Romero Vigara J C, Llisterri Caro J L, Turégano Yedro M, Cinza Sanjurjo S, Muñoz González L, Silvero Y A, Segura Fragoso A, Santianes Patiño J, García García J I, Benítez Rivero J
Centro de Salud de Talarrubias, Talarrubias, Badajoz, España.
Centro de Salud Ingeniero Joaquín Benlloch, Valencia, España.
Semergen. 2019 Sep;45(6):366-374. doi: 10.1016/j.semerg.2018.10.004. Epub 2018 Dec 9.
To describe the clinical and socio-sanitary characteristics of adults older than 65 years attended in a Primary Care setting.
The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a descriptive, cross-sectional and multicentre study, in which patients older than 65 years attended in clinical practice in Primary Care in Spain were consecutively included.
A total of 2,461 patients (mean age 76.0±6.9 years, 57.9% women) were included in the study. The coexistence of cardiovascular risk factors and comorbidities was frequent, with arterial hypertension (73.7%) being the most prevalent, followed by dyslipidaemia (58.3%), arthrosis (56.4%), obesity (34.0%), and diabetes (28.9%). Some degree of cognitive impairment was observed in 13.4% of patients. Women had higher rates of frailty (61.0% vs. 51.8%; P<.001). Just under half (47.4%) of subjects were taking more than 6 drugs, with the prescription being higher in women (44.2% vs. 49.8%; P=.047). Just under half (49.5%) of patients made more than 10 visits to Primary Care, 25.9% of patients 4 or more visits to the specialist, and 22.3% of patients were admitted to hospital in the last year.
The PYCAF study shows that elderly patients have a higher prevalence of chronic cardiovascular and non-cardiovascular diseases, which leads to high polypharmacy. The latter has consequences both on patient safety and on the direct and indirect costs of the National Health System that emanate from the care of patients over 65 years of age. Half the sample has fragility.
描述在初级保健机构就诊的65岁以上成年人的临床和社会卫生特征。
PYCAF研究(脆弱老年人的患病率和特征)是一项描述性、横断面和多中心研究,连续纳入在西班牙初级保健临床实践中就诊的65岁以上患者。
共纳入2461例患者(平均年龄76.0±6.9岁,57.9%为女性)。心血管危险因素和合并症并存的情况很常见,其中动脉高血压(73.7%)最为普遍,其次是血脂异常(58.3%)、关节病(56.4%)、肥胖(34.0%)和糖尿病(28.9%)。13.4%的患者存在一定程度的认知障碍。女性的虚弱率更高(61.0%对51.8%;P<0.001)。近一半(47.4%)的受试者服用超过6种药物,女性的处方率更高(44.2%对49.8%;P=0.047)。近一半(49.5%)的患者到初级保健机构就诊超过10次,25.9%的患者到专科医生处就诊4次或更多次,22.3%的患者在过去一年中住院。
PYCAF研究表明,老年患者慢性心血管疾病和非心血管疾病的患病率较高,这导致了高药物治疗率。后者对患者安全以及国家卫生系统因照顾65岁以上患者而产生的直接和间接成本都有影响。样本中有一半存在脆弱性。