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Using hospital discharge database to characterize Chagas disease evolution in Spain: there is a need for a systematic approach towards disease detection and control.

Herrador Z, Rivas E, Gherasim A, Gomez-Barroso D, García J, Benito A, Aparicio P - PLoS Negl Trop Dis (2015)

Bottom Line: Being male [aOR: 1.3 (1.00-1.77)], aged 45 and 64 years [aOR: 2.59 (1.42-4.71)], and a median hospitalization cost above 3,065 euro [aOR: 2.03 (3.73-7.86)] were associated with hospitalizations with organ affectation.Since 2005, the number of detected infections increased in Spain.The predominant patients' profile (asymptomatic women at fertile age) and the conditions associated with organ affectation underlines the need for increased efforts towards the early detection of T cruzi.

View Article: PubMed Central - PubMed

Affiliation: National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain; Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain.

ABSTRACT
After the United States, Spain comes second in the list of countries receiving migrants from Latin America, and, therefore, it is the European country with the highest expected number of infected patients of Chagas disease. We have studied the National Health System's Hospital Discharge Records Database (CMBD) in order to describe the disease evolution from 1997 to 2011 in Spain. We performed a retrospective descriptive study using CMBD information on hospitalizations including Chagas disease. Data was divided in two periods with similar length in time: 1997-2004 and 2005-2011. Hospitalization rates were calculated and clinical characteristics were described. We used multivariable logistic regression to calculate adjusted odds-ratio (aOR) for the association between various conditions and being hospitalized with organ affectation. A total of 1729 hospitalization records were identified. Hospitalization rates for the two periods were 18 and 242.8/100000 population, respectively. The median age was 35 years (range 0-87), 74% were female and the 16-45 age-group was mostly represented (69.8%). Overall, 23.4% hospitalizations included the diagnosis of Chagas disease with organ complications. Being male [aOR: 1.3 (1.00-1.77)], aged 45 and 64 years [aOR: 2.59 (1.42-4.71)], and a median hospitalization cost above 3,065 euro [aOR: 2.03 (3.73-7.86)] were associated with hospitalizations with organ affectation. Since 2005, the number of detected infections increased in Spain. The predominant patients' profile (asymptomatic women at fertile age) and the conditions associated with organ affectation underlines the need for increased efforts towards the early detection of T cruzi.

No MeSH data available.


Related in: MedlinePlus

Distribution of Chagas disease related hospitalization by sex, Spain, 1998–2011.
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pntd.0003710.g004: Distribution of Chagas disease related hospitalization by sex, Spain, 1998–2011.

Mentions: The median age of the 1729 hospitalizations was 35 years (range 0–87) with the 16–45 age-group being mostly represented with 1207/1729 (69.8%). A total of 74% hospitalized were female, predominating in all age-groups (Fig 4). For 206/1729 (11.9%) records, Chagas disease was registered as the first diagnosis while for 878/1729 (50.7%) appeared as second diagnosis. Other diagnoses in first position are summarized in S1 Table. In the remaining 37.4% records, Chagas disease appeared in any of the last 12 positions. The most frequent main diagnostics associated with Chagas disease were related to pregnancy, giving birth or postpartum complications (36.6%), heart and circulatory conditions (15.3%) and digestive system conditions (9.1%). The hospital departments with higher number of Chagas related admissions were Obstetrics-Gynecology (37.1%), Cardiology (13.1%), Internal Medicine (11.2%) and Digestive Diseases (7.9%) (S3 Table). Overall, 1302/1792 (75.3%) hospitalizations were related to Chagas disease without organ complications, while 388/1792 (23.4%) hospitalizations were recorded as Chagas disease with organ complications, of which 317/388 (81.7%) were due to heart complications and 71/388 (17.9%) were due to another organ complications. Invasive or non-invasive medical procedures were documented for 1463/1729 (84.6%) hospitalizations. We identified 290 different types of medical procedures; 579/1463 (33.5%) procedures were related to obstetrical surgery, 375/1463 (21.7%) were diagnosis or therapy procedures and 190/1463 (11%) were related to heart surgery. Of the total 1729 hospitalizations, 487 (28.2%) had registered a surgical intervention. The admission period was inferior to one week in 71% of Chagas related hospitalizations. The predominant admission type was urgent (76.6%) and 61.5% had a severity level of 2 (out of 4). Around 95% of them were discharged at home, decease occurring in 1.2% of overall Chagas related hospitalizations. The hospitalization median cost was 3,064.9 euros (range 287.3–939,324.1). Costs were covered by social security health care service for 95% of the cases (Table 2).


