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dc.contributor.advisorCadena Sanabria, Miguel Oswaldospa
dc.contributor.advisorOchoa Vera, Miguel Enriquespa
dc.contributor.authorAmaris Vergara, Amaury Alexisspa
dc.date.accessioned2020-06-26T19:59:56Z
dc.date.available2020-06-26T19:59:56Z
dc.date.issued2017
dc.identifier.urihttp://hdl.handle.net/20.500.12749/1744
dc.description.abstractAntecedentes: La estratificación pronóstica en Falla cardiaca (FC) es crucial para guiar el manejo clínico y tomar decisiones referentes al tratamiento, brindar educación a pacientes, familias y monitorear la calidad del cuidado de salud Métodos: Estudio observacional prospectivo, de una serie de clínica de pacientes con diagnóstico de FC del estudio FORCE, a quienes se le realizó seguimiento y visita a los 18 meses. Resultados: de los 120 pacientes incluidos en el estudio FORCE en 2015, se lograron contactar 95 pacientes en 2017. 17 pacientes fallecieron para una mortalidad del 17.8%. A los 78 pacientes restantes, se les realizó un seguimiento a 18 meses. La frecuencia de hospitalización fue del 78% en el periodo evaluado. En el análisis bivariado se encontró un aumento significativo del riesgo de mortalidad en pacientes con fuerza de empuñadura bajo con RR 2.9 IC 95% (1.11 – 7.59). Este comportamiento también se observó en pacientes pertenecientes al grupo III y IV de NYHA que a menor fuerza prensil hay mayor riesgo significativo RR 2.42 IC 95% (1.07 – 5.45). En el modelo multivariado solo se encontró asociación significativa para la clase funcional de manera global con respecto a mortalidad, con un OR 3.52 IC 95% (1.47 – 8.39). Sin embargo, en el análisis de subgrupo por sexo, resalta que sólo se mantienen estos resultados en el grupo de hombres con un OR 3.21 IC 95% (1.11– 9.26) P < 0.031. En cuanto al desenlace de hospitalización el promedio de fuerza de agarre fue menor en las mujeres hospitalizadas vs las que no presentaron el desenlace (18kg/f vs 22kg/f p0.0261). Conclusiones: el principal hallazgo de este estudio es que en pacientes con FC, hay una correlación entre la clase funcional NYHA y fuerza de agarre con el desenlace de mortalidad y hospitalización.. El presente estudio aporta evidencia estadística que justifica futuros estudios prospectivos que incluyan un mayor numero de pacientes y tiempo de seguimiento para confirmar esta relación. La fuerza prensil, por lo tanto, representa una medida aislada de función del músculo esquelético y fragilidad y podría aumentar la caracterización de pacientes con FC avanzada, y podría jugar un papel importante en predecir tasa de hospitalización.spa
dc.description.tableofcontentsNTRODUCCIÓN 1. OBJETIVO GENERAL 14 1.1 Objetivo Específicos 14 2. PLANTEAMIENTO DEL PROBLEMA 15 3. MARCO TEORICO Y ESTADO DEL ARTE 16 4. METODOLOGIA 24 4.1 Diseño 4.2 Universo 4.3 Población objeto 4.4 Muestra 4.5 Criterios de inclusión y exclusión 4.6 Muestreo 4.7 Variables 4.8 Recolección de la información 28 4.8.1 Evaluación inicial 4.8.2 Recolección de datos 4.8.3 Procesamiento y control de calidad de los datos 4.9 Procesamiento y análisis estadístico 29 8 5. CONSIDERACIONES ETICAS 30 6. RESULTADOS 31 7. DISCUSION 38 8. CONCLUSIONES 42 9. BIBLIOGRAFIA 89spa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleEvaluación de la fuerza de prensión de puño y su relación pronóstica en pacientes con falla cardíaca de la Foscal: estudio Force IIspa
dc.title.translatedEvaluation of the grip strength of the fist and its prognostic relationship in patients with Foscal heart failure: estudio Force IIeng
dc.degree.nameEspecialista en Medicina Internaspa
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 Internaspa
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.keywordsHeart diseaseeng
dc.subject.keywordsIschemic heart diseaseeng
