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Brugos Larumbe, Antonio

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https://academica-e.unavarra.es/handle/2454/48753

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Brugos Larumbe

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Antonio

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Ciencias de la Salud

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0000-0001-6951-6396

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7894

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2021 - 20223
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Author: Guillén Aguinaga, Sara ×

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    PublicationOpen Access
    Variability in the control of type 2 diabetes in primary care and its association with hospital admissions for vascular events. The APNA study
    (MDPI, 2021) Guillén Aguinaga, Sara; Forga, Lluís; Brugos Larumbe, Antonio; Guillén Grima, Francisco; Guillén Aguinaga, Laura; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
    Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. This study aimed to analyze how the differences in delivered care (variability of glycosylated hemoglobin (HbA1c) achieved targets) affect hospital admissions for cardiovascular events (CVEs) in T2D patients. Methods: We analyzed the electronic records in primary care health centers at Navarra (Spain) and hospital admission for CVEs. We followed 26,435 patients with T2D from 2012 to 2016. The variables collected were age, sex, health center, general practitioner practice (GPP), and income. The clinical variables were diagnosis of T2D, weight, height, body mass index (BMI), blood pressure (BP), HbA1c, low-density lipoprotein cholesterol (LDL-C), smoking, and antecedents of CVEs. We calculated, in each GPP practice, the proportion of patients with HbA1c ≥ 9. A non-hierarchical K-means cluster analysis classified GPPs into two clusters according to the level of compliance with HbA1C ≥ 9% control indicators. We used logistic and Cox regressions. Results: T2D patients had a higher probability of admission for CVEs when they belonged to a GPP in the worst control cluster of HbA1C ≥ 9% (HR = 1.151; 95% CI, 1.032–1.284).
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    PublicationOpen Access
    Schizophrenia and hospital admissions for cardiovascular events in a large population: the APNA study
    (MDPI, 2022) Guillén Aguinaga, Sara; Brugos Larumbe, Antonio; Guillén Aguinaga, Laura; Ortuño, Felipe; Guillén Grima, Francisco; Forga, Lluís; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
    (1) Background: patients with schizophrenia have higher mortality, with cardiovascular diseases being the first cause of mortality. This study aims to estimate the excess risk of hospital admission for cardiovascular events in schizophrenic patients, adjusting for comorbidity and risk factors. (2) Methods: the APNA study is a dynamic prospective cohort of all residents in Navarra, Spain. A total of 505,889 people over 18 years old were followed for five years. The endpoint was hospital admissions for a cardiovascular event. Direct Acyclic Graphs (DAG) and Cox regression were used. (3) Results: schizophrenic patients had a Hazard Ratio (HR) of 1.414 (95% CI 1.031–1.938) of hospital admission for a cardiovascular event after adjusting for age, sex, hypertension, type 2 diabetes, dyslipidemia, smoking, low income, obesity, antecedents of cardiovascular disease, and smoking. In non-adherent to antipsychotic treatment schizophrenia patients, the HR was 2.232 (95% CI 1.267–3.933). (4) Conclusions: patients with schizophrenia have a higher risk of hospital admission for cardiovascular events than persons with the same risk factors without schizophrenia. Primary care nursing interventions should monitor these patients and reduce cardiovascular risk factors.
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    PublicationOpen Access
    Being born in winter-spring and at around the time of an influenza pandemic are risk factors for the development of schizophrenia: the apna study in Navarre, Spain
    (MDPI, 2021) Álvarez-Mon, Miguel Ángel; Guillén Aguinaga, Sara; Pereira-Sánchez, Víctor; Onambele, Luc; Al-Rahamneh, Moad J.; Brugos Larumbe, Antonio; Guillén Grima, Francisco; Ortuño, Felipe; Ciencias de la Salud; Osasun Zientziak
    Background: we analyzed the relationship between the prevalence of schizophrenia and the season of birth and gestation during a period of an influenza pandemic. Methods: cross-sectional analysis of a prospective population-based cohort of 470,942 adults. We fitted multivariant logistic regression models to determine whether the season of birth and birth in an influenza-pandemic year (1957, 1968, 1977) was associated with schizophrenia. Results: 2077 subjects had been diagnosed with schizophrenia. Logistic regression identified a significantly greater prevalence of schizophrenia in men than in women (OR = 1.516, CI 95% = 1.388–1.665); in those born in the winter or spring than in those born in the summer or autumn (OR = 1.112, CI 95% = 1.020–1.212); and in those born in a period of an influenza pandemic (OR = 1.335, CI 95% = 1.199–1.486). The increase in risk was also significant when each influenza pandemic year was analyzed separately. However, neither month of birth nor season of birth, when each of the four were studied individually, were associated with a statistically significant increase in that risk. Conclusions: the winter–spring period and the influenza pandemics are independent risk factors for developing schizophrenia. This study contradicts many previous studies and thus revitalizes a locked debate in understanding the neurodevelopmental hypothesis of this disorder.