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dc.contributor.advisorNaranjo Junoy, Francisco Fernandospa
dc.contributor.advisorMeléndez Flórez, Héctor Juliospa
dc.contributor.authorPeralta Álvarez, Lilia Marcelaspa
dc.contributor.authorSerrano Báez, Gustavo Adolfospa
dc.date.accessioned2020-06-26T19:59:27Z
dc.date.available2020-06-26T19:59:27Z
dc.date.issued2018
dc.identifier.urihttp://hdl.handle.net/20.500.12749/1724
dc.description.abstractEn los últimos 20 años varios avances realizados en cuanto al diagnóstico precoz y tratamiento agresivo de los pacientes oncológicos, han derivado en la disminución de la mortalidad global en un 20%; la mejora en el tratamiento del cáncer se traduce en un aumento del número de pacientes que no se curan pero que viven con esta patología. Debido a que se prevé que el número de pacientes que viven con cáncer aumentará en los próximos años, se deduce que también aumentará la demanda de pacientes que requieren tratamiento en la Unidad de Cuidado Intensivo (UCI), ya sea por complicaciones relacionadas con la neoplasia per sé o por los efectos secundarios derivados del tratamiento. La decisión de ingresar a estos pacientes en la UCI presenta, muchas veces, dilemas de tipo éticos, religiosos, administrativos, familiares y hasta de tipo médico, por lo que es preciso conocer muy bien el pronóstico y evolución de la neoplasia en estos pacientes. El hecho de que en múltiples estudios observacionales la mortalidad de los pacientes oncológicos en la UCI sea comparable a la de pacientes no oncológicos, es relevante y trascendente dado que podría modificar un ―paradigma‖ de conducta y decisión ante un paciente oncológico que requiera un tratamiento intensivo. Así, consideramos que el objetivo del ingreso de un paciente oncológico a una unidad de terapia intensiva es mejorar su expectativa vital, sin que las medidas que se adopten impliquen una disminución significativa de su calidad de vida tras el alta hospitalaria. Este último condicionante ha sido y sigue siendo un argumento utilizado en muchos centros para no ingresar a un paciente onco-hematológico en UCI, el cual tiene débil evidencia científica; por lo tanto los avances en la comprensión de la fisiopatología de ciertas complicaciones que se desarrollan en pacientes críticamente enfermos con tumores malignos, ha dado lugar a un tratamiento eficaz lo que a su vez se traduce en aumento de la supervivencia, por lo tanto en la UCI una resucitación adecuada y precoz sin limitaciones iniciales a técnicas de soporte vital ha demostrado disminuir también la mortalidad de este grupo de pacientes.spa
dc.description.tableofcontents1. Introducción 8 2. Planteamiento del problema 9 3. Marco teórico y estado del arte 12 3.1. Datos y cifras globales cáncer 13 3.2. Perspectivas históricas del Cáncer y la Unidad de Cuidado Intensivo 13 3.3. Mejora del pronóstico de cáncer de pacientes en la UCI 15 3.4. Ingreso en la UCI y políticas de restricción de los pacientes con cáncer 18 3.5. Indicaciones de ingreso en la UCI de los pacientes con cáncer 24 3.6. Predictores de mortalidad en pacientes oncologicos criticos 30 3.7. Manejo del paciente en estado crítico con cáncer en UCI 32 4. Objetivos e hipótesis 36 4.1. Pregunta de investigación 37 4.2. Hipótesis 37 4.3. Objetivos 37 5. Metodología 38 5.1. Tipo de estudio 38 5.2. Población 38 5.3. Muestra 38 5.4. Criterios de selección 38 5.5. Variables del estudio 38 5.6. Recolección de información 39 5.7. Construcción de la base de datos 39 5.8. Plan de análisis 39 5.9. Aspectos éticos 40 5.10. Alcances esperados 40 5.11. Cronograma de actividades 41 5.12. Presupuesto 41 6. Resultados 43 6.1. Selección de muestra 43 6.2. Datos sociodemográficos 43 6.3. Caracterización del cáncer al ingreso a UCI 46 6.4. Distribución según la clasificación de severidad de enfermedad, APACHE IV (Score Acute Physiology and Chronic Health Evaluation, por sus siglas en inglés) ............................................................................................................................................ 50 6.5. Prioridad de ingreso a UCI ............................................................................................. 51 6.6. Días de estancia promedio en UCI 52 6.7. Mortalidad en pacientes con cáncer ingresados a UCI 53 6.8. Mortalidad según los antecedentes personales en UCI 53 6.9. Mortalidad según las indicaciones de ingreso a la UCI 55 7. Discusión 57 8. Conclusiones 64 9. Bibliografía 65 10. ANEXOS 81 10.1. Anexo 1: Operacionalización de las variables 81 10.2. Anexo 2: Instrumento de recolección de información 84 10.3. Anexo 3: Escala de clasificación de APACHE IV 85spa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleMortalidad en paciente oncológico crítico en cuidado intensivospa
