Título : Análisis de los pacientes diagnosticados de isquemia mesentérica en el servicio de urgencias del H. U. san Juan de Alicante en un periodo de 4 años |
Autor : Ruiz Andreu, Nerea |
Tutor: Díaz Fernández, María Elena Chiner Vives, Eusebi |
Editor : Universidad Miguel Hernández |
Departamento: Departamentos de la UMH::Medicina Clínica |
Fecha de publicación: 2024-05-12 |
URI : https://hdl.handle.net/11000/35574 |
Resumen :
Introducción:
La Isquemia mesentérica (IM) consiste en una reducción del flujo sanguíneo a nivel intestinal
que ocasiona una elevada morbimortalidad.
Método:
Se realizó un estudio retrospectivo de 4 años analizando el comportamiento de la IM en el
servicio de urgencias del HUSJ evaluando las caract... Ver más
Introduction:
Mesenteric ischaemia (MI) consists of reduced blood flow at the intestinal level causing high
morbidity and mortality.
Method:
A 4-year retrospective study was conducted analysing the behaviour of MI in the emergency
department of the HUSJ evaluating clinical, epidemiological characteristics and risk factors,
in addition to correlating Manchester triage with mortality, as well as time to intervention,
risk factors and comorbidities with mortality. Student's t-test or Wilconxon's test and
Chi-square test for qualitative variables were used for statistical study.
Results:
Forty patients, 60 % female and 40 % male, aged 78 ± 14 years, were studied. The incidence
was 4/100000/year. Abdominal pain 72.4%, 12.5%, gastrointestinal bleeding 10% and
diarrhoea 5%, with a mean symptom evolution time of 21 ± 22 hours. Contrast-enhanced CT
was performed in 67.5%, angio CT in 25% and non-contrast in 7.5%, with intestinal
pneumatosis in 39%. Elevated D-dimer and acidosis due to increased lactate were observed
in 40%. The main risk factors were arrhythmias and peripheral vascular disease (PVD).
Surgery was performed by laparotomy 42.5%, thrombectomy 5% and the rest was
conservative. Mean time to surgery was 8 ± 2h and pharmacological time 4 ± 1 hour.
Mortality was 27.5%. There was a significant relationship between triage and mortality,
corresponding to the most severe degrees (p=0.05). Male patients had higher ICU admission
(p=0.046) and evp (p=0.032). Mortality was related to arrhythmias (p=0.019), complications
(p=0.041), ICU intervention (0.005) and leukocytosis (p=0.02). With tendency in case of occlusive ischaemia, peripheral vascular disease, Dyslipemia, DM and intestinal pneumatosis
(p=0.06).
Conclusions:
Triage of patients was adequate in severity level and mortality. D-dimer and leukocytosis
were useful in clinical suspicion and prognosis. The main risk factors were more arrhythmias,
PVE, obstructive ischaemia. CT was basic for diagnosis with pneumatosis being the most
specific finding and with the worst prognosis. Overall mortality was low, probably due to
increased awareness, diagnosis and early treatment.
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Palabras clave/Materias: Isquemia mesentérica mortalidad triaje factores de riesgo |
Área de conocimiento : CDU: Ciencias aplicadas: Medicina |
Tipo de documento : info:eu-repo/semantics/bachelorThesis |
Derechos de acceso: info:eu-repo/semantics/openAccess |
Aparece en las colecciones: TFG- Medicina
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