RESUMEN

BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that is associated with an increased risk of major adverse cardiovascular events (MACE). The main goal was to analyze the links and associations between AF and MACE. METHODS: A multicenter, observational, retrospective, community-based study of a cohort (n = 40,297) of the general population aged 65-95 years between 1 January 2015 and 31 December 2021 without a previous diagnosis of AF or MACE in the Primary Care setting. RESULTS: 2574 people (6.39%) developed a first AF event, resulting in an overall incidence of 8.9/1000 people-years [CI95% 8.6-9.2]. The incidence of MACE among those with AF was 75.1/1000 people-years [CI95% 70.8-79.5], whereas among those without AF, it was 20.6/1000 people-years [CI 95% 20.2-21.1], resulting in a rate ratio of 3.65 [CI 95% 3.43-3.88, p < 0.001]. Besides, the incidence of HF with AF was 40.1 people-years [CI 95% 37.1-43.2], while in the group without AF, it was 8.3 people-years [CI 95% 7.9-8.6, p < 0.001], with a rate ratio of 4.85 [CI 95% 4.45-55.3, p < 0.001]. Before an AF diagnosis, there is already a higher risk of chronic kidney disease, ischemic cardiopathy, and peripheral artery disease. A higher risk of poor nutritional status was detected among those with MACE (49.7% vs. 26.6%, p < 0.001). CONCLUSIONS: AF diagnosis increases the incidence of heart failure fourfold. Additional information is required to establish the connection between AF, major adverse cardiovascular events, and nutritional status.

RESUMEN

Introducción: Entre un tercio y la mitad de la población que ha padecido un ictus presenta un trastorno neuropsiquiátrico (TNp), el cual suele estar infradiagnosticado. Objetivo: Estudiar la asociación entre la presencia de TNp y las estrategias de afrontamiento en pacientes con ictus. Sujetos y métodos: Estudio prospectivo, longitudinal y comparativo en una muestra de pacientes con ictus isquémico con y sin presencia de TNp. Se recogieron variables sociodemográficas y clínicas. Se evaluó la afectación neurológica (National Institute of Health Stroke Scale) y el afrontamiento (Brief Coping Orientation to Problems Experienced) a los tres y a los 12 meses. El período de estudio fue de 2013 a 2017. Resultados: Se analizó a 82 pacientes, con una edad media de 67,6 ± 10,4 años, y eran hombres el 52,4%. De ellos, 14 con TNp y 36 sin TNp respondieron a la escala de afrontamiento Brief Coping Orientation to Problems Experienced, y los 32 restantes fueron excluidos por afasia/disfasia. A los tres meses se observaron dimensiones de afrontamiento activo, apoyo social, negación y desconexión conductual en el grupo TNp, y a los 12 meses persistió la negación y la desconexión conductual, y aparecieron dimensiones de planificación, autodistracción y autoinculpación. Conclusiones: Los resultados muestran la necesidad de motivar a los pacientes a buscar estrategias más eficaces, identificando los problemas cuando aparecen, de considerarlos superables y de inhibir respuestas impulsivas o inadecuadas, sustituyéndolas por respuestas emocionales y conductas adecuadas.(AU)

Introduction: Between one third and one half of the population that has suffered a stroke present with a neuropsychiatric disorder (NPD), which often goes underdiagnosed. Aim: To study the association between the presence of NPDs and coping strategies in stroke patients. Subjects and methods. Prospective, longitudinal and comparative study in a sample of patients with ischaemic stroke with and without the presence of NPDs. Both sociodemographic and clinical variables were collected. Neurological impairment (National Institute of Health Stroke Scale) and coping (Brief Coping Orientation to Problems Experienced) were assessed at three and 12 months. The period studied was from 2013 to 2017. Results: A total of 82 patients were analysed, with a mean age of 67.6 ± 10.4 years, 52.4% of whom were male. Of them, 14 with NPD and 36 without NPD answered the Brief Coping Orientation to Problems Experienced coping scale, and the remaining 32 were excluded because of aphasia/dysphasia. At three months, dimensions of active coping, social support, denial and behavioural disengagement were observed in the NPD group, and at 12 months, denial and behavioural disengagement persisted, and planning, self-distraction and self-incrimination dimensions appeared. Conclusions: Results show the need to motivate patients to seek more effective strategies, to identify problems when they arise, to consider them as surmountable and to inhibit impulsive or inappropriate responses, replacing them with emotional responses and appropriate behaviours.(AU)

