Mostrar el registro sencillo del ítem

dc.contributor.advisorJiménez, Jose Luis
dc.contributor.authorBolaños Noguera, Iván Dario
dc.contributor.authorMejía Mazo, Pablo
dc.coverage.spatialColombiaspa
dc.coverage.temporal2021spa
dc.date.accessioned2022-02-01T16:27:41Z
dc.date.available2022-02-01T16:27:41Z
dc.date.issued2022-01-31
dc.identifier.urihttp://hdl.handle.net/10654/39986
dc.description.abstractIntroducción: El delirium posoperatorio es una entidad clínica caracterizada por una alteración del estado mental que se da de manera fluctuante, se ha determinado que se asocia a una mayor morbimortalidad en el intraoperatorio y su enfoque se debe basar en un manejo multidisciplinar enfocado en la identificación de los factores predisponentes, la optimización de estos, y el establecimiento de protocolos que promuevan estrategias en transoperatorio que ha demostrado reducir su incidencia con el objetivo de impactar en desenlaces como mortalidad, estancia hospitalaria y en unidad de cuidados intensivos, menor tasa de institucionalización de los pacientes después del alta y finalmente reducir los costos asociados a la atención en salud. Objetivo: determinar la proporción de anestesiólogos colombianos que establecen estrategias para la identificación de factores de riesgo para delirium posoperatorio, estrategias para su prevención, y directrices para su diagnóstico y tratamiento. Metodología: utilizando una encuesta auto aplicada de 15 preguntas por vía electrónica a través de la plataforma de la sociedad colombiana de anestesiología y reanimación (SCARE) se encuestó a los anestesiólogos adscritos a ella y que deseen participar de la encuesta excluyendo a médicos no anestesiólogos y encuestas incompletas. Resultados: se enviaron un total de 2870 correos electrónicos de los cuales se obtuvieron 261 encuestas completas, la edad media de los encuestados fue de 41.75 años con una desviación estándar de 9.89 años con un IC del 95% (40.6-42.89), 62.1% hombres, 37.8% mujeres. El 79.9% de los anestesiólogos utiliza estrategias para la identificación de pacientes con factores de riesgo, el 81.6% no cuentan con protocolos institucionales para el abordaje del delirium posoperatorio, la mayoría establece estrategias para la optimización preoperatoria, y manejo intraoperatorio, el 79% no aplica escalas para el diagnóstico del delirium posoperatorio y el 50.5% realiza tratamiento farmacológico cuando este se presenta. Conclusiones: la mayoría de los anestesiólogos colombianos establece estrategias para la identificación de pacientes con riesgo de delirium posoperatorio sin embargo hay una baja proporción de hospitales que cuentan con protocolos institucionales enfocados en su atención, llama la atención que la mayoría no aplica escalas diagnosticas para su identificación.spa
dc.description.tableofcontents1. Título 5 2. Resumen 5 3. Formulación del Problema 3.1 Planteamiento del Problema 6 3.2 Justificación 8 3.3 Pregunta de Investigación 9 4. Marco teórico 9 5. Objetivos 5.1 Objetivo general 14 5.2 Objetivos específicos 15 6. Hipótesis 15 7. Metodología 15 7.1 Tipo de estudio 15 7.2 Definición de la población 16 7.3 Criterios de elegibilidad 16 7.4 Diseño muestral 16 7.5 Cálculo del tamaño de la muestra 16 7.6 Definición de variables 17 7.7 Técnicas de recolección de la información 19 7.8 Definición de los sesgos y control 20 7.9 Análisis estadístico 21 8. Consideraciones éticas 21 9. Resultados 22 10. Discusión 37 11. Fortalezas y Limitaciones 41 12. Conclusiones 41 13. Referencias Bibliográficas 43 14. Anexos 47spa
dc.format.mimetypeapplicaction/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.titleProporción de los anestesiólogos colombianos que utilizan estrategias para el abordaje del delirium postoperatoriospa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.type.localTesis/Trabajo de grado - Monografía - Especializaciónspa
dc.description.abstractenglishIntroduction: Postoperative delirium is a clinical entity characterized by an altered mental state that occurs in a fluctuating manner, it has been determined that it is associated with greater intraoperative morbidity and mortality and its approach should be based on multidisciplinary management focused on the identification of the predisposing factors, the optimization of these, and the establishment of protocols that promote intraoperative strategies that have been shown to reduce their incidence with the aim of impacting outcomes such as mortality, hospital and intensive care unit stay, lower rate of institutionalization of patients after discharge and ultimately reduce the costs associated with health care. Objective: