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Concordancia en interpretación electrocardiográfica en síndromes coronarios agudos entre especialistas del servicio de urgencias y cardiólogos

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dc.contributor.advisorIsaza-Restrepo, Daniel
dc.contributor.advisorRodríguez, David Rene
dc.contributor.advisorMoreno, Karen
dc.contributor.advisorBeltrán Rodríguez, Johnny Adalber
dc.creatorCamargo Castro, William
dc.creatorCaicedo Arbelaez, Felipe
dc.creator.degreeEspecialista en Medicina de Emergencias
dc.date.accessioned2013-08-21T13:13:56Z
dc.date.available2013-08-21T13:13:56Z
dc.date.created2013-08-12
dc.date.issued2013
dc.descriptionIntroducción: El ECG es una herramienta básica en el estudio del dolor torácico, no hay evidencia que demuestre si la interpretación electrocardiográfica de los especialistas de medicina interna y emergencias es similar a la de cardiólogos en casos de SCA. El propósito de este estudio es determinar si existe concordancia en interpretación de los hallazgos electrocardiográficos más frecuentes en la fase aguda de los síndromes coronarios. Metodología: Estudio retrospectivo de concordancia diagnóstica electrocardiográfica, realizado en un hospital universitario de cuarto nivel. Se escogieron los hallazgos electrocardiográficos más frecuentes en síndromes coronarios agudos para ser evaluados por 3 diferentes especialidades y se hizo el análisis de concordancia mediante el cálculo estadístico kappa. Resultados: Se analizaron 200 electrocardiogramas aleatorizados, de pacientes con SCA entre noviembre de 2012 a abril de 2013. La edad promedio fue 65,14 años, la mayoría hombres (62,5%), la hipertensión arterial y enfermedad coronaria fueron las comorbilidades más frecuentes. Se encontró un grado de concordancia moderada (k = 0.61 – 0.80, p <0.001) entre cardiólogos vs emergenciólogos y cardiólogos vs internistas, excepto en lesión subendocárdica (k = 0.11 y 0.24 respectivamente), hubo un grado de concordancia débil (k = 0.41 – 0.60, p <0.001) entre emergenciólogos e internistas. El hallazgo en el que hubo grado de concordancia muy bueno (k > 0.81) fue bloqueo de rama izquierda. Conclusión: Existe grado de concordancia moderada en la lectura electrocardiográfica en la mayoría de variables en relación con síndrome coronario agudo entre los especialistas de medicina interna y emergencias al compararlo con cardiólogos.spa
dc.description.abstractThe electrocardiogram is a basic tool in the study of chest pain, there is no evidence that probes if the electrocardiographic interpretation of the emergency medicine and internal medicine specialist are similar to the cardiologist in cases of ACS. The purpose of this study is to determine if there is concordance between the interpretation of the most frequent electrocardiographic findings in the acute phase of the coronary syndromes. Methods: Retrospective study of diagnostic electrocardiographic concordance performed in a fourth level university hospital. The most frequent electrocardiographic findings in acute coronary syndrome were chosen to be evaluated by three different specialties and the concordance analysis were carried out through a kappa statistical analysis. Results: 200 randomized electrocardiograms of patients with acute coronary syndrome were analyzed between November of 2012 to April of 2013. The average age of the patients were 65 years, the male population were greater (62, 5%), the most frequent comorbidities were high blood pressure and coronary disease. The concordance between cardiologist vs emergency medicine specialist and cardiologist vs internal medicine were moderated (k= 0. 61 -0. 80, p &lt; 0, 001) except in subendocardic injury (k = 0. 11 y 0. 24 respectively), there were a weak concordance level between emergency medicine and internal medicine (k = 0. 41 – 0. 60, p &lt; 0. 001). The best level of concordance found in the study were the left branch blockage (k &gt; 0. 81). Conclusion: There is a moderated degree of concordance level in the electrocardiographic interpretation in the majority of variables in the cases of acute coronary syndromes among the specialist in internal medicine and emergency medicine compared with cardiologists. eng
dc.format.mimetypeapplication/pdf
dc.format.tipoDocumentospa
dc.identifier.doihttps://doi.org/10.48713/10336_4628
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/4628
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Medicina de Emergenciasspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
dc.rights.ccAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma.spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectconcordanciaspa
dc.subjectelectrocardiogramaspa
dc.subject.decsELECTROCARDIOGRAFÍA - UTILIZACIÓNspa
dc.subject.decsSÍNDROME CORONARIO AGUDO - ULTRASONOGRAFÍAspa
dc.subject.decsSÍNDROME CORONARIO AGUDO - DIAGNÓSTICOspa
dc.subject.keywordconcordanceeng
dc.subject.keywordelectrocardiogrameng
dc.subject.lembCardiología::Investigacionesspa
dc.subject.lembMedicina de urgencias::Investigacionesspa
dc.titleConcordancia en interpretación electrocardiográfica en síndromes coronarios agudos entre especialistas del servicio de urgencias y cardiólogosspa
dc.typemasterThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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