Study design A retrospective population-based study. Objectives Describe the incidence of traumatic spinal cord injury (TSCI) and mortality risks, based on the characteristics of the patient, anatomical level of the lesion, setting/cause of the injury, and type of healthcare support received within the regional trauma network (highly specialized trauma center or spoke hospital). Setting Between 2011 and 2020, 1303 patients with incident TSCI were identified in a population of 4.9 million inhabitants. Methods Hospital discharge records and mortality records were used to identify patients and outcomes. Cox regression models were fitted to estimate mortality risks across several subgroups. Results Over the past decade, age-sex-standardized TSCI incidence rates remained stable with 26.5 cases (95% CI, 25.0–27.9) per 1,000,000 inhabitants (mean age 59.2 years) and most cases were males (68.3%). Incidence was directly associated with age while the male to female ratio was inversely related. Most TSCIs were cervical lesions (52.1%), and the most common cause of injury were traffic crashes (29.9%) followed by occupational accidents (29.8%). Sex, cause of the trauma, or inpatient hospital management were not associated with an increased risk of death. Mortality rates were greater for cervical lesions, and increased with age, remaining stably high among older individuals even 12 months after the accident. One-month mortality risk was significantly higher at ≥75 years compared to <55 years (adjusted HR 9.14 (95% CI, 4.17–20.03)). Conclusion Public health policies should aim at reducing preventable TSCIs, and special attention should be drawn to long-term management of elderly patients in the attempt to decrease mortality rates.

Background Veneto was one of the Italian regions hit hardest by the early phase of the coronavirus disease (COVID-19) pandemic. Aim This paper describes the public health response and epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the Veneto Region from 21 February to 2 April 2020. Methods Information on the public health response was collected from regional health authorities’ official sources. Epidemiological data were extracted from a web-based regional surveillance system. The epidemic curve was represented by date of testing. Characteristics of hospitalised COVID-19 cases were described and compared to those never admitted to hospital. Age- and sex-stratified case-fatality ratios (CFRs) were calculated. Results Key elements of the regional public health response were thorough case-finding and contact tracing, home care for non-severe cases, creation of dedicated COVID-19 healthcare facilities and activation of sub-intensive care units for non-invasive ventilation. As at 2 April 2020, 91,345 individuals were tested for SARS-CoV-2 and 10,457 (11.4%) were positive. Testing and attack rates were 18.6 per 1,000 and 213.2 per 100,000 population, respectively. The epidemic peaked around 20 to 24 March, with case numbers declining thereafter. Hospitalised cases (n = 3,623; 34.6%) were older and more frequently male compared with never-hospitalised cases. The CFR was 5.6% overall, and was higher among males and people > 60 years of age. Conclusion In the Veneto Region, the strict social distancing measures imposed by the Italian government were supported by thorough case finding and contact tracing, as well as well-defined roles for different levels of care.

