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Objective: Estimating the decrease in life expectancy (LE) of the population of Madrid and its districts and its relationship with socioeconomic variables in the first year of the COVID-19 pandemic., Method: Death records were obtained from the Municipal Register of inhabitants (Municipal Statistics Service). Based on Chiang II method, life expectancy at birth and at 65 years of age (LEB and LE65) were calculated, as well as their 95% confidence intervals both for men and women and their gross, net and minimum falls for each district in 2020 over 2019, their correlation with some socioeconomic variables distribution and the existence of multiple linear regression explicative models., Results: In 2020, deaths in Madrid increased by 46.1% compared with the previous year, the LEB was 79.31 years in men and 85.25 years in women, meaning a decrease of 3.67 and 2.56 years respectively (4.42% and 2.91%). All districts registered decreases in LE, with the largest decrease in men in Tetuan (4.72 years) and in women in Chamartín (3.91 years). The most affected were the southern districts, especially in men. Immigrant and people over 80 years old rates explained 24% of the drop in LE in men, using linear regression model., Conclusions: The decrease in LE recorded in Madrid and its districts in 2020 is bigger than in Spain (1.6 years), takes us back to values of 2002 (LE65) and 2008 (LEB), has a sharper fall in the south and is territorially unequally distributed, according to socioeconomic variables and being associated with some of them., (Copyright © 2021 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Patients with addiction are a vulnerable group in which there is little data on the infection and severity of COVID-19. The objective of this study was to analyze the seroprevalence against SARS-CoV-2 in users in treatment for addictions in Madrid and to describe the factors related to the infection in this group., Methods: Cross-sectional descriptive study (June-October 2020), in a non-probabilistic sample of 473 patients with Substance Use Disorder, from the 8 Addiction Care Centers (CAD) of the Madrid City Council. Their demographic, habits and health characteristics, IgM and IgG for SARS-CoV-2, previous PCR, presence of symptoms, contact with COVID-19 cases were described, and multivariate analysis was performed using binary logistic regression., Results: 5.1% of the users had positive serology for SARS-CoV-2 (5.8% in men and 2.7% in women). The patients with the highest percentage of seropositivity were between 50-59 years old (8.3%), being the most prevalent main substance consumed alcohol (7.4%). Having a previous positive CRP showed a significant odds ratio (OR) regarding being seropositive in the frequentist analysis., Conclusions: The highest seroprevalence rate occurred among men, epidemiologically known factors being the ones that showed the greatest strength of association. The CAD seropositive user profile was a man at the age of 50, an alcohol user and without comorbidities. No characteristic related to substance use was found to justify the difference in risk of infection with the general population., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: Health care-related infections are a public health problem, among them surgical site infection (SSI) are the most frequent in hospitals. The objetive of this study was to assess the effect of the compliance to antibiotic prophylaxis protocol on the incidence of surgical site infection in hysterectomized patients., Methods: A prospective cohort study was carried out between October 2009 and December 2018. The incidence of SSI was studied after a maximum period of 30 days from the moment of surgery. The degree of adequacy of antibiotic prophylaxis in hysterectomy and the effect of its inadequacy on the incidence of infection was evaluated using relative risk (RR) adjusted with a logistic regression model., Results: A total of 1,025 interventions were studied in 1,022 women. The cumulative incidence of SSI was 2,1% (n = 22). The most frequent etiology of infection was Escherichia coli (23.1%) and Proteus mirabilis (23.1%). Antibiotic prophylaxis was indicated in 1,014 interventions (98.9%) being administered in 1,009 of them (99.5%). The adherence to the protocol was 92,5%. The main cause of non-compliance was the time of onset (40.9%), followed by the choice of the antibiotic (35.2%). The effect of inadequate prophylaxis on the incidence of infection was RR = 0.9; 95% CI 0.2-3.9; p> 0.05., Conclusions: The adequacy of antibiotic prophylaxis was very high, with a low incidence of surgical site infection. No association was found between adequacy of prophylaxis and incidence of infection in hysterectomy. The continuous improvement of epidemiological surveillance in gynecology should be emphasized., (©The Author 2020. