Comparación del EuroSCORE LOG y II dentro de la caracterización de variables asociadas a mortalidad postquirúrgica en una cohorte de pacientes adultos con cardiopatía isquémica de dos instituciones de la zona metropolitana de Bucaramanga

dc.contributorNaranjo Junoy, Francisco Fernando
dc.contributorNaranjo Junoy, Francisco Fernando [0000176095]
dc.contributorNaranjo Junoy, Francisco Fernando [0000-0001-8628-8743]
dc.contributorNaranjo Junoy, Francisco Fernando [Francisco-Naranjo-Junoy-2075424896]
dc.contributorNaranjo Junoy, Francisco Fernando [francisco-fernando-alberto-gabino-naranjo-junoy]
dc.creatorOrtega Ramírez, Gustavo Andrés
dc.creatorRojas Restrepo, Luis Alberto
dc.date.accessioned2023-02-21T18:13:15Z
dc.date.accessioned2023-06-12T20:30:57Z
dc.date.available2023-02-21T18:13:15Z
dc.date.available2023-06-12T20:30:57Z
dc.date.created2023-02-21T18:13:15Z
dc.date.issued2014
dc.identifierhttp://hdl.handle.net/20.500.12749/19071
dc.identifierinstname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifierreponame:Repositorio Institucional UNAB
dc.identifierrepourl:https://repository.unab.edu.co
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/6663037
dc.description.abstractEl manejo del infarto de miocardio incluye una cadena sistemática de acciones como la estratificación del riesgo pre quirúrgico para mejorar la calidad de la atención y la asignación y uso óptimo de los recursos disponibles. Esto requiere una actualización constante de los score, para optimizar la discriminación del desenlace. Objetivo general: Comparar la probabilidad de mortalidad postquirúrgica dada por el EuroSCORE LOG y II en una cohorte de pacientes adultos con cardiopatía isquémica atendida en dos instituciones de la zona metropolitana de Bucaramanga, Colombia. Metodología: estudio observacional analítico tipo cohorte retrospectiva, con muestreo no probabilístico de casos concurrentes. Pacientes mayores de 18 años, captados entre 2011- 2014, en dos instituciones de la zona metropolitana de Bucaramanga. Se realizó análisis descriptivo, bivariado y capacidad discriminativa (curvas ROC), sensibilidad y especificidad. Resultados: En los fallecidos la edad promedio fue mayor (M: 75.6 años), la fracción de eyección estaba más comprometida (35.8%) y el índice del EuroSCORE LOG y del EuroSCORE II fueron más altos (17.5 vs. 11.31). También se observó mayor disfunción neurológica (16.67% vs. 1%), proporción de pacientes en estado preoperatorio crítico (50% vs.9%) y alteración en la movilidad (16.67% vs. 1%34% fueron complicaciones postoperatorias de tipo cardíaco,(choque intraoperatorio:(29/36¡ 80.5%). Dentro de las complicaciones postoperatorias no cardíacas (5%) el mayor exponente fue el sangrado (3/5; 60%). Solo el 6% de los pacientes fallecieron para una tasa de letalidad de 5.6%. Conclusión: Uno de los problemas principales, es que los score suelen ser estáticos por la carencia de una continua actualización por lo que pueden sobreestimar el riesgo. En el presente estudio, se predijo una mortalidad del 10% con elEuroSCORE LOG y del 16% con el EuroSCORE II en comparación con la realmente observada en la cohorte de 5.6%. Se podría concluir entonces que pese a su calibración y capacidad discriminatoria satisfactoria, se subestimo los pacientes de alto riesgo, estableciendo una necesidad de diferenciar su aplicación como emergencia vs. Intervención programada.
dc.languagespa
dc.publisherUniversidad Autónoma de Bucaramanga UNAB
dc.publisherFacultad Ciencias de la Salud
dc.publisherEspecialización en Medicina Crítica y Cuidado Intensivo del Adulto
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dc.relationhttps://apolo.unab.edu.co/en/persons/francisco-fernando-alberto-gabino-naranjo-junoy
dc.rightshttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.rightsAbierto (Texto Completo)
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia
dc.titleComparación del EuroSCORE LOG y II dentro de la caracterización de variables asociadas a mortalidad postquirúrgica en una cohorte de pacientes adultos con cardiopatía isquémica de dos instituciones de la zona metropolitana de Bucaramanga


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