Please use this identifier to cite or link to this item: https://hdl.handle.net/11000/29780

Aplicación de un nuevo score pronóstico específico para Hemorragia Subaracnoidea espontánea de mortalidad a los 30 días en pacientes ingresados en el servicio de Medicina Intensiva del Hospital General Universitario Dr. Balmis de Alicante.


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Title:
Aplicación de un nuevo score pronóstico específico para Hemorragia Subaracnoidea espontánea de mortalidad a los 30 días en pacientes ingresados en el servicio de Medicina Intensiva del Hospital General Universitario Dr. Balmis de Alicante.
Authors:
Vidal González, Pablo
Tutor:
Jaime Sánchez, Francisco Ángel
Editor:
Universidad Miguel Hernández de Elche
Department:
Departamentos de la UMH::Medicina Clínica
Issue Date:
2023-05-13
URI:
https://hdl.handle.net/11000/29780
Abstract:
Introducción: la hemorragia subaracnoidea espontánea (HSAe) es un sangrado intracraneal ocasionado por la rotura de un lecho vascular cerebral. A pesar de no ser uno de los tipos de infarto más frecuentes, debido a la población más joven a la que afecta y por sus mayores secuelas funcionales, la e...  Ver más
Introduction: The subarachnoid hemorrhage spontaneous (SAH) is an intracraneal hemorrhage caused by the break of a cerebral vessel. It is not one of the most common strokes, but it is needed to evaluate the prognosis as soon as possible, because of the younger population affected and the greater functional aftereffects. Knowing the prognosis allows informing the patients and relatives properly, and taking better medical decisions. Objective: Use a predictive model of early mortality, defined as the one ocurred within the firts 30 days, developed by R. Núñez en his Doctoral Thesis at the Univesity of Murcia. Materials and methods: An observational, retrospective, single-center study was carried out in patients admitted with SAH diagnosis throughout 2022, in the Intensive Care Unit of the Hospital General Universitario Dr. Balmis de Alicante. The prognostic score was calculated and univariate analysis was stratified by mortality at 30 days of different sociodemographic variables, comorbidity, analytical, radiological, treatment and complications. Results: A total of 56 patients made up the study sample. Seven of the total cases died, the actual mortality was 12.5%. The prognostic score calculation gave a value of 15.7% ± 21.8. There was no statistically significant association between actual and predicted mortality (p-value 0.137). The median age was 59 (49-70), in those who died was 61 (49- 70) (p-value 0.941). 57% of the patients were women, 71 % of them in the deceased group (p-value 0.686). 29% of the total consumed tobacco (p-value 1,000). The prevalence of HT in the deceased group was 43% (p-value 0.669). At admission severe coma (GCS < 9) measured by the Glasgow Comma Scale was observable in 30% (p-value 0.012). In the group of deceased patients: all had a grade IV on the Fisher scale (FS) (pvalue 0.027) and 3 patients (43%) were admitted with a grade V on the Hunt-Hess scale (H-H) (p-value 0.114). 38 patients received ventilatory support (69%), including all the deceased (p-value 0.084). In the same group, 43% had endocranial hypertension (HEC) (p-value 0.074). 24 patients were treated with external ventricular shunt (EVD), 86% of the deceased group (p-value 0,035). 25% developed delayed cerebral ischemia (DCI) (pvalue 0.35). The median natremia in the deceased group was 153 (148-156) (p-value 0.005). The main treatment was coils (89%), including those who died (87%). 14% of patients presented a perimesencephalic pattern. Conclusions: The actual mortality was lower than that observed in the literature. When related to predicted mortality, there was no association. Of the variables selected, hypernatremia, EVD, GCS and FS grade were associated with 30-day mortality. Although more women were affected, no gender association was observed.
Keywords/Subjects:
hemorragia subaracnoidea espontánea (HSAe)
diagnóstico
Knowledge area:
CDU: Ciencias aplicadas: Medicina
Type of document:
info:eu-repo/semantics/bachelorThesis
Access rights:
info:eu-repo/semantics/openAccess
Appears in Collections:
TFG- Medicina



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