Browsing by Author "Bambs Sandoval, Claudia Elena"

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    Association between demographic, clinical characteristics and severe complications by SARS-CoV-2 infection in a community-based healthcare network in Chile
    (2024) Leniz Martelli, Javiera; Hernández Jaña, Sam Steven; Soto Durán, Mauricio Javier; Soto, Mauricio; Arenas, Eduardo; Margozzini Maira, Paula Andrea; Suárez, Francisco; Capurro, Daniel; Rojas Villar, María Paulina; Bambs Sandoval, Claudia Elena
    Background Most of the evidence on risk factors for COVID-19 complications comes from North America or Europe with very little research from Latin-America. We aimed to evaluate the association between sociodemographic, clinical factors and the risk of COVID-19 complications among adults in Chile, the fifth Latin-American country with more COVID-19 reported cases since de beginning of the Pandemic. Methods A retrospective population-based cohort study using data from electronic health records from a large Primary Care Network, linked to national hospital, immunization, Covid-19 PCR surveillance, mortality and birth records. We included people 18+ years old enrolled in the Primary Care Network between 1st January 2020 and 31st December 2021. Using Multivariate Cox proportional hazard models, we evaluate the association between sociodemographic, clinical characteristics with three COVID-19 complications: (1) a hospital admission, (2) an ICU admission, and (3) death due to a COVID-19 infection that occurred between the 1st January 2020 and the 31st December 2021. Results 44,674 people were included. The mean age was 44.30 (sd 17.31), 55.6% were female, 15.9% had a type of healthcare insurance for people from the lowest category of income, 11.6% and 9.4% had a record of hypertension or diabetes mellitus diagnosis. Among the 44,674 people, 455 (1.02%) had a hospital admission due to a COVID-19 infection and 216(0.48%) of them also had an ICU admission. Among the 44,674 people,148(0.33%) died due to COVID-19 infection. Older age and male sex were consistently associated with a higher risk of the three COVID-19 complications. Hypertension and diabetes were associated with a higher risk of a hospital admission and death, but not with an ICU admissions due to COVID-19 infection. Having two or more COVID-19 vaccine doses compared with no doses was associated with a lower risk of any hospital admission (HR 0.81; 95% CI 0.77–0.84), an ICU admission (HR 0.60; 95% CI 0.57–0.63) and death (HR 0.50; 95% CI 0.46–0.54). Pregnant or puerperal women were more likely to be admitted to hospital (HR 2.89; 95% CI 1.41–5.89) or ICU (HR 3.04; 95% CI 1.01–9.14). Conclusions Sociodemographic and clinical factors associated with COVID-19 complications such as age, sex and pre-existing conditions were comparable to those reported in similar studies from higher-income countries, and can be used to predict severity in COVID-19 patients.
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    Association between Lifetime Tobacco Use and Alcohol Consumption Trajectories and Cardiovascular and Chronic Respiratory Diseases among Older People
    (MDPI, 2021) Madero Cabib, Ignacio; Bambs Sandoval, Claudia Elena
    Background: We identify representative types of simultaneous tobacco use and alcohol consumption trajectories across the life course and estimate their association with cardiovascular and chronic respiratory diseases (CVDs and CRDs) among older people in Chile. Methods: We used data from a population-representative, face-to-face and longitudinal-retrospective survey focused on people aged 65-75 (N = 802). To reconstruct trajectory types, we employed weighted multichannel sequence analysis. Then, we estimated their associations with CVDs and CRDs through weighted logistic regression models. Results: Long-term exposure to tobacco use and alcohol consumption across life are associated with the highest CVD and CRD risks. Long-term nonsmokers and nondrinkers do not necessarily show the lowest CVDs and CRDs risks if these patterns are accompanied by health risk factors such as obesity or social disadvantages such as lower educational levels. Additionally, trajectories showing regular consumption in one domain but only in specific periods of life, whether early or late, while maintaining little or no consumption across life in the other domain, lead to lower CVDs or CRDs risks than trajectories indicating permanent consumption in both domains. Conclusions: A policy approach that considers CVDs and CRDs as conditions that strongly depend on previous individual experiences in diverse life domains can contribute to the improved design and evaluation of preventive strategies of tobacco use and alcohol consumption across the life course.