Asunto(s)

RESUMEN

INTRODUCTION: Between one third and one half of the population that has suffered a stroke present with a neuropsychiatric disorder (NPD), which often goes underdiagnosed. AIM: To study the association between the presence of NPDs and coping strategies in stroke patients. SUBJECTS AND METHODS: Prospective, longitudinal and comparative study in a sample of patients with ischaemic stroke with and without the presence of NPDs. Both sociodemographic and clinical variables were collected. Neurological impairment (National Institute of Health Stroke Scale) and coping (Brief Coping Orientation to Problems Experienced) were assessed at three and 12 months. The period studied was from 2013 to 2017. RESULTS: A total of 82 patients were analysed, with a mean age of 67.6 ± 10.4 years, 52.4% of whom were male. Of them, 14 with NPD and 36 without NPD answered the Brief Coping Orientation to Problems Experienced coping scale, and the remaining 32 were excluded because of aphasia/dysphasia. At three months, dimensions of active coping, social support, denial and behavioural disengagement were observed in the NPD group, and at 12 months, denial and behavioural disengagement persisted, and planning, self-distraction and self-incrimination dimensions appeared. CONCLUSIONS: Results show the need to motivate patients to seek more effective strategies, to identify problems when they arise, to consider them as surmountable and to inhibit impulsive or inappropriate responses, replacing them with emotional responses and appropriate behaviours.

TITLE: Trastornos neuropsiquiátricos y estrategias de afrontamiento emocionales en pacientes postictus. Estudio longitudinal.Introducción. Entre un tercio y la mitad de la población que ha padecido un ictus presenta un trastorno neuropsiquiátrico (TNp), el cual suele estar infradiagnosticado. Objetivo. Estudiar la asociación entre la presencia de TNp y las estrategias de afrontamiento en pacientes con ictus. Sujetos y métodos. Estudio prospectivo, longitudinal y comparativo en una muestra de pacientes con ictus isquémico con y sin presencia de TNp. Se recogieron variables sociodemográficas y clínicas. Se evaluó la afectación neurológica (National Institute of Health Stroke Scale) y el afrontamiento (Brief Coping Orientation to Problems Experienced) a los tres y a los 12 meses. El período de estudio fue de 2013 a 2017. Resultados. Se analizó a 82 pacientes, con una edad media de 67,6 ± 10,4 años, y eran hombres el 52,4%. De ellos, 14 con TNp y 36 sin TNp respondieron a la escala de afrontamiento Brief Coping Orientation to Problems Experienced, y los 32 restantes fueron excluidos por afasia/disfasia. A los tres meses se observaron dimensiones de afrontamiento activo, apoyo social, negación y desconexión conductual en el grupo TNp, y a los 12 meses persistió la negación y la desconexión conductual, y aparecieron dimensiones de planificación, autodistracción y autoinculpación. Conclusiones. Los resultados muestran la necesidad de motivar a los pacientes a buscar estrategias más eficaces, identificando los problemas cuando aparecen, de considerarlos superables y de inhibir respuestas impulsivas o inadecuadas, sustituyéndolas por respuestas emocionales y conductas adecuadas.

Asunto(s)

RESUMEN

OBJECTIVE: To identify factors related to a poor health-related and global quality of life (QoL) in a cohort of non-demented Parkinson's disease (PD) patients and compare to a control group. METHODS: The data correspond to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures. RESULTS: QoL was worse in PD patients (n = 692; 62.6 ±â€¯8.9 years old, 60.3% males) than controls (n = 206; 61 ±â€¯8.3 years old, 49.5% males): PDQ-39, 17.1 ±â€¯13.5 vs 4.4 ±â€¯6.3 (p < 0.0001); PQ-10, 7.3 ±â€¯1.6 vs 8.1 ±â€¯1.2 (p < 0.0001); EUROHIS-QOL8, 3.8 ±â€¯0.6 vs 4.2 ±â€¯0.5 (p < 0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (r = 0.72; p < 0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (r = 0.65; p < 0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire [FOGQ]) provided the highest contribution to the model (ß = 0.32, 0.28, and 0.27, respectively; p < 0.0001); whereas mood and gait problems contributed the most to global QoL (PQ-10, ß = -0.46 and -0.21, respectively; EUROHIS-QOL8, ß = -0.44 and -0.23, respectively). CONCLUSIONS: QoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.

Asunto(s)