Browsing by Author "Mendoza, Laura"
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Publication Riesgo de muerte por COVID-19 comparado con muertes por enfermedades respiratorias, 2015-2019, Chile(2024) Orellana, Julio; Horna, Olivia; Mendoza, Laura; Herrera, Ana; Cavada, GabrielObjetivo: Determinar cuando el riesgo de muerte por COVID-19 durante el 2020-2023 difiere del riesgo de muerte por enfermedades respiratorias virales ocurridas durante 2015-2019. Materiales y métodos: Estudio ecológico de series de tiempo. Las muertes por COVID-19 se obtuvieron del Ministerio de Salud y las muertes por enfermedades virales (códigos CIE-10 J09X, J100, J101, J108, J110, J111, J118, J120, J121, J122, J123, J128, J129 y J189) del Departamento de Estadísticas e Información de Salud. Para el análisis, se generó el período prepandémico (2015-2019) calculando la mediana de muertes y de habitantes por meses y año por enfermedades respiratorias virales. Luego se calculó la tasa de mortalidad general anual usando como numerador las muertes anuales y denominador la población del país al 30 de junio de cada año. Para la comparación del periodo prepandémico y pandémico según mes y año, se utilizó el modelo de regresión Poisson. Se reporta Incidence Rate Ratio (TIR) e Intervalos de confianza al 95%. Resultados: Entre 2015-2019 se registraron 15081 defunciones por enfermedades respiratorias virales y desde marzo-2020 hasta agosto-2023 se registraron 53376 por COVID-19. La mayor mortalidad por COVID-19 fue el 2020, 2021 y 2022, TIR:5,57, 7,18 y 4,07 respectivamente. Desde el 2023 la mayor mortalidad es mayor por enfermedades respiratorias virales (TIR:0,93,IC95%:0,88-0,99). Conclusión: El análisis de incidencias de mortalidad, puede ser un criterio útil para el manejo de epidemias, ya que es una manera de aproximarnos a inferir que la gravedad de la pandemia de COVID-19 podría estar concluyendo. Objective: Determine when the risk of death from COVID-19 in 2020-2023 differs from the risk of death from viral respiratory illness in 2015-2019. Materials and Methods: Ecological time series study. Deaths due to COVID-19 were obtained from the Ministry of Health and deaths due to viral diseases (ICD-10 code: J09X, J100, J101, J108, J110, J111, J118, J120, J121, J122, J123, J128, J129 and J189) from the "Departamento de Estadísticas e Información de Salud". For the analysis, the pre-pandemic period (2015-2019) was generated by calculating the median number of deaths and inhabitants per month and year due to viral respiratory diseases. Then, the annual overall mortality rate was calculated using as numerator the annual deaths and denominator the population of the country as of June 30 of each year. The Poisson regression model was used to compare the pre-pandemic and pandemic periods by month and year. Incidence Rate Ratio (IRR) and 95% confidence intervals are reported. Results: Between 2015-2019 there were 15081 deaths due to viral respiratory diseases and from March-2020 to August-2023 there were 53376 deaths due to COVID-19. The highest mortality due to COVID-19 was in 2020, 2021 and 2022, IRR:5.57, 7.18 and 4.07 respectively. Since 2023, the highest mortality is due to viral respiratory diseases (IRR:0.93,95%CI:0.88-0.99). Conclusion: The analysis of mortality incidences can be a useful criterion for the management of epidemics, since it is a way to approximate that the severity of the COVID-19 pandemic could be coming to an end.Item The boundaries of mild chronic obstructive pulmonary disease (COPD): Design of the searching clinical COPD onset (SOON) study(BMJ Publishing Group, 2017) Labarca, Gonzalo; Bustamante, Andrea; Valdivia, Gonzalo; Diaz, Rodrigo; Huete, Alvaro; Mac Nab, Paul; Mendoza, Laura; Leppe, Jaime; Lisboa, Carmen; Saldias, Fernando; Diaz, OrlandoINTRODUCTION: Clinical onset of chronic obstructive pulmonary disease (COPD) is the point at which the disease is first identifiable by physicians. It is a poorly defined stage which seems to include both mild spirometric and non-spirometric disease, and could be described as early grade COPD, for practical purposes. While dyspnoea; chronic bronchitis and CT imaging evidence of emphysema and airway disease may be present very early, the lone significance of dyspnoea, the most relevant symptom in COPD in identifying these individuals, has been scarcely assessed.The Searching Clinical COPD Onset (SOON) Study was designed primarily to detect clinical, physiological and structural differences between dyspnoeic and non-dyspnoeic individuals with early grade COPD. It is hypothesised that presence of dyspnoea in early disease may identify a subtype of individuals with reduced exercise capacity, notwithstanding of their spirometry results. In addition, dyspnoeic individuals will share worse quality of life, lower physical activity, greater lung hyperinflation greater emphysema and airway thickness and reduced peripheral muscle mass than their non-dyspnoeic counterpart. METHODS AND ANALYSIS: SOON is a monocentric study, with a cross sectional design aimed at obtaining representative samples of current or ex-smoker-adults aged ≥45 and ≤80 years. Two hundred and forty participants will be enrolled into four strata, according to normal spirometry or mild spirometric obstruction and presence or not of dyspnoea modified Medical Research Council score ≥1. The primary outcome will be the difference between dyspnoeic and non-dyspnoeic individuals on the 6-min walk test performance, regardless of their spirometry results. To account for the confounding effect of heart failure on dyspnoea, stress echocardiography will be also performed. Secondary outcomes will include clinical (quality of life, physical activity), physiological (exercise testing) and structural characteristics (emphysema, airway disease and peripheral muscle mass by CT imaging). ETHICS AND DISSEMINATION: The Institutional Ethics Committee from Pontificia Universidad Católica de Chile has approved the study protocol and signed informed consent will be obtained from all participants. The findings of the trial will be disseminated through relevant peer-reviewed journals and international conference presentations.