The Burden of Disease in Mexican Older Adults: Premature Mortality Challenging a Limited-Resource Health System

Parra-Rodríguez, Lorena; González-Meljem, José Mario; Gómez–Dantés, Héctor; Gutiérrez‐Robledo, Luis Miguel; López-Ortega, Mariana; García-Peña, Carmen; Medina-Campos, Raúl Hernán

doi:10.1177/0898264319836514

Cited by 20 publications

(15 citation statements)

References 24 publications

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“…Although the aging rate is not as high as in other countries, Mexico has one of the highest prevalences of chronic non-degenerative diseases; especially obesity, diabetes, and hypertension, in both young and older adults [9]. Consequently, it is suspected that the risk of fatal complications due to COVID-19 is higher than in other countries.…”

Section: Introductionmentioning

confidence: 99%

Early estimation of the risk factors for hospitalization and mortality by COVID-19 in Mexico

et al. 2020

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Background Due to a high prevalence of chronic non-degenerative diseases, it is suspected that COVID 19 poses a high risk of fatal complications for the Mexican population. The present study aims to estimate the risk factors for hospitalization and death in the Mexican population infected by SARS-CoV-2. Methods and findings We used the publicly available data released by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health (Secretaría de Salud, SSA). All records of positive SARS-CoV-2 cases were included. Two multiple logistic regression models were fitted to estimate the association between hospitalization and mortality, with other covariables. Data on 10,544 individuals (57.68% men), with mean age 46.47±15.62, were analyzed. Men were about 1.54 times more likely to be hospitalized than women (p<0.001, 95% C.I. 1.37-1.74); individuals aged 50-74 and �74 were more likely to be hospitalized than people aged 25-49 (OR 2.05, p<0.001, 95% C.I. 1.81-2.32, and OR 3.84, p<0.001, 95% C.I. 2.90-5.15, respectively). People with hypertension, obesity, and diabetes were more likely to be hospitalized than people without these comorbidities (p<0.01). Men had more risk of death in comparison to women (OR = 1.53, p<0.001, 95% C.I. 1.30-1.81) and individuals aged 50-74 and �75 were more likely to die than people aged 25-49 (OR 1.96, p<0.001, 95% C.I. 1.63-2.34, and OR 3.74, p<0.001, 95% C.I. 2.80-4.98, respectively). Hypertension, obesity, and diabetes presented in combination conveyed a higher risk of dying in comparison to not having these diseases (OR = 2.10; p<0.001, 95% C.I. 1.50-2.93). Hospitalization, intubation and pneumonia entail a higher risk of dying (OR 5.02, p<0.001, 95% C.I. 3.88-6.50; OR 4.27, p<0.001, 95% C.I. 3.26-5.59, and OR = 2.57; p<0.001, 95% C.I. 2.11-3.13, respectively). Our study's main limitation is the lack of information on mild (asymptomatic) or moderate cases of COVID-19.

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Section: Introductionmentioning

confidence: 99%

Early estimation of the risk factors for hospitalization and mortality by COVID-19 in Mexico

et al. 2020

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“…Although the aging rate is not as high as in other countries, Mexico has one of the highest prevalence of chronic non-degenerative diseases, especially obesity, diabetes, and hypertension, in both young and older adults (9). In this respect, it is suspected that the risk of fatal complications is higher than in other countries.…”

Section: Introductionmentioning

confidence: 99%

Early estimation of the risk factors for hospitalisation and mortality by COVID-19 in Mexico