to determine the proportion of Colombian anesthesiologists who establish strategies for the identification of risk factors for postoperative delirium, strategies for its prevention, and guidelines for its diagnosis and treatment. Methodology: using a self-applied survey of 15 questions electronically through the platform of the Colombian Society of Anesthesiology and Resuscitation (SCARE), the anesthesiologists attached to it and who wish to participate in the survey were surveyed, excluding non-anesthesiologists and non-anesthesiologists. incomplete surveys. Results: a total of 2870 emails were sent, of which 261 completed surveys were obtained, the mean age of the respondents was 41.75 years with a standard deviation of 9.89 years with a 95% CI (40.6-42.89), 62.1% men, 37.8% women. 79.9% of anesthesiologists use strategies to identify patients with risk factors, 81.6% do not have institutional protocols for dealing with postoperative delirium, most establish strategies for preoperative optimization and intraoperative management, 79% do not applies scales for the diagnosis of postoperative delirium and 50.5% perform pharmacological treatment when it occurs. Conclusions: the majority of Colombian anesthesiologists establish strategies for the identification of patients at risk of postoperative delirium, however there is a low proportion of hospitals that have institutional protocols focused on their care, it is striking that most do not apply diagnostic scales for their carespa
dc.title.translatedProportion of Colombian anesthesiologists who use strategies to deal with postoperative deliriumspa
dc.subject.keywordsElderly patientspa
dc.subject.keywordsSurgeryspa
dc.subject.keywordsDeliriumspa
dc.subject.keywordsPolypharmacyspa
dc.subject.keywordsCognitive impairmentspa
dc.publisher.programAnestesiologíaspa
dc.creator.degreenameEspecialista en Anestesiologíaspa
dc.subject.decsANESTESIOLOGIAspa
dc.subject.decsCOMPLICACIONES POSOPERATORIASspa
dc.subject.decsDELIRIOspa
dc.description.degreelevelEspecializaciónspa
dc.publisher.facultyFacultad de Medicinaspa
dc.type.driverinfo:eu-repo/semantics/bachelorThesisspa
dc.rights.creativecommonsAttribution-NonCommercial-NoDerivatives 4.0 Internationalspa
dc.relation.referencesHughes CG, Boncyk CS, Culley DJ, Fleisher LA, Leung JM, McDonagh DL, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention. Anesth Analg. 2020 Jun;130(6):1572–90.spa
dc.relation.referencesJin Z, Hu J, Ma D. Postoperative delirium: perioperative assessment, risk reduction, and management. Br J Anaesth. 2020 Oct;125(4):492–504.spa
dc.relation.referencesAldecoa C, Bettelli G, Bilotta F, Sanders RD, Audisio R, Borozdina A, et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017 Apr;34(4):192–214.spa
dc.relation.referencesGreaves D, Psaltis PJ, Davis DHJ, Ross TJ, Ghezzi ES, Lampit A, et al. Risk Factors for Delirium and Cognitive Decline Following Coronary Artery Bypass Grafting Surgery: A Systematic Review and Meta‐Analysis. J Am Heart Assoc. 2020 Nov 17;9(22):e017275.spa
dc.relation.referencesShi Z, Mei X, Li C, Chen Y, Zheng H, Wu Y, et al. Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living. Anesthesiology. 2019 Sep 1;131(3):492–500.spa
dc.relation.referencesEhsani R, Djalali Motlagh S, Zaman B, Sehat Kashani S, Ghodraty MR. Effect of General Versus Spinal Anesthesia on Postoperative Delirium and Early Cognitive Dysfunction in Elderly Patients. Anesthesiol Pain Med. 2020 Aug 8;10(4):1–8.spa
dc.relation.referencesMarcantonio ER, Juarez G, Goldman L, Mangione CM, Ludwig LE, Lind L, et al. The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials. Anesth Analg. 2020;61(1):1911–22.spa
dc.relation.referencesAgrawal S, Turk R, Burton BN, Ingrande J, Gabriel RA. The association of preoperative delirium with postoperative outcomes following hip surgery in the elderly. J Clin Anesth. 2020 Mar;60(August 2019):28–33.spa
dc.relation.referencesZywiel MG, Hurley RT, Perruccio A V., Hancock-Howard RL, Coyte PC, Rampersaud YR. Health Economic Implications of Perioperative Delirium in Older Patients After Surgery for a Fragility Hip Fracture. J Bone Jt Surg. 2015 May 20;97(10):829–36.spa
dc.relation.referencesDing X, Gao X, Chen Q, Jiang X, Li Y, Xu J, et al. Preoperative Acute Pain Is Associated with Postoperative Delirium. Pain Med. 2021 Feb 4;22(1):15–21.spa
dc.relation.referencesSun Y, Ye F, Wang J, Ai P, Wei C, Wu A, et al. Electroencephalography-Guided Anesthetic Delivery for Preventing Postoperative Delirium in Adults: An Updated Meta-analysis. Anesth Analg. 2020 Sep 27;131(3):712–9.spa