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Background: Rheumatoid arthritis (RA) is a chronic autoimmune rheumatic disease that is associated with multiple comorbidities and has a significant economic impact on the Spanish health system. The objective of this study was to estimate the rates of hospitalization of rheumatoid arthritis in Spain, and describing hospitalization rates and their changing by age, region, RA variant, and when RA as a main cause of hospitalization or a comorbidity., Methods: Observational descriptive study that reviewed hospital records from the CMBD. We included all hospitalizations of patients in Spain whose main diagnosis or comorbidity in the ICD-9-CM was rheumatoid arthritis during the period of 2002-2017., Results: A total of 315,190 hospitalizations with the RA code were recorded; 67.3% were in women. The mean age of the patients was 68.5 ± 13.9 years. The median length of hospital stay was 7 days (IQR 3-11 days). In 29,809 of the admissions, RA was coded as the main diagnosis (9.4%). When RA was not coded as the main diagnosis, the most frequent main diagnoses were diseases of the circulatory system (18.9%) and diseases of the respiratory system (17.4%). The hospitalization rate during the period of 2002-2017 was 43.8 (95% CI: 43.7-44.0) per 100,000 inhabitants and constantly increased during the period. The total cost for the healthcare system was 1.476 million euros, with a median of 3542 euros per hospitalization (IQR 2646-5222 euros)., Conclusions: In Spain, the hospitalization rate of patients with RA increased during the study period, despite the decrease in the hospitalization rate when RA was the main diagnosis.

Objectives: To assess the adherence to the antibiotic prophylaxis protocol in patients undergoing prostate surgery and evaluate the effect of antibiotic prophylaxis on surgical site infections (SSI)., Material and Methods: A prospective cohort study was carried out between January 2009 and September 2016. The global compliance with the antibiotic prophylaxis protocol was evaluated studying the items: time of onset, route of administration, antibiotic prescribed, duration and dose. Percentages of adequacy are described. The incidence of infection was calculated after 30 days of follow-up. Relationship between the adequacy to the protocol and the surgical site infection are described with the relative risk. RESULTS: A total of 595 patients were studied. The global adequacy was 93.8%. The leading cause of inadequacy was the time of onset 3%. The incidence of surgical site infection was 1%. No relationship between the inadequacy of antibiotic prophylaxis and surgical site infection (RR=1.1%; 95%CI: 1.0-1.2) was found. No relationship between the procedure (laparoscopic or open surgery) and surgical site infection (RR=0.4%; 95%CI: 0.1-1.9) was found., Conclusions: The adequacy of antibiotic prophylaxis was high. The incidence of surgical site infection was low and compliance of antibiotic prophylaxis contributes to diminish surgical site infection incidence.

Background: Antibiotic prophylaxis is one of the most effective ways to avoid surgical site infection (SSI). The present study evaluates compliance with the antibiotic prophylaxis protocol and the effect of non-compliance on the incidence of SSI in breast surgery., Methods: A prospective cohort study was carried out from July 2008 to July 2018. It assessed the degree of compliance with antibiotic prophylaxis in breast surgery and the causes of non-compliance: choice of antibiotic, route of administration, time of onset, dose and duration. The incidence of SSI was studied during the 30 days after intervention (90 in the case of implants or prostheses). Relative risk (RR) was used to assess the effect of inadequate prophylaxis., Results: We studied 1,328 interventions in 1,212 women. The cumulative incidence of SSI was 1.7% (n=22) and the most common etiology was Staphylococcus aureus (47.1%). Overall antibiotic prophylaxis protocol compliance was 95.3%, (including the 568 interventions where it was not indicated). The principle causes of non-compliance were the time of onset (46.8%) and choice of antibiotic (40.3%). Non-compliance significantly increased both incidence of SSI (8.1 vs 1.3%, p=0,003) and its risk (RR=6.5, CI95% 2.3-18.1)., Conclusions: The overall protocol compliance rate was very high. Non-compliance with prophylaxis protocol at least doubled the risk of SSI in breast surgery.