dc.title.translatedMortality in a critical cancer patient in intensive careeng
dc.degree.nameEspecialista en Medicina Crítica y Cuidado Intensivo del Adultospa
dc.coverageBucaramanga (Santander, Colombia)spa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.programEspecialización en Medicina Crítica y Cuidado Intensivo del Adultospa
dc.description.degreelevelEspecializaciónspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.subject.keywordsIntensive care
dc.subject.keywordsMedicine
dc.subject.keywordsEmergency medicine
dc.subject.keywordsOncology
dc.subject.keywordsCritical medicine
dc.subject.keywordsIntensive adult care
dc.subject.keywordsInvestigations
dc.subject.keywordsRelationship with patients
dc.subject.keywordsEarly treatment
dc.subject.keywordsHealth care
dc.subject.keywordsCritical cancer patients
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2spa
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dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000176095*
dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000320609*
dc.contributor.orcidhttps://orcid.org/0000-0003-1791-8099*
dc.subject.lembCuidados intensivosspa
dc.subject.lembMedicinaspa
dc.subject.lembMedicina de urgenciasspa
dc.subject.lembOncologíaspa
dc.subject.lembMedicina críticaspa
dc.subject.lembCuidado intensivo del adultospa
dc.subject.lembInvestigacionesspa
dc.subject.lembRelación con los pacientesspa
dc.description.abstractenglishIn the last 20 years, several advances made in the early diagnosis and aggressive treatment of cancer patients have resulted in a 20% reduction in global mortality; the improvement in cancer treatment translates into an increase in the number of patients who are not cured but who live with this pathology. Since the number of patients living with cancer is expected to increase in the coming years, it follows that the demand for patients requiring treatment in the Intensive Care Unit (ICU) will also increase, either due to complications related to neoplasia. per se or due to the side effects derived from the treatment. The decision to admit these patients to the ICU often presents ethical, religious, administrative, family and even medical dilemmas, so it is necessary to know very well the prognosis and evolution of the neoplasia in these patients. The fact that in multiple observational studies the mortality of cancer patients in the ICU is comparable to that of non-cancer patients is relevant and transcendent since it could modify a ―paradigm‖ of conduct and decision when faced with an oncology patient who requires treatment. intensive. Thus, we consider that the objective of admission of an oncology patient to an intensive care unit is to improve their life expectancy, without the measures adopted implying a significant decrease in their quality of life after hospital discharge. This last conditioner has been and continues to be an argument used in many centers for not admitting an onco-hematological patient to the ICU, which has weak scientific evidence; Therefore, advances in the understanding of the pathophysiology of certain complications that develop in critically ill patients with malignant tumors, has led to effective treatment, which in turn translates into increased survival, therefore in the Adequate and early ICU resuscitation without initial limitations to life support techniques has also been shown to decrease mortality in this group of patients.eng
dc.subject.proposalTratamiento precoz
dc.subject.proposalAtención en salud
dc.subject.proposalPacientes oncológicos críticos
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*


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