Search

Aims: To analyze trends in asthma hospitalizations in patients over 15 years of age in Spain. To identify possible changes in incidence, demographic characteristics, clinical conditions, and outcomes., Methods: We conducted an observational retrospective epidemiological study using the Spanish National Hospital Discharge Database and included all patients hospitalized with a diagnosis of asthma from 2011 to 2020., Results: A total of 1,102,923 patients were hospitalized with a code for asthma in any diagnostic position; of these, 153,749 (13.94%) had asthma coded as the primary diagnosis (asthma exacerbation). The number of patients with an asthma exacerbation decreased over time, from 15,356 in 2011 to 8804 in 2020. In-hospital mortality (IHM) remained low (around 1.5%) and stable in this subgroup of patients. When the diagnosis of asthma appeared in any diagnostic position, hospitalizations increased for all ages and sexes. In this case, a significant change was observed for IHM, which increased from 3.27% in 2011-12 to 4.36% in 2019-20 (p < 0.001). The main risk factors for IHM in both cases were age over 65 years, need for mechanical ventilation, and associated diagnoses of pneumonia, heart disease, or atrial fibrillation. In contrast, obesity was a predictor of lower mortality., Conclusion: Our results suggest a decline in the incidence of hospitalizations for asthma exacerbations from 2011 to 2020. In contrast, the number of patients with asthma in any diagnostic position increased progressively, as did mortality, probably owing to an increase in comorbidities in a gradually ageing population., Competing Interests: Declaration of competing interest All authors declare that they have none Conflict of Interest., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The aim of this study is to examine trends from 2016 to 2019 in the incidence of hospitalizations and in-hospital mortality (IHM) of subjects < 18 years with community-acquired pneumonia (CAP), assessing possible sex differences. We used Spanish national hospital discharge data to select all patients < 18 years with CAP. We identified 43,511 children (53% boys) hospitalized with CAP. The incidence of CAP was significantly higher in boys than in girls, with an age-adjusted incidence rate ratio of 1.05 (95%CI 1.03-1.07) for boys compared to girls, and rose from 126 per 100,000 children in 2016 to 131 in 2019 (p < 0.0001). There were no sex differences in isolated pathogens, comorbidities, length of hospital stay, or IHM. Variables independently associated with IHM were age 10 to 17 years, congenital heart disease, neurological diseases, and use of invasive mechanical ventilation. Asthma was a protective factor for IHM among girls., Conclusion: The incidence of hospital admissions for CAP was higher among boys than among girls and rose significantly from 2016 to 2019. There were no sex differences in hospital outcomes. Age 10 to 17 years, congenital heart disease, neurological diseases, and use of mechanical ventilation were risk factors for IHM in both sexes, while asthma was a protective factor among girls. No differences were found in IHM over time., What Is Known: • Community-acquired pneumonia is one of the most common reasons for hospitalizations among children. • There are few studies that allow to know the evolution of community-acquired pneumonia in children., What Is New: • Incidence of hospital admissions for community-acquired pneumonia was higher in boys than girls and it rose significantly from 2016 to 2019. • Age 10 to 17 years, congenital heart disease, neurological diseases and use of mechanical ventilation were risk factors for in-hospital mortality in both sexes., (© 2022. The Author(s).)

Background: This study's objectives were to compare the prevalence of mental disorders and consumption of psychiatric medications in asthmatic subjects with non-asthmatic controls and identify risk factors associated with psychiatric conditions., Methods: This was an epidemiological case-control study based on the 2020 European Health Survey in Spain self-reported data. Each asthmatic subject was paired with a non-asthmatic control. Study variables included demographics, use of healthcare services, comorbidities, and risky behaviours were compared., Results: There were 22,072 participants in the survey; 1151 cases and 1151 controls were selected. The prevalence of mental disorders (25.5% versus 13.4%; p < 0.001) and consumption of psychiatric medications (25.8% versus 15.6%; p < 0.001) were higher in cases than controls. In asthmatic subjects, female gender (OR 1.814; p = 0.001), age over 80 years (OR 2.558; p = 0.002), poor self-rated health (OR 2.047; p < 0.001), visits to a psychologist (OR 10.854; p < 0.001) and chronic pain (OR 1.938; p < 0.001) were independently associated with mental disorder diagnoses. Meanwhile, female sex (OR 1.710; p < 0.001), age over 80 years (OR 3.802; p < 0.001), poor self-rated health (OR 2.482; p < 0.001), visits to a psychologist (OR 2.694; p < 0.001) and chronic pain (OR 1.494; p = 0.012) were risk factors independently associated with psychiatric medication consumption., Conclusions: The prevalence of psychiatric conditions were higher in asthmatic subjects. Female gender, older age, worse self-rated health, visits to a psychologist and chronic pain were associated with psychiatric conditions in asthmatic subjects., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: We aimed to analyze the prevalence of bronchiectasis among patients hospitalized with asthma and to assess the effect of suffering bronchiectasis on in-hospital mortality (IHM)., Methods: We used the Spanish National Hospital Discharge Database from 2000 to 2015 to evaluate all admissions for asthma exacerbation as the main diagnosis, dividing them according to the presence or absence of associated bronchiectasis. We assessed time trends in the prevalence, clinical characteristics, length of hospital stay, costs, and IHM., Results: Of 342,644 admissions for asthma, 10,377 (3.02%) had bronchiectasis. The prevalence of bronchiectasis increased from 2.16% in 2001 to 4.47% in 2015 ( p  < 0.001). Compared to patients without bronchiectasis, those with bronchiectasis were more frequently women (77.06% vs. 22.94%, p  < 0.001), were older (68.87 ± 15.16 vs. 47.05 ± 30.66 years, p  < 0.001) and had more comorbid conditions (Charlson comorbidity index ≥ 2: 9.45% vs. 6.58%, p  < 0.001). Pseudomonas (8% vs. 0.66%, p  < 0.001), Aspergillus (0.93% vs. 0.15%, p  < 0.001), eosinophilia (0.29% vs. 0.17%, p  = 0.005) and IHM (2.07% vs. 1.2%, p  < 0.001) were more frequent in patients with bronchiectasis. After multivariable adjustments, IHM was not associated with bronchiectasis. The presence of bronchiectasis was associated with a longer length of hospital stay and higher costs., Conclusions: Admissions for asthma with bronchiectasis have increased over time in Spain. In our investigation, the presence of bronchiectasis was not associated with higher IHM, but it increased the length of hospital stay and costs.