BackgroundRheumatoid arthritis (RA) prevalence is believed to be around 1% worldwide, although it varies considerably among different populations.[1] Several environmental factors such as smoking, certain infections, and diet contribute to the risk of RA and differ between populations.[2] The pooled prevalence of RA was estimated to be 0.54% (95% CI 0.50–0.59) in Europe,[1] but no studies have recently evaluated the epidemiology of RA in Italy.ObjectivesWe aimed at estimating the incidence and prevalence of RA in northeastern Italy over the period 2012–2020.MethodsA retrospective population-based study was conducted in the Veneto Region (4.9 million people) using the Population Registry, an administrative health database where all residents are recorded. The population registry was linked with healthcare co-payments exemptions, hospital discharge records, and mortality records. Between 2012 and 2020, RA prevalence was defined by a healthcare copayment exemption for RA (national registry code 006) or any hospital diagnosis of RA (ICD-9-CM 714.x), whichever came first. Incident RA was defined from 2013 to 2020 to exclude prevalent cases. Standardized incidence and prevalence rates were reported by age and gender.ResultsDuring the study period, we identified 37,996 prevalent RA patients, with 12,875 incident cases. Across the study period, RA standardized prevalence increased from 0.50% (95% CI 0.50; 0.51) to 0.57% (95% CI 0.57; 0.58). RA point prevalence in 2020 according to gender and age is reported in Figure 1. RA incidence corresponded to 33.1 (32.5; 33.7) per 100,000 person-years, with the lowest incidence observed in the last two years of the study: 27.4 (25.9; 28.9) in 2020 and 32.2 (30.6; 33.8) in 2019 (Table 1). The peak for both prevalence and incidence was around the eighth decade of life. Incidence was 2-times higher in females: female-to-male incidence rate ratio (IRR) 2.3 (2.2; 2.4) (p<0.0001), with a peak among people aged 20-29 years, where female-to-male IRR was 3.1 (2.4; 3.9) and the lowest value among patients aged ≥70 years, where F:M IRR was 1.6 (1.4; 1.8).ConclusionThe prevalence of RA in Italy is 0.57%, in line with data from other European countries. Incidence was confirmed to be higher among females, especially in younger patients.References[1]Almutairi K et al. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int 2021;41:863–877.[2]Tobon, GJ, et al. The environment, geo-epidemiology, and autoimmune disease: Rheumatoid arthritis. J Autoimmun 2010;35:10–14.Figure 1.The point prevalence of Rheumatoid Arthritis in The Veneto Region in 2020 by age and gender.Table 1.Incidence of Rheumatoid Arthritis in the Veneto Region between 2013 and 2020.YearNew diagnosis, numberPopulationCrude rate (95%IC) x 100,000Standardized IR (95%IC)x100,000*New diagnosis, numberStandardized IR (95%IC)x100,000*MaleFemaleMaleFemale20131.6154.901.41532.9 (31.3; 34.6)34.2 (32.5; 35.8)475114020.8 (18.9; 22.7)46.9 (44.1; 49.6)20141.7384.905.71235.4 (33.8; 37.1)36.4 (34.7; 38.1)508123021.9 (20.0; 23.9)50.2 (47.3; 53.0)20151.5754.902.69432.1 (30.5; 33.7)32.7 (31.1; 34.3)462111319.8 (18.0; 21.6)45.0 (42.4; 47.7)20161.6254.890.64833.2 (31.6; 34.8)33.5 (31.9; 35.2)487113820.7 (18.8; 22.5)45.8 (43.1; 48.5)20171.6514.883.37333.8 (32.2; 35.4)33.8 (32.2; 35.4)461119019.4 (17.6; 21.1)47.6 (44.9; 50.3)20181.7104.880.93635.0 (33.4; 36.7)34.8 (33.1; 36.4)504120620.9 (19.1; 22.7)48.0 (45.3; 50.7)20191.5964.884.59032.7 (31.1; 34.3)32.2 (30.6; 33.8)463113319.0 (17.3; 20.8)44.8 (42.2; 47.4)20201.3654.879.13328.0 (26.5; 29.5)27.4 (25.9; 28.9)40695916.5 (14.9; 18.1)37.8 (35.4; 40.2)TOT**12.87539.128.50132.9 (32.3; 33.5)33.1 (32.5; 33.7)3766910919.9 (19.2; 20.5)45.7 (44.8; 46.6)Acknowledgements:NIL.Disclosure of InterestsMargherita Zen Speakers bureau: Abbvie, Ely Lilly, GSK, Galapagos, AstraZeneca, Laura Salmaso: None declared, Claudio Barbiellini Amidei: None declared, Alessandro Giollo Speakers bureau: Galapagos, Abbvie, Ugo Fedeli: None declared, Stefania Bellio: None declared, Federico Arru: None declared, Ilenia Gennaio: None declared, Mario Saia: None declared, Andrea Doria Speakers bureau: GSK, AstraZeneca, UCB, Pfizer, Consultant of: GSK, AstraZeneca.

Deterioration of physical and functional capacities is often seen in nursing homes. The present study aimed at assessing the effectiveness of an individually tailored physical exercise intervention on mobility and functional decline in nursing home residents in a 1-year follow-up period. Information on gender, age, education, profession and cognitive status was collected at baseline and at 6 and 12 months of the intervention. The decline in functional capacity and mobility was assessed using the Barthel index. Some 221 participants were included. Results from the multivariate logistic regression showed how residents who never participated in physical activities had a five-fold higher risk of mobility decline compared with residents who did engage for the whole follow-up time. A lower effect was seen in residents who participated for only 6 months. Although dementia appeared to be a significant predictor of decline, a substantial stabilisation in mobility capacity was noted in patients with both mild and severe dementia performing exercise. The findings suggest that preventing or slowing physical decline in nursing home residents is an achievable goal, and even those with a higher degree of cognitive decline may benefit from a tailored physical activity plan.

No abstract