The aim of this study is to report the epidemiological characteristics of a food poisoning outbreak due to scombroid fish in a hospital. A case-control study (1:4) was conducted. Patients either symptomatic of food poisoning (cases) or asymptomatic (controls) eating at the hospital cafeteria were included. To identify the source of the outbreak, sanitary control factors were assessed. Microbiological studies and the mast cell tryptase test were performed. All cases and controls received a questionnaire enquiring about symptoms and foods consumed. The odds ratios (OR) for all risk factors and their 95% confidence intervals (CI) were assessed. In total, 20 individuals (90% female) were included in the study: four cases and 16 controls. The overall mean age was 43 years (SD: 10.2). The most frequent symptom observed was facial and neck erythaema (100%). Microbiological cultures were negative, the mast cell tryptase test was normal and breakdown of the cold chain did not occur. The most likely source of the outbreak was fried anchovies (OR: 34.7; 95% CI: 1.50-809.6; p=0.02). Methods suitable to the rapid assessment of the outbreak allowed us to establish prompt preventive measures and identify the likely aetiology., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To assess hand hygiene compliance covertly in medical students in a university teaching hospital., Methods: Cross-sectional study. Hand hygiene compliance in medical students was assessed in the units of Neonatology, Paediatrics, Neurology and Orthopaedic surgery. The five moments were covertly observed so as the hand rub technique. Hand hygiene compliance was described with the compliance percentages of the five moments., Results: We studied 456 opportunities of hand hygiene. Global compliance was 44.3%. The most registered unit was Orthopaedic surgery (59.6%). According to the different moments, global compliance was better "after touching a patient" (60.2%). The unit with the highest hand hygiene compliance was Neonatology (60%). Hand hygiene compliance was better in the different hospitalisation units (50%) than in the office rooms (33%) (P<0.05) and the mean duration of hand hygiene was 22 seconds., Conclusions: Most of the moments were registered in the unit of Orthopaedic surgery and the moment with the highest hand hygiene compliance was "after touching a patient". The most hand hygiene compliance percentage was observed in Neonatology. Hand hygiene compliance was moderate, and it could and must be improved., (©The Author 2019. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Background: Surgical wound infection is one of the leading causes of healthcare-associated infections. One of the most common measures for its reduction is the pre-surgical preparation. The aim of this study was to evaluate the adequacy to the pre-surgical protocol in patients undergoing neck surgery and the relationship with the incidence of surgical wound infection., Material and Methods: Observational cohort study, conducted from January 2011 to December 2017. Variables related to patient, pre-surgical preparation and infection were collected. Infection rate was calculated after a maximum period of 30days after surgery. The effect of the pre-surgical preparation's adequacy and infection was evaluated., Results: The study included 131 patients. The global adequacy of the pre-surgical protocol was 84.7%, being the main cause of inadequacy the application of the mouthwash (7.6% of the interventions). The overall incidence of surgical wound infection during the follow-up period was 4.6% (95%CI: 1.0%-8.2%). No relationship between the adequacy to the protocol and the presence of infection was found (P=.59)., Conclusions: Adequacy of the pre-surgical preparation in our hospital was high and the incidence of surgical wound infection was low, and no relationship was found between the two. The results show a high safety culture in this surgery. However, there is still room for improvement in the quality of care of our patients., (Copyright © 2019 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Surgical site infection (SSI) is the main cause of nosocomial infection in Spain. The aim of this study was