las Enfermedades de Declaración Obligatoria. El objetivo de este trabajo incluye describir los atributos cualitativos y cuantitativos del sistema y evaluar la exhaustividad mediante el sistema de captura-recaptura de tres fuentes de información. Métodos: El estudio abarca los años 1999-2001 en Tenerife. La información se obtuvo de tres fuentes: el Sistema de las Enfermedades de Declaración Obligatoria, los Laboratorios de Microbiología y el Conjunto Mínimo Básico de Datos hospitalario. Se aplicaron los Protocolos de Evaluación de un Sistema de Vigilancia de los Centers of Disease Control and Prevention, de Atlanta. Para la estimación del número de casos se usó un modelo log-linear. Los cálculos de la exhaustividad y los intervalos de confianza al 95% se realizaron en el paquete estadístico SPSS10. Resultados: La sensibilidad del sistema resultó ser del 84,9% y el valor predictivo positivo del 80,4%. El retraso en la notificación (oportunidad) osciló entre los 0,5 y 13 días, con una mediana de 3 días. La aceptabilidad global del sistema ha sido del 76,64%. El valor de la exhaustividad fue del 98,1%. Conclusiones: La vigilancia de esta enfermedad es buena, con una sensibilidad que hablaría de un buen nivel de declaración, reafirmada por la exhaustividad. Aunque el valor predictivo positivo es alto, podría apuntar hacia la rápida instauración de tratamiento antibiótico que impediría la confirmación microbiológica. El sistema es oportuno, permitiendo la rápida adopción de medidas de intervención

    Hospitalizations realted to herpes zoster infection in the Canary Islands, Spain (2005-2014)

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    Abstract Background Herpes zoster is an important problem of public health especially among the elderly in Spain. Methods A population-based retrospective epidemiological study to estimate the burden of herpes zoster requiring hospitalization in the Canary Islands, Spain was conducted by using data from the national surveillance system for hospital data, Conjunto Mínimo Básico de Datos. Records of all patients admitted to hospital with a diagnosis of herpes zoster in any position and cases of primary diagnosis (ICD-9-MC codes 053.0–053.9) during a 10-year period (2005–2014), were selected. Results A total of 1088 hospitalizations with a primary or secondary diagnosis of herpes zoster were identified during the study period. Annually there were 6.99 hospitalizations by herpes zoster per 100,000 population. It increases with age reaching a maximum in persons ≥85 years of age (43.98 admissions per 100,000). Average length of hospitalization was 16 days and 73 patients died, with a case-fatality rate of 4.03%. In 22% of the cases hospitalized, herpes zoster was the primary diagnosis. Conclusion The hospitalization burden of herpes zoster in adults in the Canary Islands was still important during the last decade and justify the implementation of preventive measures, like vaccination in the elderly or other high risk groups to reduce the most severe cases of the disease

    Additional file 1: of Hospitalizations realted to herpes zoster infection in the Canary Islands, Spain (2005-2014)

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    Table S1 Hospitalization rate, mortality rate and case-fatality rate related to herpes zoster infection by group of age in the Canary Islands, Spain (2005–2014) – Principal Diagnosis only. (DOCX 13 kb

    Pre-hospital antibiotic treatment and mortality caused by invasive meningococcal disease, adjusting for indication bias.

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    Background: Mortality from invasive meningococcal disease (IMD) has remained stable over the last thirty years and it is unclear whether pre-hospital antibiotherapy actually produces a decrease in this mortality. Our aim was to examine whether pre-hospital oral antibiotherapy reduces mortality from IMD, adjusting for indication bias. Methods: A retrospective analysis was made of clinical reports of all patients (n = 848) diagnosed with IMD from 1995 to 2000 in Andalusia and the Canary Islands, Spain, and of the relationship between the use of pre-hospital oral antibiotherapy and mortality. Indication bias was controlled for by the propensity score technique, and a multivariate analysis was performed to determine the probability of each patient receiving antibiotics, according to the symptoms identified before admission. Data on in-hospital death, use of antibiotics and demographic variables were collected. A logistic regression analysis was then carried out, using death as the dependent variable, and prehospital antibiotic use, age, time from onset of symptoms to parenteral antibiotics and the propensity score as independent variables. Results: Data were recorded on 848 patients, 49 (5.72%) of whom died. Of the total number of patients, 226 had received oral antibiotics before admission, mainly betalactams during the previous 48 hours. After adjusting the association between the use of antibiotics and death for age, time between onset of symptoms and in-hospital antibiotic treatment, pre-hospital oral antibiotherapy remained a significant protective factor (Odds Ratio for death 0.37, 95% confidence interval 0.15–0.93). Conclusion: Pre-hospital oral antibiotherapy appears to reduce IMD mortality.FIS (00/0049-01/02/03), Junta de Andalucía (247/00) and, partially, the IRYSS network (G03/202).Ye

    Development of a prediction model for postoperative pneumonia A multicentre prospective observational study

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    BACKGROUND Postoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems. OBJECTIVE To identify independent variables associated with the occurrence of postoperative pneumonia. DESIGN A prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database). SETTING Sixty-three hospitals in Europe. PATIENTS Patients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period. MAIN OUTCOME MEASURE The primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 degrees C; leucocyte count more than 12 000 mu l(-1). RESULTS Postoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P < 0.001). We identified five variables independently associated with postoperative pneumonia: functional status [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.58 to 3.12], pre-operative SpO(2) values while breathing room air (OR 0.83, 95% CI 0.78 to 0.84), intra-operative colloid administration (OR 2.97, 95% CI 1.94 to 3.99), intra-operative blood transfusion (OR 2.19, 95% CI 1.41 to 4.71) and surgical site (open upper abdominal surgery OR 3.98, 95% CI 2.19 to 7.59). The model had good discrimination (c-statistic 0.89) and calibration (Hosmer-Lemeshow P = 0.572). CONCLUSION We identified five variables independently associated with postoperative pneumonia. The model performed well and after external validation may be used for risk stratification and management of patients at risk of postoperative pneumonia
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