Using hospital discharge database to characterize Chagas disease evolution in Spain: there is a need for a systematic approach towards disease detection and control.

Herrador Z, Rivas E, Gherasim A, Gomez-Barroso D, García J, Benito A, Aparicio P - PLoS Negl Trop Dis (2015)

Distribution of Chagas disease related hospitalization by sex, Spain, 1998–2011.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401715&req=5

pntd.0003710.g004: Distribution of Chagas disease related hospitalization by sex, Spain, 1998–2011.
Mentions: The median age of the 1729 hospitalizations was 35 years (range 0–87) with the 16–45 age-group being mostly represented with 1207/1729 (69.8%). A total of 74% hospitalized were female, predominating in all age-groups (Fig 4). For 206/1729 (11.9%) records, Chagas disease was registered as the first diagnosis while for 878/1729 (50.7%) appeared as second diagnosis. Other diagnoses in first position are summarized in S1 Table. In the remaining 37.4% records, Chagas disease appeared in any of the last 12 positions. The most frequent main diagnostics associated with Chagas disease were related to pregnancy, giving birth or postpartum complications (36.6%), heart and circulatory conditions (15.3%) and digestive system conditions (9.1%). The hospital departments with higher number of Chagas related admissions were Obstetrics-Gynecology (37.1%), Cardiology (13.1%), Internal Medicine (11.2%) and Digestive Diseases (7.9%) (S3 Table). Overall, 1302/1792 (75.3%) hospitalizations were related to Chagas disease without organ complications, while 388/1792 (23.4%) hospitalizations were recorded as Chagas disease with organ complications, of which 317/388 (81.7%) were due to heart complications and 71/388 (17.9%) were due to another organ complications. Invasive or non-invasive medical procedures were documented for 1463/1729 (84.6%) hospitalizations. We identified 290 different types of medical procedures; 579/1463 (33.5%) procedures were related to obstetrical surgery, 375/1463 (21.7%) were diagnosis or therapy procedures and 190/1463 (11%) were related to heart surgery. Of the total 1729 hospitalizations, 487 (28.2%) had registered a surgical intervention. The admission period was inferior to one week in 71% of Chagas related hospitalizations. The predominant admission type was urgent (76.6%) and 61.5% had a severity level of 2 (out of 4). Around 95% of them were discharged at home, decease occurring in 1.2% of overall Chagas related hospitalizations. The hospitalization median cost was 3,064.9 euros (range 287.3–939,324.1). Costs were covered by social security health care service for 95% of the cases (Table 2).

Bottom Line: Being male [aOR: 1.3 (1.00-1.77)], aged 45 and 64 years [aOR: 2.59 (1.42-4.71)], and a median hospitalization cost above 3,065 euro [aOR: 2.03 (3.73-7.86)] were associated with hospitalizations with organ affectation.Since 2005, the number of detected infections increased in Spain.The predominant patients' profile (asymptomatic women at fertile age) and the conditions associated with organ affectation underlines the need for increased efforts towards the early detection of T cruzi.

View Article: PubMed Central - PubMed

Affiliation: National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain; Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain.

ABSTRACT
After the United States, Spain comes second in the list of countries receiving migrants from Latin America, and, therefore, it is the European country with the highest expected number of infected patients of Chagas disease. We have studied the National Health System's Hospital Discharge Records Database (CMBD) in order to describe the disease evolution from 1997 to 2011 in Spain. We performed a retrospective descriptive study using CMBD information on hospitalizations including Chagas disease. Data was divided in two periods with similar length in time: 1997-2004 and 2005-2011. Hospitalization rates were calculated and clinical characteristics were described. We used multivariable logistic regression to calculate adjusted odds-ratio (aOR) for the association between various conditions and being hospitalized with organ affectation. A total of 1729 hospitalization records were identified. Hospitalization rates for the two periods were 18 and 242.8/100000 population, respectively. The median age was 35 years (range 0-87), 74% were female and the 16-45 age-group was mostly represented (69.8%). Overall, 23.4% hospitalizations included the diagnosis of Chagas disease with organ complications. Being male [aOR: 1.3 (1.00-1.77)], aged 45 and 64 years [aOR: 2.59 (1.42-4.71)], and a median hospitalization cost above 3,065 euro [aOR: 2.03 (3.73-7.86)] were associated with hospitalizations with organ affectation. Since 2005, the number of detected infections increased in Spain. The predominant patients' profile (asymptomatic women at fertile age) and the conditions associated with organ affectation underlines the need for increased efforts towards the early detection of T cruzi.

No MeSH data available.


Related in: MedlinePlus