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    Childhood Socioeconomic Position and Cardiovascular Disease Among Older Women and Men: The Moderating Role of Parenthood Onset
    (2022) Ortiz Llorens, Manuel Ricardo; Cabib Madero, Ignacio Andres; Bambs Sandoval, Claudia Elena; Horta, Bernardo
    Objectives: Based on a life-course approach, the purpose of this study is to analyze how the age at the birth of a first child moderates the relationship between childhood socioeconomic position (SEP) and cardiovascular diseases (CVD) incidence in old age, separately for women and men. Methods: We used a rich and representative life history survey of people aged from 65 to 75 living in Santiago, Chile (n = 802), and weighted multivariate statistical models. Data collection process involved the use of face-to-face life history calendars, administered by well-trained interviewers. Results: Early motherhood increases the risk of suffering CVD among older women with a disadvantaged childhood SEP, while late motherhood decreases it. By contrast, early fatherhood decreases CVD risk among older men with an adverse childhood SEP, while late fatherhood increases it. Conclusion: Our findings about the moderating role of parenthood onset on CVD risk among older women and men with a disadvantaged childhood SEP contributes to public health reflections on unexplored cardiovascular risk factors, which lead to substantial changes in women’s and men’s life courses, and might optimize cardiovascular prevention strategies.
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    Cohort profile: the Cohorts Consortium of Latin America and the Caribbean (CC-LAC)
    (2020) Carrillo Larco, Rodrigo M.; Di Cesare, Mariachiara ; Hambleton, Ian R.; Hennis, Anselm; Irazola, Vilma; Stern, Dalia; Ferreccio Readi, Fresia Catterina; Lotufo, Paulo; Perel, Pablo; Gregg, Edward W.; Ezzati, Majid; Goodarz, Danaei; Miranda, J. Jaime; Aguilar-Salinas, Carlos A.; Álvarez Váz, Ramón; Amadio, Marselle B.; Baccino, Cecilia; Arenas, Sandra; Bambs Sandoval, Claudia Elena; Cortés Arancibia, Sandra Isabel; Cohorts Consortium of Latin America and the Caribbean (CC-LAC)
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    Impact of common cardio metabolic risk factors on fatal and non fatal cardiovascular disease in Latin America and the Caribbean: an individual level pooled analysis of 31 cohort studies
    (Elsevier Ltd, 2021) Carrillo-Larco, Rodrigo M.; Stern, Dalia; Hambleton, Ian; Hennis, Anselm; Cesare, Mariachiara Di; Lotufo, Paulo; Ferreccio Readi, Fresia Catterina; Irazola, Vilma; Perel, Pablo; Gregg, Edward W.; Miranda, J. Jaime; Ezzati, Majid; Goodarz, Danaei; Aguilar-Salinas, Carlos A.; Alvarez-Váz, Ramón; Marselle B., Amadio; Baccino, Cecilia; Bambs Sandoval, Claudia Elena; Bastos, Joao Luiz; Cortés Arancibia, Sandra Isabel; Cohorts Consortium of Latin America and the Caribbean (CC-LAC)
    Background: estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains unknown. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n=168,287) and non-fatal (13 cohorts, n=27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 100,000 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those estimated from cohorts in high-income countries. Funding: Wellcome Trust (214185/Z/18/Z)
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    Variación estacional de las defunciones por infarto agudo del miocardio en Chile
    (2021) Cerda Lorca, Jaime Rodrigo; Bambs Sandoval, Claudia Elena
    Background: Hospitalization and deaths due to cardiovascular diseases (CVD), have a peak in frequency during winter.Aim:To assess the existence of seasonal variation in deaths due to acute myocardial infarction (AMI) in Chile.Material and Methods:Analysis of death report databases available at the website of the Chilean Ministry of Health. The seasonality of deaths due to AMI (codes ICD-10 I21, I22, I23) occuring in Chile between 2001-2016 were analyzed using a geometric model assuming a sinusoidal cyclic pattern.Results:During the period 2001-2016, a total of 94,788 deaths due to AMI were registered, corresponding to 93,349 corrected deaths. Of the latter, 29.2% occurred in winter, 24.9% in spring, 24.0% in autumn and 21.8% in summer. The geometric model showed a marked sinusoidal pattern for the aggregated data. The peak-to-low ratio of deaths was 1.41 (95% CI 1.38-1.44). The peak of deaths occurred during July in 14 out of 16 years analyzed.Conclusions:In Chile, deaths due to AMI have a marked seasonal pattern, characterized by a higher number of deaths in winter and a lower number in summer.