Estratificación de riesgo y pronóstico de mortalidad en pacientes con síndrome coronario agudo aplicando score de Timi y score de Grace estudio realizado en Hospital Abel Gilbert Pontón de la ciudad de Guayaquil de enero a diciembre del año 2016
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
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Introducción: la estratificación de riesgo es uno de los principales ejes en el manejo de pacientes con síndromes coronarios agudos (SCA). Actualmente está recomendado el estadiaje en base a escalas de predicción, las más relevantes son la escala de GRACE y TIMI. Objetivo: Determinar el score de GRACE y TIMI como algoritmos para estadificar el riesgo de mortalidad intrahospitalaria posterior a un episodio de síndrome coronario agudo en pacientes mayores a 40 años ingresados al Hospital Abel Gilbert Pontón durante el año 2016. Métodos: Estudio de enfoque cuantitativo, diseño no experimental, de corte transversal utilizando método observacional y analítico. Resultados:100 pacientes con SCA fue la muestra de trabajo, de los cuales 90 padecieron SCACEST, 8 pacientes con SCASEST y 2 pacientes con Angina Inestable. Score TIMI: Bajo riesgo con puntaje de 1 representaron el 16% de los casos, puntaje de 2 fueron el 49%,en cuanto a Riesgo moderado 25% de la muestra con puntaje de 3 y el 4% tuvo un puntaje de 4. Un 10% del total de la muestra presenta puntaje de 4 y 5, los pacientes con Riesgo alto fueron 6%. Para el Score de GRACE, el 6% presenta un bajo riesgo de mortalidad intrahospitalaria, el 58% de pacientes tiene un alto riesgo de mortalidad intrahospitalaria, y el grupo de riesgo intermedio fue de 36%. Conclusión: el género masculino, las edades comprendidos entre 40 a 69 años y los pacientes provenientes de áreas urbanas son losmás propensos a sufrir eventos síndrome coronario agudo. En el Score TIMI se carece de una variable en aproximadamente la mitad de los casos, por lo que sus resultados son cuestionables para aplicaciones estadísticas, pese a ser factible la recolección de sus datos
Background: Risk stratification is one of the main axes in the management of patients with acute coronary syndromes (ACS). Staging is currently recommended based on prediction scales, the most relevant being the scale of GRACE and TIMI. Objective: To determine the GRACE and TIMI scores as algorithms for staging the risk of in - hospital mortality following an episode of acute coronary syndrome in patients older than 40 years admitted to Hospital Abel Gilbert Pontón during 2016. Methods: Quantitative study, non-experimental design, cross-sectional using observational and analytical method. Results: 100 patients with ACS were the work sample, of which 90 suffered SCACEST, 8 patients with NSTEACS and 2 patients with unstable angina. Score TIMI: Low risk with a score of 1 represented 16% of the cases, a score of 2 was 49%, as for moderate risk 25% of the sample with a score of 3 and 4% had a score of 4. One 10% of the total sample had scores of 4 and 5, patients with high risk were 6%. For the GRACE score, 6% had a low in-hospital mortality risk, 58% had high in-hospital mortality risk, and the intermediate risk group was 36%. Conclusion: The male gender, ages ranging from 40 to 69 years and patients from urban areas are the most likely to suffer acute coronary syndrome events. In the TIMI Score a variable is lacking in approximately half of the cases, reason why its results are questionable for statistical applications, in spite of being feasible the collection of its data.
Background: Risk stratification is one of the main axes in the management of patients with acute coronary syndromes (ACS). Staging is currently recommended based on prediction scales, the most relevant being the scale of GRACE and TIMI. Objective: To determine the GRACE and TIMI scores as algorithms for staging the risk of in - hospital mortality following an episode of acute coronary syndrome in patients older than 40 years admitted to Hospital Abel Gilbert Pontón during 2016. Methods: Quantitative study, non-experimental design, cross-sectional using observational and analytical method. Results: 100 patients with ACS were the work sample, of which 90 suffered SCACEST, 8 patients with NSTEACS and 2 patients with unstable angina. Score TIMI: Low risk with a score of 1 represented 16% of the cases, a score of 2 was 49%, as for moderate risk 25% of the sample with a score of 3 and 4% had a score of 4. One 10% of the total sample had scores of 4 and 5, patients with high risk were 6%. For the GRACE score, 6% had a low in-hospital mortality risk, 58% had high in-hospital mortality risk, and the intermediate risk group was 36%. Conclusion: The male gender, ages ranging from 40 to 69 years and patients from urban areas are the most likely to suffer acute coronary syndrome events. In the TIMI Score a variable is lacking in approximately half of the cases, reason why its results are questionable for statistical applications, in spite of being feasible the collection of its data.
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Síndrome coronario agudo, Mortalidad, Score de TIMI, Score de GRACE, Epidemiología analítica, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador