Evaluación de Escala de Alvarado en pacientes con apendicitis aguda en Hospital de Pasaje
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Una de las causas más frecuentes de consulta en el departamento de urgencias
del Hospital San Vicente de Paúl. Pasaje es la apendicitis aguda, teniendo como origen
varias patologías quirúrgicas y no quirúrgicas las mismas que deben ser evaluadas y
analizadas por el cirujano de emergencias, ya que requiere tratamiento quirúrgico para
evitar complicaciones. Debido a las dificultades en el diagnóstico inicial se han
desarrollado diversos algoritmos, métodos y estudios complementarios con el propósito
de tener un diagnóstico temprano y acertado, que reduzca la tasa de complicaciones, y
apendicetomías negativas. En 1986 Alvarado publicó una escala que lleva su nombre,
pese a que esta escala ha sido sujeta de validación como método objetivo simple,
económico, y orientado al diagnóstico clínico de apendicitis aguda, este está fuera del
protocolo de atención de pacientes con diagnóstico de apendicitis aguda.
Al realizar un diagnóstico incorrecto se eleva la morbimortalidad de dicha
patología, por esta razón la necesidad de realizar un diagnóstico certero, temprano, y
eficaz, que son necesarios para realizar una tratamiento quirúrgico a tiempo y evitar
complicaciones como la perforación apendicular, abscesos intraabdominales, peritonitis
local o generalizada, sepsis, e incluso llegar a un desenlace fatal, que elevan la estancia
hospitalaria y sus costos, Objetivo: Evaluación de la escala de Alvarado como guía de
apoyo en pacientes con diagnóstico de apendicitis aguda en el servicio de emergencia
del hospital san Vicente de Paul de Pasaje. Metodología: Se realizó un estudio
cuantitativo, retrospectivo y longitudinal en 362 pacientes que ingresaron al servicio de
urgencias, durante julio a diciembre del año 2015 en la que se analizaron síntomas,
signos y datos de laboratorio para ser medidas y cuantificadas, de los cuales 135
pacientes un 37,29% recibieron tratamiento quirúrgico. Resultados y Conclusiones.
Se presentó una sensibilidad de 88,9%, y especificidad de 57.7% de la escala de
Alvarado, con una validez predictiva positiva de 99.1%, y una validez predictiva
negativa de 15%, en el diagnóstico de apendicitis aguda, siendo de gran utilidad para el
diagnóstico de la patología
One of the most frequent causes of consultation in the emergency department of San Vicente de Paul Hospital Passage is acute appendicitis, with the origin several surgical and nonsurgical all of which must be evaluated and analyzed by the emergency surgeon pathologies, requiring surgical treatment to avoid complications. Because of the difficulties in the initial diagnosis they have been developed various algorithms, methods and complementary studies in order to have an early and accurate diagnosis, which reduces the rate of complications and negative appendectomies. In 1986 Alvarado published a scale that bears his name, although this scale has been subject to validation as simple, economic objective method-oriented clinical diagnosis of acute appendicitis, this is out of the treatment protocol of patients diagnosed with appendicitis acute. When making an incorrect diagnosis morbidity and mortality of this disease rises, therefore the need for an effective accurate diagnosis, early, and they are required to perform a surgical treatment early and avoid complications such as ruptured appendix, intra-abdominal abscesses, local or generalized peritonitis, sepsis, and even get a fatal outcome, uplifting hospital stay and costs. Objective: Assessment Scale Alvarado guide support in patients with diagnosis of acute appendicitis in the hospital emergency service St. Vincent de Paul of Passage. Methodology: quantitative, retrospective and longitudinal study was conducted in 362 patients admitted to the emergency department during July to December 2015 in which symptoms, signs and laboratory data to be measured and quantified were analyzed, of which 135 patients with a 37.29% received surgical treatment. Results and Conclusions. a sensitivity of 88.9% and specificity of 57.7% of the scale of Alvarado, with a positive predictive value of 99.1% and a negative predictive value of 15% in the diagnosis of acute appendicitis, I appear to be useful for the diagnosis of pathology.
One of the most frequent causes of consultation in the emergency department of San Vicente de Paul Hospital Passage is acute appendicitis, with the origin several surgical and nonsurgical all of which must be evaluated and analyzed by the emergency surgeon pathologies, requiring surgical treatment to avoid complications. Because of the difficulties in the initial diagnosis they have been developed various algorithms, methods and complementary studies in order to have an early and accurate diagnosis, which reduces the rate of complications and negative appendectomies. In 1986 Alvarado published a scale that bears his name, although this scale has been subject to validation as simple, economic objective method-oriented clinical diagnosis of acute appendicitis, this is out of the treatment protocol of patients diagnosed with appendicitis acute. When making an incorrect diagnosis morbidity and mortality of this disease rises, therefore the need for an effective accurate diagnosis, early, and they are required to perform a surgical treatment early and avoid complications such as ruptured appendix, intra-abdominal abscesses, local or generalized peritonitis, sepsis, and even get a fatal outcome, uplifting hospital stay and costs. Objective: Assessment Scale Alvarado guide support in patients with diagnosis of acute appendicitis in the hospital emergency service St. Vincent de Paul of Passage. Methodology: quantitative, retrospective and longitudinal study was conducted in 362 patients admitted to the emergency department during July to December 2015 in which symptoms, signs and laboratory data to be measured and quantified were analyzed, of which 135 patients with a 37.29% received surgical treatment. Results and Conclusions. a sensitivity of 88.9% and specificity of 57.7% of the scale of Alvarado, with a positive predictive value of 99.1% and a negative predictive value of 15% in the diagnosis of acute appendicitis, I appear to be useful for the diagnosis of pathology.
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Escala de Alvarado, Apendicitis, Estudios retrospectivos, Hospital San Vicente de Paúl, Cantón Pasaje, Ecuador, Evaluación