dc.subject.keywordsChagasic cardiomyopathyeng
dc.subject.keywordsMedicineeng
dc.subject.keywordsInternal medicineeng
dc.subject.keywordsInvestigationseng
dc.subject.keywordsComplicationseng
dc.subject.keywordsPatientseng
dc.subject.keywordsPrevention and controleng
dc.subject.keywordsHeart failureeng
dc.subject.keywordsNew York Heart Association (NYHA) functional classeng
dc.subject.keywordsGrip strengtheng
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=0001339250;https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000898465*
dc.contributor.googlescholarhttps://scholar.google.es/citations?hl=es#user=jQUx5WcAAAAJ*
dc.contributor.orcidhttps://orcid.org/0000-0001-9807-3029;https://orcid.org/0000-0002-4552-3388*
dc.contributor.orcidhttps://orcid.org/0000-0002-5984-8386*
dc.contributor.scopushttps://www.scopus.com/authid/detail.uri?authorId=56437735000;https://www.scopus.com/authid/detail.uri?authorId=36987156500*
dc.contributor.researchgatehttps://www.researchgate.net/profile/Miguel_Cadena-Sanabria;https://www.researchgate.net/profile/Miguel_Ochoa7*
dc.subject.lembEnfermedades cardíacasspa
dc.subject.lembCardiopatía isquémicaspa
dc.subject.lembCardiomiopatía chagásicaspa
dc.subject.lembMedicinaspa
dc.subject.lembMedicina internaspa
dc.subject.lembInvestigacionesspa
dc.subject.lembComplicacionesspa
dc.subject.lembPacientesspa
dc.subject.lembPrevención y controlspa
dc.description.abstractenglishBackground: Prognostic stratification in heart failure (HF) is crucial to guide clinical management and make decisions regarding treatment, provide education to patients, families, and monitor the quality of health care Methods: A prospective observational study of a clinical series of patients with a diagnosis of CF from the FORCE study, who were followed up and visited at 18 months. Results: of the 120 patients included in the FORCE study in 2015, 95 patients were contacted in 2017. 17 patients died for a mortality of 17.8%. The remaining 78 patients were followed up for 18 months. The frequency of hospitalization was 78% in the evaluated period. In the bivariate analysis, a significant increase in the risk of mortality was found in patients with low grip strength with RR 2.9 95% CI (1.11 - 7.59). This behavior was also observed in patients belonging to NYHA group III and IV, where the lower the grip strength, the greater the significant risk RR 2.42 95% CI (1.07 - 5.45). In the multivariate model, only a significant association was found for the functional class globally with respect to mortality, with an OR 3.52 95% CI (1.47 - 8.39). However, in the subgroup analysis by sex, it stands out that only these results in the group of men with an OR 3.21 95% CI (1.11– 9.26) P <0.031. Regarding the hospitalization outcome, the average grip strength was lower in hospitalized women vs those who did not present the outcome (18kg / f vs 22kg / f p0.0261). Conclusions: the main finding of this study is that in patients with CF, there is a correlation between NYHA functional class and grip strength with the outcome of mortality and hospitalization. The present study provides statistical evidence that justifies future prospective studies that include a greater number of patients and follow-up time to confirm this relationship. Grip strength, therefore, represents an isolated measure of skeletal muscle function and frailty and could enhance the characterization of patients with advanced HR, and could play an important role in predicting hospitalization rates.eng
dc.subject.proposalFalla cardíaca
dc.subject.proposalClase funcional de New York Heart Association (NYHA)
dc.subject.proposalFuerza prensil
dc.subject.proposalChagas
dc.type.redcolhttp://purl.org/redcol/resource_type/TM
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*


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