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Proporción de los anestesiólogos colombianos que utilizan estrategias para el abordaje del delirium postoperatorio
dc.contributor.advisor | Jiménez, Jose Luis | |
dc.contributor.author | Bolaños Noguera, Iván Dario | |
dc.contributor.author | Mejía Mazo, Pablo | |
dc.coverage.spatial | Colombia | spa |
dc.coverage.temporal | 2021 | spa |
dc.date.accessioned | 2022-02-01T16:27:41Z | |
dc.date.available | 2022-02-01T16:27:41Z | |
dc.date.issued | 2022-01-31 | |
dc.identifier.uri | http://hdl.handle.net/10654/39986 | |
dc.description.abstract | Introducción: 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.tableofcontents | 1. 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 47 | spa |
dc.format.mimetype | applicaction/pdf | spa |
dc.language.iso | spa | spa |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.title | Proporción de los anestesiólogos colombianos que utilizan estrategias para el abordaje del delirium postoperatorio | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.type.local | Tesis/Trabajo de grado - Monografía - Especialización | spa |
dc.description.abstractenglish | Introduction: 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 care | spa |
dc.title.translated | Proportion of Colombian anesthesiologists who use strategies to deal with postoperative delirium | spa |
dc.subject.keywords | Elderly patient | spa |
dc.subject.keywords | Surgery | spa |
dc.subject.keywords | Delirium | spa |
dc.subject.keywords | Polypharmacy | spa |
dc.subject.keywords | Cognitive impairment | spa |
dc.publisher.program | Anestesiología | spa |
dc.creator.degreename | Especialista en Anestesiología | spa |
dc.subject.decs | ANESTESIOLOGIA | spa |
dc.subject.decs | COMPLICACIONES POSOPERATORIAS | spa |
dc.subject.decs | DELIRIO | spa |
dc.description.degreelevel | Especialización | spa |
dc.publisher.faculty | Facultad de Medicina | spa |
dc.type.driver | info:eu-repo/semantics/bachelorThesis | spa |
dc.rights.creativecommons | Attribution-NonCommercial-NoDerivatives 4.0 International | spa |
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dc.relation.references | Evered 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 |
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dc.relation.references | Terrando 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 |
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dc.relation.references | van 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.references | Smith 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 |
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dc.relation.references | Alvarez-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.proposal | Paciente anciano | spa |
dc.subject.proposal | Cirugía | spa |
dc.subject.proposal | Delirium | spa |
dc.subject.proposal | Polifarmacia | spa |
dc.subject.proposal | Deterioro cognitivo | spa |
dc.publisher.grantor | Universidad Militar Nueva Granada | spa |
dc.type.coar | http://purl.org/coar/resource_type/c_7a1f | * |
dc.type.hasversion | info:eu-repo/semantics/acceptedVersion | spa |
dc.identifier.instname | instname:Universidad Militar Nueva Granada | spa |
dc.identifier.reponame | reponame:Repositorio Institucional Universidad Militar Nueva Granada | spa |
dc.identifier.repourl | repourl:https://repository.unimilitar.edu.co | spa |
dc.rights.local | Acceso abierto | spa |
dc.coverage.sede | Medicina | spa |
dc.rights.coar | http://purl.org/coar/access_right/c_abf2 |
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