Carrillo-Vega¹,

Salinas-Escudero

García-Peña³

et al. 2020

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Background. With its high prevalence of chronic non-degenerative diseases, it is suspected that in Mexico there is a high risk of fatal complications from COVID-19. The present study aims to estimate the risk factors for hospitalisation and death in the Mexican population infected by SARS-CoV-2.Methods and Findings. We used the publicly available data released by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health (Secretaría de Salud, SS). All records of positive SARS-CoV-2 cases were included. Two multiple logistic regression models were fitted to estimate the association between the hospitalisation and mortality, with other covariables. Data on 10,544 individuals (57.68% men), with mean age 46.47±15.62, were analysed.Men were about 1.54 times as likely to be hospitalized than women (p<0.001, 95% C.I. 1.37-1.74); individuals aged 50-74 and ≥74 years were more likely to be hospitalized than people from 25-49 years (OR 2.05, p<0.001, 95% C.I. 1.81-2.32, and OR 23.84, p<0.001, 95% C.I. 2.90-5.15, respectively).People with hypertension, obesity, and diabetes were more likely to be hospitalised than people without these morbidities (p<0.01). Men had more risk of death in comparison to women (OR=1.53, p<0.001, 95% C.I. 1.30-1.81) and individuals aged 50-74 and ≥75 years were more likely to die than people from 25-49 years (OR 1.96, p<0.001, 95% C.I. 1. and OR 3.74, p<0.001, respectively). Hypertension, obesity, and diabetes presented in combination, provided a higher risk of dying in comparison to not having these diseases (OR=2.10; p<0.001, 95% C.I. 1.50-2.93).Hospitalisation, intubation and pneumonia conferred a higher risk of dying (OR 5.02, p<0.001, OR 4.27, p<0.001, and OR=2.57; p<0.001, respectively). The main limitation of our study is the lack of information on mild (asymptomatic) or moderate cases of COVID-19. Conclusions.The present study points out that in Mexico, where an important proportion of the population develops two or more chronic conditions simultaneously, high mortality is a sever outcome for those infected by SARS-CoV-2.

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“…Our results could be similar to other contexts, since EDs worldwide are busy and unprepared to treat the oldest patients ( 15 ). On the other hand, our sample has unique features that could differentiate results, such as high rates of diabetes, hypertension, and overall metabolic syndrome ( 2 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…This has been increasingly recognized by health professionals, along with the urgency to have systems in place that account for an aging population ( 1 ). In addition to the well-recognized and frequent chronic diseases in older adults, there are other specific conditions (e.g., geriatric syndromes, frailty, dementia) linked to aging with unique clinical features ( 2 , 3 ). It is worth noting that acute health problems (e.g., elective surgery, decompensation of prevalent chronic diseases, traumatic injuries, etc.)…”

Section: Introductionmentioning

confidence: 99%

Hospital Complications and Frailty in Mexican Older Adults: An Emergency Care Cohort Analysis

et al. 2020

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Objectives: To describe the association of frailty level on admittance to the Emergency Department (ED) with various hospital complications including delirium, low phase angle, and low handgrip strength. Design: Prospective cohort. Setting: ED rooms of two public general hospitals in Mexico City. Participants: A total of 548 persons 60 years or older who were admitted to the ED and who were alive during follow-up testing at home were included. Measurements: A 32-item frailty index (FI) was measured on admission to the ED. Outcome measures included delirium, phase angle, and hand grip strength measured during different stages of the hospitalization (i.e., from admission to the ED through to follow-up at home). Results: From this final sample, mean age was 76 years (± SD 7.2) and 58.4% ( n = 320) were women. Mean waiting time in the ED was 5.1 h (± SD 6.2), the average stay in the ED was 99.9 (±68.2) h, and 274 subjects (50%) were admitted to a general ward after ED admission. FI was not associated with phase angle and was negatively associated with handgrip strength at admission to ED (β = −3.97, confidence interval [CI] 95% −5.56 −2.38, p < 0.001), discharge from ED (β = −3.94, CI 95% −5.97 −1.90, p < 0.001), and discharge from hospital (β = −4.93, CI 95% −7.68 −2.18, p = 0.01). FI was positively associated with delirium (β = 3.68, CI 95% 1.53–5.83, p < 0.01). Conclusion: Higher frailty at ED admission was associated with lower hand grip strength and delirium during hospitalization in Mexican older adults.

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The Burden of Disease in Mexican Older Adults: Premature Mortality Challenging a Limited-Resource Health System

Cited by 20 publications

References 24 publications

Early estimation of the risk factors for hospitalization and mortality by COVID-19 in Mexico

Early estimation of the risk factors for hospitalization and mortality by COVID-19 in Mexico

Early estimation of the risk factors for hospitalisation and mortality by COVID-19 in Mexico

Hospital Complications and Frailty in Mexican Older Adults: An Emergency Care Cohort Analysis

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