Utilización de la escala de Fisher en el diagnóstico de hemorragia subaracnoidea en el Hospital Luis Vernaza enero-junio 2013 y la implementación de una guía de manejo
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2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La hemorragia Subarácnoidea constituye un síndrome más que una entidad patológica aislada, que acontece como consecuencia de la ruptura de uno o más vasos sanguíneos. El objetivo del estudio fue evaluar la utilidad de la escala de Fisher valorada por TAC en los pacientes con Hemorragia Subarácnoidea. En cuanto a la metodología se revisaron 60 historias clínicas que fueron relacionadas con el criterio de inclusión de haber sido diagnosticada radiológicamente con HSA no traumática en el Hospital Luis Vernaza en el periodo Enero – Junio 2013. Este estudio fue de tipo descriptivo, retrospectivo con diseño no experimental, tomando los datos de filiación y el diagnóstico radiológico de las películas de tomografía. En cuanto a los resultados podemos darnos cuenta que de los pacientes estudiados 14 de ellos presentaron vasoespasmo como complicación de la hemorragia Subarácnoidea, lo que representa el 37,83%. Se determinó que 8 de los pacientes presentaron al ingreso el estadio Fisher 4, lo que representa el 21,62%; en estadio Fisher 3, 19 pacientes (51,35%), en estadio Fisher 2, 10 pacientes que representan el 27,03%; se determinó que de los pacientes con Fisher 2 el 100% vivió. Dentro del rango de Fisher 3, 12 pacientes vivieron y 7 fallecieron, lo que corresponde a 63 y 37%, respectivamente. En cuanto al grado Fisher 4, de los 8 pacientes 6 murieron y 2 vivieron, lo que representa el 75 y 25%, respectivamente. En cuanto a las variables sociodemográficas, de acuerdo a este estudio la edad predominante de aparición de la hemorragia Subarácnoidea es de 51 a 60 años, con el 43,2%; y el sexo femenino predomino con un porcentaje de 62,16%. En cuanto a los resultados, con esta investigación estableceremos una guía de manejo para su correcta descripción, graduación y manejo del vasoespasmo que se producen en estos pacientes, para de esta manera ayudar al manejo oportuno y eficaz de estos pacientes.
Subarachnoid hemorrhage is a syndrome rather than a single disease entity, which occurs as a result of the breakdown of one or more blood vessels. The aim of the study was to evaluate the usefulness of the scale of Fisher valued by TAC in patients with subarachnoid hemorrhage. In terms of methodology 60 medical records that were related to the inclusion criteria being diagnosed radiologically with nontraumatic SAH in Vernaza Luis Hospital in the period were revised January - June 2013 This study was descriptive, retrospective non-experimental design, taking demographics and radiological diagnostic scan films. As for the results we can see that the patients studied 14 of them showed vasospasm complicating subarachnoid hemorrhage, accounting for 37.83%. It was determined that 8 patients presented at stage 4 income Fisher, representing 21.62%; Fisher Stage 3, 19 patients (51.35%), Fisher stage 2, 10 patients, accounting for 27.03%; found that patients with Fisher 2 100% lived. Within the range of Fisher 3, 12 and 7 patients lived died, corresponding to 63 and 37%, respectively. As for Fisher grade 4 of 8 patients lived 6 and died 2, representing 75 and 25%, respectively. With regard to sociodemographic variables, according to this study the predominant age of onset of subarachnoid hemorrhage is 51 to 60 years, with 43.2%; and female predominance with a percentage of 62.16%. As for the results, this research will establish a management guide for correct description, classification and management of vasospasm occurring in these patients, and in this way help the timely and effective management of these patients.
Subarachnoid hemorrhage is a syndrome rather than a single disease entity, which occurs as a result of the breakdown of one or more blood vessels. The aim of the study was to evaluate the usefulness of the scale of Fisher valued by TAC in patients with subarachnoid hemorrhage. In terms of methodology 60 medical records that were related to the inclusion criteria being diagnosed radiologically with nontraumatic SAH in Vernaza Luis Hospital in the period were revised January - June 2013 This study was descriptive, retrospective non-experimental design, taking demographics and radiological diagnostic scan films. As for the results we can see that the patients studied 14 of them showed vasospasm complicating subarachnoid hemorrhage, accounting for 37.83%. It was determined that 8 patients presented at stage 4 income Fisher, representing 21.62%; Fisher Stage 3, 19 patients (51.35%), Fisher stage 2, 10 patients, accounting for 27.03%; found that patients with Fisher 2 100% lived. Within the range of Fisher 3, 12 and 7 patients lived died, corresponding to 63 and 37%, respectively. As for Fisher grade 4 of 8 patients lived 6 and died 2, representing 75 and 25%, respectively. With regard to sociodemographic variables, according to this study the predominant age of onset of subarachnoid hemorrhage is 51 to 60 years, with 43.2%; and female predominance with a percentage of 62.16%. As for the results, this research will establish a management guide for correct description, classification and management of vasospasm occurring in these patients, and in this way help the timely and effective management of these patients.
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Tomografía computarizada por rayos X, Hemorragia subaracnoidea, Escala de Fisher, Epidemiología descriptiva, Estudios retrospectivos, Hospital Luis Vernaza, Cantón Guayaquil, Ecuador