to analyze the incidence of SSI and to evaluate its risk factors in patients undergoing rectal surgery., Methods: Prospective cohort study, conducted from January 2013 to December 2016. Patient, surgical intervention and infection variables were collected. Infection rate was calculated after a maximum period of 30 days of incubation. The effect of different risk factors on infection was assessed using the odds ratio adjusted by a logistic regression model., Results: The study included 154 patients, with a mean age of 69.5±12 years. The most common comorbidities were diabetes mellitus (24.5%), chronic obstructive pulmonary disease (17%) and obesity (12.6%). The overall incidence of SSI during the follow-up period was 11.9% (CI95%: 7.8-17.9) and the most frequent microorganism was Escherichia coli (57.9%). Risk factors associated with surgical wound infection in the univariate analysis were blood transfusion, drain tubes and vasoactive drug administration (P<.05)., Conclusions: The incidence of SSI in rectal surgery was low. It is crucial to assess SSI incidence rates and to identify possible risk factors for infection. We recommend implementing surveillance and hospital control programs., (Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To assess compliance with the antibiotic prophylaxis protocol for patients who underwent renal surgery and its effect on the incidence of surgical wound infection., Material and Methods: We performed a prospective cohort study and assessed the overall compliance and each aspect of the antibiotic prophylaxis (start, administration route, antibiotic of choice, duration and dosage) and reported the compliance rates. The qualitative variables were compared with the chi-squared test, and the quantitative variables were compared with Student's t-test. We studied the effect of antibiotic prophylaxis compliance on the incidence of surgical wound infection in renal surgery, with the relative risk., Results: The study included 266 patients, with an overall compliance rate of 90.6%. The major cause of noncompliance (3.8%) was the start of the prophylaxis, and the incidence rate of surgical wound infections was 3.4%. We found no relationship between antibiotic prophylaxis noncompliance and surgical wound infections (RR=0.26; 95%CI: 0.1-1.2; P>.05). Laparoscopic surgery had a lower incidence of surgical wound infections than open surgery (RR=0.10; 95%CI: 0.01-0.79)., Conclusions: The antibiotic prophylaxis compliance was high. The incidence of surgical site infection was low, and there was no relationship between the incidence of surgical site infection and antibiotic prophylaxis compliance. The incidence of infection was lower in laparoscopic surgery., (Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: The surgical site infection is the main cause of nosocomial infection in surgical patients, being antibiotic prophylaxis one of the most important factors for preventing it. This study evaluates adequacy of antibiotic prophylaxis in hip arthroplasty surgery as well as its effect on preventing surgical site infection., Methods: A prospective cohort study was carried out from January 2011 to December 2016. We assessed the degree of adequacy of antibiotic prophylaxis in hip arthroplasty. Incidence of surgical site infection was studied after a maximum incubation period of 90 days. In order to assess the effect of inadequate prophylaxis on surgical site infection we used the relative risk adjusted with a logistic regression model., Results: We studied 681 patients. Incidence of surgical site infection was 4% (95% CI 2.5-5.5). Antibiotic prophylaxis was administered in 99% of cases, with an overall protocol adequacy of 74%. The main cause of non-compliance was the length of prescription (22.2%; 149 patients). The effect of inadequate prophylaxis on surgical site infection was RRadjusted=0.47; 95%CI 0.19-1.17, (p>0.05)., Conclusions: Adequacy of antibiotic prophylaxis was high. No relationship between prophylaxis adequacy and incidence of surgical site infection was founded. Surveillance allows us to assess surgical site infection and risk factors., (© The Author 2018. Published by Sociedad Española de Quimioterapia.)

Objetivo: Las infecciones de sitio quirúrgico se pueden evitar y los programas de control basados en paquetes de medidas preventivas son eficaces para reducir su incidencia. El objetivo de este estudio fue evaluar el efecto de un Plan de Mejora de Calidad y Seguridad Clínica del paciente intervenido de apendicectomía en la incidencia de infección del sitio quirúrgico., Método: Se realizó un estudio cuasi-experimental con análisis antes y después de la introducción de un Plan de Calidad y Seguridad Clínica. Se incluyeron pacientes intervenidos de apendicectomía. Se estudió la incidencia de infección del sitio quirúrgico durante los 30 días posteriores a la cirugía (periodo máximo de incubación de infección quirúrgica). Se evaluó el efecto de la intervención con la odds ratio (OR) ajustada con un modelo de regresión logística., Resultados: Se incluyeron 606 pacientes, 267 en el periodo 2009-2010 (antes del plan) y 339 durante 2012-2013 (después del plan). La incidencia de infección del sitio quirúrgico descendió después del plan del 6 al 5.6% (OR: 0.72; intervalo de confianza del 95%: 0.33-1.56; p = 0.839). Hubo mayor cumplimiento de la profilaxis antibiótica, de la preparación prequirúrgica y de la adherencia a la higiene de manos tras la introducción de las medidas., Conclusiones: Aunque la reducción de la incidencia de infección del sitio quirúrgico no presentó diferencias estadísticamente significativas tras las medidas adoptadas, se ha conseguido mejorar la administración de la profilaxis antibiótica, la adherencia a la higiene de manos y la preparación prequirúrgica., Objective: Surgical site infections can be prevented. Control programs based on care bundle have proven to be effective in reducing its incidence. The objective of this study was to assess the effectiveness of a Plan for Quality Improvement and Clinical Safety in preventing the incidence of surgical site infection in patients undergoing appendectomy., Method: A quasi-experimental study was designed for analysis before and after the introduction of a Plan for Quality and Clinical Safety. Patients undergoing appendectomy were included. The incidence of surgical site infection was studied within 30 days from the time of surgery (maximum incubation period of surgical site infection). The effectiveness of the intervention was evaluated using the odds ratio (OR) adjusted with a logistic regression model., Results: A total of 606 patients were included, of which 267 were operated in the period 2009-2010 (before the plan) and 339 in 2012-2013 (after the plan). The incidence of surgical site ­infection decreased after the plan from 6 to 5.6% (OR: 0.72; 95% confidence interval: 0.33-1.56; p = 0.839). There was greater compliance of antibiotic prophylaxis, preoperative preparation and adherence to hand hygiene after the introduction of the measures., Conclusions: Although the reduction in the incidence of surgical site infection after the measures adopted did not show statistical significant differences, important progress has been made in the compliance of antibiotic prophylaxis, adherence to hand hygiene and in the preoperative preparation., (Copyright: © 2018 Permanyer.)

Background: Surgical site infection (SSI) has a considerable clinical and economic impact at the hospital level, so prevention and monitoring are considered a high priority. The objective of this study was to assess compliance with the protocol of antibiotic prophylaxis in colon surgery and the effect of its inadequacy for the incidence of SSI., Methods: Prospective cohort study from July 2008 to July 2016. Compliance with antibiotic prophylaxis protocol and the causes of non-compliance were evaluated in colon surgery: duration and starting, choice, route of administration and dose of the antibiotic. The incidence of SSI was studied after a maximum incubation period of 30 days. Relative risk (RR) was used to evaluate the non-compliance causes of prophylaxis., Results: The study included 771 patients. The cumulative incidence of SSI was 5.8% (n=45), of which 2/3 were superficial incisional infections. The most common cause of SSI was Escherichia coli (28%). Antibiotic prophylaxis was administered in 97.8% of patients, with an overall protocol compliance of 91.9%. The principle cause of non-compliance was the choice of antibiotic (58.2%). No relationship between the inadequacy of prophylaxis and incidence of surgical site infection was found (RR=0.5; CI95% 0.1-1.8)., Conclusions: The overall adequacy rate to antibiotic prophylaxis protocol was high. No significant association between the adequacy of prophylaxis and incidence of surgical site infection in colon surgery was found.

Background: There are many factors that can influence surgical site infections (SSI) in cholecystectomies. Incidence of cholecystectomy SSI was studied and compared with the incidence in Madrid Region, Spain, and the United States., Methods: A prospective cohort study was conducted which included all patients who underwent gallbladder surgery for 5 consecutive years, at the Alcorcón Foundation University Teaching Hospital. SSI incidence rate was calculated. An association between risk factors and SSI incidence was assessed with the relative risk (RR). Infection rates were compared to those in the Madrid Region and to the overall Spanish and United States rates using the standardized infection ratio (SIR)., Results: The study included 1532 patients. Cumulative overall SSI was 1.96% (95% confidence interval [CI]: 1.3-2.7). The SIR was 0.89 with respect to the Madrid Region, 0.77 with respect to Spain's rate, and 1.77 with respect to the United States' rate. A laparoscopic route protected against infection (RR = 0.43; 95% CI: 0.2-0.9). Razor shaving in surgical preparation, duration of surgery, and neoplasm increased SSI incidence., Conclusions: SSI incidence rates among cholecystectomized patients at our hospital are higher than rates in the United States. A laparoscopic route protected against SSI., (Copyright: © 2017 SecretarÍa de Salud)

Objective: Antibiotic prophylaxis is the most suitable tool for preventing surgical wound infection. This study evaluated adequacy of antibiotic prophylaxis in surgery for knee arthroplasty and its effect on surgical site infection., Material and Method: Prospective cohort study. We assessed the degree of adequacy of antibiotic prophylaxis, the causes of non-adequacy, and the effect of non-adequacy on surgical site infection. Incidence of surgical site infection was studied after a maximum incubation period of a year. To assess the effect of prophylaxis non-adequacy on surgical site infection we used the relative risk adjusted with the aid of a logistic regression model., Results: The study covered a total of 1749 patients. Antibiotic prophylaxis was indicated in all patients and administered in 99.8% of cases, with an overall protocol adequacy of 77.6%. The principal cause of non-compliance was the duration of prescription of the antibiotics (46.5%). Cumulative incidence of surgical site infection was 1.43%. No relationship was found between prophylaxis adequacy and surgical infection (RR=1.15; 95% CI: .31-2.99) (P>.05)., Discussion: Surveillance and infection control programs enable risk factors of infection and improvement measures to be assessed. Monitoring infection rates enables us to reduce their incidence., Conclusions: Adequacy of antibiotic prophylaxis was high but could be improved. We did not find a relationship between prophylaxis adequacy and surgical site infection rate., (Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Antibiotic prophylaxis is the most suitable tool for preventing surgical site infection. This study assessed compliance with antibiotic prophylaxis in surgery for acute appendicitis, and the effect of this compliance on surgical site infection., Material and Methods: Prospective cohort study to evaluate compliance with antibiotic prophylaxis protocol in appendectomies. An assessment was made of the level of compliance with prophylaxis, as well as the causes of non-compliance. The incidence of surgical site infection was studied after a maximum incubation period of 30 days. The relative risk adjusted with a logistic regression model was used to assess the effect of non-compliance of prophylaxis on surgical site infection., Results: The study included a total of 930 patients. Antibiotic prophylaxis was indicated in all patients, and administered in 71.3% of cases, with an overall protocol compliance of 86.1%. The principal cause of non-compliance was time of initiation. Cumulative incidence of surgical site infection was 4.6%. No relationship was found between inadequate prophylaxis compliance and infection (relative risk=0.5; 95% CI: 0.1-1.9) (P>.05)., Conclusions: Compliance of antibiotic prophylaxis was high, but could be improved. No relationship was found between prophylaxis compliance and surgical site infection rate., (Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.)

Objective: Antibiotic prophylaxis is the most suitable tool for preventing surgical site infection (SSI), so the development of guidelines and assessment of its monitoring is essential. In this study protocol compliance of antibiotic prophylaxis in rectal surgery and the effect of its adequacy in terms of pre-ention of SSI was assessed., Methods: Prospective cohort study was conducted from 1 January 2009 to 30 December 2015. The degree of compliance with antibiotic prophylaxis and causes of non-compliance in rectal surgery was evaluated. The incidence of SSI was studied after a maximum period of 30 days of incubation. To assess the effect of prophylaxis non-compliance on SSI the relative risk (RR) adjusted with the aid of a logistic regression model was used., Results: The study covered a total of 244 patients. The patients infected reached 20 cases with a SSI cumulative incidence of 8.2% (CI95%: 4.8-11.6). Antibiotic prophylaxis was indicated in all patients and was administered in 98% of cases, with an overall protocol compliance 92.5%. The principal cause of non-compliance was the choice of antibiotic 55.6% (n=10). The effect of inadequacy of antibiotic prophylaxis on surgical infection was RR=0.58, CI95%: 0.10-4.10 (P>0.05)., Conclusions: Compliance with antibiotic prophylaxis was high. No relationship between the adequacy of prophylaxis and incidence of surgical site infection in rectal surgery was found.