dc.relation.referencesKang T, Park SY, Lee JH, Lee SH, Park JH, Kim SK, et al. Incidence & Risk Factors of Postoperative Delirium After Spinal Surgery in Older Patients. Sci Rep. 2020;10(1):1–6.spa
dc.relation.referencesEvered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, et al. Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery-20181. J Alzheimers Dis. 2018;66(1):1–10.spa
dc.relation.referencesSamuel M, Inouye SK, Robinson T, Blaum C, Busby-Whitehead J, Boustani M, et al. American Geriatrics Society abstracted clinical practice guideline for postoperative delirium in older adults. J Am Geriatr Soc. 2015;63(1):142–50.spa
dc.relation.referencesBrown CH, Laflam A, Max L, Lymar D, Neufeld KJ, Tian J, et al. The Impact of Delirium after Cardiac Surgical Procedures on Postoperative Resource Use. Ann Thorac Surg. 2016;101(5):1663–9.spa
dc.relation.referencesManiar HS, Lindman BR, Escallier K, Avidan M, Novak E, Melby SJ, et al. Delirium after surgical and transcatheter aortic valve replacement is associated with increased mortality. J Thorac Cardiovasc Surg. 2016;151(3):815-823.e2.spa
dc.relation.referencesPedemonte JC, Plummer GS, Chamadia S, Locascio JJ, Hahm E, Ethridge B, et al. Electroencephalogram burst-suppression during cardiopulmonary bypass in elderly patients mediates postoperative delirium. Anesthesiology. 2020;133(2):280–92.spa
dc.relation.referencesRaats JW, Van Eijsden WA, Crolla RMPH, Steyerberg EW, Van Der Laan L. Risk factors and outcomes for postoperative delirium after major surgery in elderly patients. PLoS One. 2015;10(8):1–12.spa
dc.relation.referencesSharma PT, Sieber FE, Zakriya KJ, Pauldine RW, Gerold KB, Hang J, et al. Recovery room delirium predicts postoperative delirium after hip-fracture repair. Anesth Analg. 2005;101(4):1215–20.spa
dc.relation.referencesXará D, Silva A, Mendonça J, Abelha F. Inadequate emergence after anesthesia: Emergence delirium and hypoactive emergence in the Postanesthesia Care Unit. J Clin Anesth. 2013;25(6):439–46.spa
dc.relation.referencesRobinson TN, Raeburn CD, Tran Z V., Brenner LA, Moss M. Motor subtypes of postoperative delirium in older adults. Arch Surg. 2011;146(3):295–300.spa
dc.relation.referencesPearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, et al. Mortality after surgery in Europe: A 7 day cohort study. Lancet. 2012;380(9847):1059–65.spa
dc.relation.referencesTerrando N, Eriksson LI, Kyu Ryu J, Yang T, Monaco C, Feldmann M, et al. Resolving postoperative neuroinflammation and cognitive decline. Ann Neurol. 2011;70(6):986–95.spa
dc.relation.referencesPicciotto MR, Higley MJ, Mineur YS. Acetylcholine as a Neuromodulator: Cholinergic Signaling Shapes Nervous System Function and Behavior. Neuron. 2012 Oct;76(1):116–29.spa
dc.relation.referencesvan Munster BC, Yazdanpanah M, Tanck MWT, de Rooij SEJA, van de Giessen E, Sijbrands EJG, et al. Genetic polymorphisms in the DRD2, DRD3, and SLC6A3 gene in elderly patients with delirium. Am J Med Genet Part B Neuropsychiatr Genet. 2009;9999B(1)spa
dc.relation.referencesSmith PJ, Blumenthal JA, Hoffman BM, Rivelli SK, Palmer SM, Davis RD, et al. Reduced cerebral perfusion pressure during lung transplant surgery is associated with risk,duration, and severity of postoperative delirium. Ann Am Thorac Soc. 2016;13(2):180–7.spa
dc.relation.referencesLi Y, Zhang B. Effects of anesthesia depth on postoperative cognitive function and inflammation: a systematic review and meta-analysis. Minerva Anestesiol. 2020 Sep;86(9):965–73.spa
dc.relation.referencesAlvarez-Bastidas L, Morales-Vera E, Valle-Leal JG, Marroquín-González J. Delirium in the elderly patient after anesthesia: Associated factors. Colomb J Anesthesiol. 2018;46(4):273–8.spa
dc.subject.proposalPaciente ancianospa
dc.subject.proposalCirugíaspa
dc.subject.proposalDeliriumspa
dc.subject.proposalPolifarmaciaspa
dc.subject.proposalDeterioro cognitivospa
dc.publisher.grantorUniversidad Militar Nueva Granadaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_7a1f*
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.identifier.instnameinstname:Universidad Militar Nueva Granadaspa
dc.identifier.reponamereponame:Repositorio Institucional Universidad Militar Nueva Granadaspa
dc.identifier.repourlrepourl:https://repository.unimilitar.edu.cospa
dc.rights.localAcceso abiertospa
dc.coverage.sedeMedicinaspa
dc.rights.coarhttp://purl.org/coar/access_right/c_abf2


Archivos en el ítem

Thumbnail
Thumbnail
Thumbnail
Thumbnail
Thumbnail
Thumbnail

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem

http://creativecommons.org/licenses/by-nc-nd/4.0/
Excepto si se señala otra cosa, la licencia del ítem se describe como http://creativecommons.org/licenses/by-nc-nd/4.0/