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Concordancia en la detección de hemorragia subaracnoidea no traumática por medio de tomografías computarizadas de cráneo simple entre clínicos y el reporte radiológico definitivo en un hospital de 4º nivel de atención en Bogotá D.C, Colombia: 2020

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dc.contributor.advisorMenéndez Ramírez, Salvador Eduardo
dc.contributor.advisorVargas Brochero, Maria Jose
dc.creatorGutiérrez Vargas, Alfredo José
dc.creator.degreeEspecialista en Medicina de Emergenciases
dc.creator.degreeLevelMaestría
dc.creator.degreetypeFull timees
dc.date.accessioned2021-09-23T19:46:07Z
dc.date.available2021-09-23T19:46:07Z
dc.date.created2021-09-14
dc.descriptionIntroducción: La hemorragia subaracnoidea (HSA) consiste en el sangrado en la cavidad encefálica por debajo de la aracnoides. Los pacientes que presentan HSA ingresan a los diversos servicios de urgencias presentando cefalea hasta en el 25% de los casos, siendo la HSA la causa de esta cefalea en el 1-3%. Establecer el diagnóstico es importante dado que los desenlaces pueden ser fatales. Por tal razón, el uso de la tomografía de cráneo (TC) simple ha venido en ascenso en las últimas décadas como método diagnóstico efectivo y rápido para el estudio de múltiples patologías neurológicas agudas. Objetivo: establecer la concordancia interobservador entre médicos clínicos y el reporte definitivo por parte del radiólogo en la detección de HSA dentro de un banco de imágenes de una institución específica de 4° nivel de atención en la ciudad de Bogotá D.C. Método: Se realizó la evaluación del banco de tomografías computarizadas de cráneo simple tomadas en el servicio de urgencias por causa no traumática en un período comprendido entre enero a junio de 2018; de éstas 619 imágenes, 1.62% correspondieron a HSA; se tomaron 195 imágenes comparando la interpretación entre médicos clínicos (emergenciólogos y residentes de Medicina de Emergencias), con muestreo no probabilístico y con selección aleatoria de las tomografías de cráneo simple evaluadas. Resultados: El porcentaje de acuerdo a la interpretación de la tomografía de cráneo simple para diagnóstico de HSA entre el médico clínico y el radiólogo fue de 81.5%, con un porcentaje esperado por el azar de 55% y un Kappa de Cohen de 0.58 (IC 95% 0.71-0.46), p<0,000). En la evaluación exploratoria por subgrupos entre emergenciólogos y radiólogos versus residentes y radiólogos se observa un comportamiento similar con un Kappa de 0.59 y 0.57, respectivamente. Discusión: El resultado de este estudio aporta al conocimiento e interpretación tomográfica de los médicos clínicos versus radiólogos, siendo una de ellas la hemorragia subaracnoidea, evidenciando concordancia moderada como punto de mejora, enfocado en ofrecerle al paciente la mejor y más oportuna conducta terapéutica posible.es
dc.description.abstractIntroduction: Subarachnoid hemorrhage (SAH) consists of bleeding in the brain cavity below the arachnoid. Patients who present with SAH are admitted to the various emergency services presenting headaches in up to 25% of cases, with SAH being the cause of this headache in 1-3%. Establishing the diagnosis is important since the outcomes can be fatal. For this reason, the use of simple skull tomography (CT) has been on the rise in recent decades as an effective and rapid diagnostic method for the study of multiple acute neurological pathologies. Objective: To establish the interobserver agreement between clinical physicians and the definitive report by the radiologist on the detection of SAH within an image bank of a specific 4th level care institution in Bogota city. Method: The evaluation of the bank of computed tomography of the simple skull taken in the emergency department for non-traumatic causes was carried out in a period between January and June 2018; of these 619 images, 1.62% corresponded to HSA; 195 images were taken comparing the interpretation between clinical physicians (emergency physicians and residents of Emergency Medicine), with non-probabilistic sampling and with random selection of the evaluated simple skull tomographies. Results: The percentage according to the interpretation of the simple skull tomography for diagnosis of SAH between the clinician and the radiologist was 81.5%, with a percentage expected by chance of 55% and a Cohen's Kappa of 0.58 (CI 95% 0.71-0.46), p <0.000). In the exploratory evaluation by subgroups between emergenciologists and radiologists versus residents and radiologists, a similar behavior is observed with a Kappa of 0.59 and 0.57, respectively. Discussion: The result of this study contributes to the knowledge and tomographic interpretation of clinicians versus radiologists, one of them being subarachnoid hemorrhage, showing moderate concordance as a point of improvement, focused on offering the patient the best and most timely therapeutic conduct possible.es
dc.format.extent49 pp.es
dc.format.mimetypeapplication/pdfes
dc.geoLocationBogotá, Colombiaes
dc.identifier.doihttps://doi.org/10.48713/10336_32513
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/32513
dc.language.isospaes
dc.publisherUniversidad del Rosario
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Medicina de Emergencias
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.accesRightsinfo:eu-repo/semantics/openAccesses
dc.rights.accesoAbierto (Texto Completo)es
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectHemorragia subaracnoideaes
dc.subjectConcordancia interobservadores
dc.subjectTomografíaes
dc.subjectDiagnósticoes
dc.subjectSensibilidades
dc.subjectEspecificidades
dc.subjectKappaes
dc.subjectComparativo entre la interpretación tomográfica de radiólogos y médicos clínicoses
dc.subject.ddcEnfermedadeses
dc.subject.keywordSubarachnoid hemorrhagees
dc.subject.keywordInterobserver agreementes
dc.subject.keywordKappaes
dc.subject.keywordTomographyes
dc.subject.keywordDiagnosises
dc.subject.keywordSensitivityes
dc.subject.keywordSpecificityes
dc.subject.keywordComparison between the tomographic interpretation of radiologists and clinicianses
dc.titleConcordancia en la detección de hemorragia subaracnoidea no traumática por medio de tomografías computarizadas de cráneo simple entre clínicos y el reporte radiológico definitivo en un hospital de 4º nivel de atención en Bogotá D.C, Colombia: 2020es
dc.title.TranslatedTitleConcordance in the detection of non-traumatic subarachnoid hemorrhage by means of simple skull scans between clinicians and the final radiological report in a 4th level of care hospital; Bogota, Colombia: 2020es
dc.typemasterThesiseng
dc.type.documentRevisión sistemáticaes
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTesis de maestríaspa
local.department.reportEscuela de Medicina y Ciencias de la Saludspa
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