Objective: To assess the changes in incidence, use of mechanical ventilation, length of stay (LOS), costs and mortality of children (0-15 years) and young adults (16-45 years) hospitalized for asthma exacerbations., Methods: We included patients hospitalized for asthma exacerbations in Spain from 2002 to 2010 (ICD9-CM codes 493.0x-493.9x). The data were collected from the National Hospital Discharge Database (entire population). We calculated the yearly age- and sex-specific incidence rates for each of the two groups., Results: We included a total of 12,038 pediatric patients and 2792 young adults hospitalized for asthma exacerbations. Overall crude incidence decreased from 20.5 to 18.7 admissions per 100.000 inhabitants in the pediatric group (p < 0.05), and from 4.12 to 3.68 admissions per 100.000 inhabitants among young adults, from 2002 to 2010 (p < 0.05). By contrast, we detected a significant increase in the use of non-invasive ventilation (NIV) in both groups. The average LOS decreased during the study period, from 3.71 (SD 2.28) to 3.16 (SD 2.11) days (p < 0.05) among pediatric patients and there were not changes among young adults. During the study period, the mean cost per patient decreased from 1558.53 (SD 443.63) to 1378.41 (SD 472.71) euros in the pediatric group (p < 0.05), while increased from 2183.44 (SD 783.15) to 2564.32 (SD 1933.98) euros among young adults (p < 0.05)., Conclusion: Our results suggest a decrease in the incidence of hospital admissions for asthma exacerbations with concomitant increase in use of NIV in asthmatic patients, both pediatric and young adults patients. Although LOS and mean cost have decreased among pediatric patients, they have not changed and increased, respectively, among young adults. A better management of the disease at primary care services may explain the improvement in the incidence and outcomes., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: To study the prevalence of anxiety and depression in patients with asthma and to identify associated factors., Material and Methods: The study was based on individual data of subjects aged ≥18 years drawn from the 2006 Spanish National Health Survey. We identified asthmatic individuals through a specific questionnaire. Presence of depression or anxiety was assessed using the following questions: ( 1 ) "Have you suffered depression or anxiety over the previous 12 months?" ( 2 ) "Has your medical doctor confirmed the diagnosis?" ( 3 ) "Have you consumed antidepressants prescribed by your physician over the last 2 weeks?" ( 4 ) "Have you consumed anxiolytics prescribed by your physician over the last 2 weeks?" Those who answered yes to questions 1, 2, and 3 or to all questions were considered "Depression sufferers," those who answered yes to questions 1, 2, and 4 were considered "Anxiety sufferers." We analyzed sociodemographic characteristics and health-related variables., Results: Of the 28,966 subjects included in the study, 1650 were classified as asthmatic (5.6%). The prevalence of anxiety was 9.7% among people with asthma and 6.6% among those without the disease (p < .01). After multivariate adjustment the probability of a subject suffering anxiety was 1.27 (95% CI 1.08-1.49) higher among those with asthma than among those without. Independent and significantly associated variables with anxiety among asthmatic patients were older age, concomitant comorbidities, and visits to general practitioner in the last 4 weeks. The prevalence of depression was 9% among asthmatics and 5.5% among those without the disease (p < .05). The multivariate adjustment revealed that suffering depression was associated with suffering asthma (adjusted OR 1.39, 95% CI 1.18-1.64). Variables associated with depression among asthmatic patients were female sex, older age, worse self-related health, concomitant comorbidities, abstemious individuals, and the need for attendance on emergency room in the last year., Conclusions: Suffering anxiety or depression is associated with suffering asthma. Associated variables with anxiety or depression among asthmatic patients include older age and concomitant comorbidities.

This study aims to assess the behavior of the oscillometric parameters in 60 patients with bronchial asthma and in 39 with cystic fibrosis. All of them underwent an impulse oscillometry (IOS) and forced spirometry. The correlations existing between FEV1 and different oscillometric endpoints were assessed. In asthmatic subjects, the oscillometry parameters that correlated best with FEV1 were impedance (Zsr) and resistance to 5 hertz (Rsr5), while it was the Zsr and reactance to 5 hertz (Xsr5) in the individuals with cystic fibrosis. In the last group of patients, no correlation was found between FEV1 and Rsr in most of the frequencies evaluated. We conclude that there are differences in the behavior of the oscillometric parameters in patients with bronchial asthma and cystic fibrosis. The oscillometric parameters having the greatest use in the detection of the obstruction to airflow vary according to the disease studied.