Complicaciones presentadas en apendicectomía en pacientes adultos mayores e inmunodeprimidos
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La apendicitis aguda es una de las patologías quirúrgicas más comunes en el servicio de emergencia, con una incidencia que bordea el 15% a nivel mundial. Sin embargo, esta patología se vincula con el desarrollo de complicaciones tanto como peritonitis, infecciones del sitio quirúrgico, entre otras, pues el estado inmunológico está vinculado al desarrollo de las mismas. Por ello varios estudios han demostrado la elevada prevalencia de peritonitis, infecciones post operatorias, entre otras vinculadas a un mayor riesgo en pacientes adultos mayores o con estados inmunocomprometidos. El trabajo presentado, está enfocado en los pacientes con más de 65 años y aquellos con HIV o neoplasias (inmunosupresión) del Hospital Universitario durante el periodo 2016 – 2017 (enero a enero), donde de forma observacional indirecta retrospectiva ,analizando los resultados de las capetas del servicio de estadística, se pudo determinar como la peritonitis se presentó en el 36% (11 casos en inmunocomprometidos y 17 en añosos), 20% de infecciones de sitio quirúrgico (4 en inmunocomprometidos y 11 en añosos), 12% de colostomías (2 en inmunocomprometidos y 7 en añosos); con un tiempo hospitalizado de 9.48 días, demostrando que estos pacientes requieren mayor enfoque terapéutico y valoración integral para reducir su tasa de mortalidad y morbilidad.
Acute appendicitis is one of the most common surgical pathologies in the emergency service, with an incidence that is around 15% worldwide. However, this pathology is linked to the development of complications as well as peritonitis, infections of the surgical site, among others, since the immunological state is linked to their development. For this reason, several studies have demonstrated the high prevalence of peritonitis, postoperative infections, among others linked to an increased risk in elderly patients or with immunocompromised conditions. Our presented work is focused on patients over 65 years old and those with HIV or neoplasias (immunosuppression) of the University Hospital during the period 2016 - 2017 (January to January), where retrospectively indirect observational analysis of the results of the folders from the statistical service, it was possible to determine how peritonitis occurred in 36% (11 cases in immunocompromised patients and 17 in elderly patients), 20% of surgical site infections (4 in immunocompromised patients and 11 in elderly patients), 12% of colostomies ( 2 in immunocompromised patients and 7 in elderly patients); with a hospitalized time of 9.48 days, demonstrating that these patients require a greater therapeutic approach and comprehensive assessment to reduce their mortality and morbidity rate.
Acute appendicitis is one of the most common surgical pathologies in the emergency service, with an incidence that is around 15% worldwide. However, this pathology is linked to the development of complications as well as peritonitis, infections of the surgical site, among others, since the immunological state is linked to their development. For this reason, several studies have demonstrated the high prevalence of peritonitis, postoperative infections, among others linked to an increased risk in elderly patients or with immunocompromised conditions. Our presented work is focused on patients over 65 years old and those with HIV or neoplasias (immunosuppression) of the University Hospital during the period 2016 - 2017 (January to January), where retrospectively indirect observational analysis of the results of the folders from the statistical service, it was possible to determine how peritonitis occurred in 36% (11 cases in immunocompromised patients and 17 in elderly patients), 20% of surgical site infections (4 in immunocompromised patients and 11 in elderly patients), 12% of colostomies ( 2 in immunocompromised patients and 7 in elderly patients); with a hospitalized time of 9.48 days, demonstrating that these patients require a greater therapeutic approach and comprehensive assessment to reduce their mortality and morbidity rate.
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APENDICITIS, APENDICECTOMIA, ANCIANO, HOSPITAL UNIVERSITARIO DE GUAYAQUIL, CANTON GUAYAQUIL, ECUADOR, DEPRESION