Milagros Fernanda Pantia Flores

Background: This study aims to describe trends in the rate of acute myocardial infarction (AMI) in patients with and without COPD in Spain, 2001-2010. Methods: We selected all patients with a discharge of AMI using national hospital discharge data. Discharges were grouped by COPD status: COPD and non COPD. The cumulative incidence of discharges attributed to AMI were calculated overall and stratified by COPD status and year. We calculated length of stay (LOS) and in-hospital mortality (IHM). Results: From 2001 to 2010, 513,517 discharges with AMI were identified (7.79% with COPD). The cumulative incidence of discharges due to AMI in COPD patients increased (from 15.69 cases per 100,000 in 2001 to 18.4 in 2003), then decreased to 12.77% in 2010. The pattern was similar in non-COPD patients. It increased from 193.22 cases per 100.000 in 2001 to 211.12 in 2010, and then decreased to 177.79 in 2010. LOS and IHM decreased significantly over time in both groups. LOS decreased from 10.71 (9.64) days in 2001 to 9.09 (9.21) days in 2010 in COPD patients, and from 9.97 (9.14) days in 2001 to 8.9 (9) days in 2010 in non-COPD patients. IHM also decreased from 12.29% in 2001 to 10.82% in 2010 in COPD patients, and from 11.67% to 8.17% in 2010 in non-COPD patients. Conclusions: AMI hospitalization rates increased initially and have since declined slowly. LOS and IHM have decreased significantly in both groups, remaining higher in COPD patients.

ABSTRACT COPD Comorbidity PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: To analyze clustering of unhealthy lifestyle behavior and its relationship with non-adherence to recommended clinical preventive care services among Spanish COPD patients. Cross-sectional study including 2,575 COPD patients from the 2006 Spanish National Health Survey and 2009 European Health Survey for Spain. Subjects were asked about the following recommended preventive practices: uptake of blood pressure (BP) measurement, lipid profile, influenza vaccination and dental examination. Lifestyle behaviors included smoking status, physical activity, alcohol consumption and obesity. Logistic regression models were built to assess the association between clustering of unhealthy lifestyle and the uptake of preventive activities. Blood pressure measurement in the previous 6 months and blood lipid test in the last year had not been taken by 11.74% and 23.26% of the subjects respectively in 2006 NHS and by 11.16% and 16.33% of the subjects respectively in EHISS 2009. 36.36% percent had not been vaccinated and 70.61% had not received dental examination in 2006 NHS and these percentages changed to 27.33% and 66.22% respectively in 2009 EHISS. Higher number of unhealthy lifestyle behaviors increased the probability of not being vaccinated and not having a dental problem. Clustering of unhealthy lifestyle behaviors is linearly associated with a greater number of preventive measures unfulfilled. Compliance with healthy lifestyles and adherence to recommended clinical preventive services is under desirable levels among Spanish COPD patients. Patients with worse lifestyles are those who also have lower uptake of recommended preventive activities. Interventions are required to identify and modify the behaviors and adherence among those who are at greatest risk for comorbid complications. Patients with worse lifestyles are those who also have lower uptake of recommended preventive activities. The following authors have nothing to disclose: Alicia Oliva Ramos, Javier de Miguel Díez, Rodrigo Jimenez García, Milagros Llanos Flores, Irene María Jarana Aparicio, Julio César Vargas Espinal, Valentín Hernández Barrera, Pilar Carrasco GarridoNo Product/Research Disclosure Information.

ABSTRACT AsthmaSESSION TYPE: Slide PresentationsPRESENTED ON: Saturday, March 22, 2014 at 12:15 PM - 01:15 PMPURPOSE: To assess the changes in incidence, length of stay (LOS) and costs of patients hospitalized for asthma exacerbations (AE), between 2002 and 2010. We included patients hospitalized for AE between 2002 and 2010 (ICD9-CM codes 493.0x-493.9x). We analyze, on the one hand, pediatric patients (0-15 years old) and, on the other hand, young adults (16-45 years old).The data were collected from the National Hospital Discharge Database (entire population). We analyzed the incidence, LOS and costs per patient in the two groups from 2002 to 2010. We included a total of 12,038 pediatric patients and 2,792 young adults with AE. Overall crude incidence decreased from 20.5 to 18.7 AE per 100.000 inhabitants in the pediatric group (p<0.05), and also decreased from 4.12 to 3.68 AE per 100.000 inhabitants in the adult group, from 2002 to 2010 (p<0.05). The mean LOS decreased progressively in both groups during the study period, from 3.71 (SD 2.28) to 3.16 (SD 2.11) days in the pediatric group and from 5.36 (SD 4.02) to 5.16 (SD 5.39) days in the adult group, from 2002 to 2010 (p<0.05). 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 it increased from 2183.44 (SD 783.15) to 2564.32 (SD 1933.98) euros in the adult group (p<0.05). Our results suggest a decrease in the incidence of hospital admissions for AE with concomitant decrease in LOS in asthmatic patients, both in pediatric age as young adults. Although the mean cost has decreased in pediatric patients group, in young adults group has increased. Better management of disease may explain the improvement in the incidence and outcomes. The following authors have nothing to disclose: Irene Jarana Aparicio, Javier De Miguel Díez, Rodrigo Jimenez García, Julio César Vargas Espinal, Milagros Llanos Flores, Alicia Oliva Ramos, Valentín Hernández Barrera, Pilar Carrasco GarridoNo Product/Research Disclosure Information.