Grados altos en la Escala de Fisher predicen el desarrollo de hidrocefalia en pacientes con hemorragia subaracnoidea espontanea

Herrera Díaz, Ana Catalina; Salgado Cardozo, Juan

doi:https://doi.org/10.48713/10336_4515

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Grados altos en la Escala de Fisher predicen el desarrollo de hidrocefalia en pacientes con hemorragia subaracnoidea espontanea

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dc.contributor.advisor	Trillos Peña, Carlos Enrique
dc.creator	Herrera Díaz, Ana Catalina
dc.creator	Salgado Cardozo, Juan
dc.creator.degree	Medico(a) y Cirujano(a)
dc.date.accessioned	2013-08-05T21:36:30Z
dc.date.available	2013-08-05T21:36:30Z
dc.date.created	2013-07-08
dc.date.issued	2013
dc.description	Objetivo: Determinar si los grados altos en la escala de Fisher son útiles como factores pronósticos en el desarrollo de hidrocefalia en pacientes colombianos con diagnóstico de hemorragia subaracnoidea (HSA) espontánea vistos en el Hospital Universitario Clínica San Rafael (HUCSR) desde Enero de 2005 a Abril de 2012 con seguimiento a 12 meses. Métodos: 251 pacientes fueron incluidos en una cohorte restrospectiva. La asociación entre la escala de Fisher y el desarrollo de hidrocefalia en pacientes con HSA espontánea fue analizada a través de un análisis bivariado y multivariado. Se realizó una revisión sistemática de literatura (RSL) enfocada en factores de riesgo asociados con el desarrollo de hidrocefalia en HSA espontánea. Resultados: En nuestra cohorte de pacientes, la etiología de la HSA fue predominantemente por ruptura de aneurismas; 78,5%. La prevalencia de hidrocefalia fue de 27,1%. La sobrevida a 12 meses fue de 65,7%. La edad promedio de los pacientes incluidos fue 55,5 ± 15 años, en su mayoría mujeres 65,7%. Tener Fisher 4 y Hunt-Hess III están asociados con el desarrollo de hidrocefalia: OR ajustado; 2.93 IC 95%: 1.51-5.65, P <0.001, OR ajustado 2.83 IC 95%: 1.31-6.17 P=0.008 respectivamente. La RSL mostró una prevalencia de hidrocefalia de 17 a 68% y una mortalidad entre un 3.0% a 33%. El 50% de los estudios analizados asocian significativamente la hemorragia intraventricular ( Fisher 4) con hidrocefalia. Conclusión: Nuestros resultados confirman conceptos actuales de que la hidrocefalia post HSA es obs-tructiva y secundaria como tener Fisher IV y deterioro neurológico al ingreso (Hunt y Hess III).	spa
dc.description.abstract	Objetive. To determine if high grades of Fisher scale are useful to predict the development of hydrocephalus in consecutive Colombian patients with spontaneous subarachnoid hemorrhage (SAH) assessed from January 2005 to April 2012 with 12 month follow-up. Methods. 251 patients were included in a restrospective manner. The association between Fisher scale and hydrocephalus was analyzed bivariate and multivariate analysis. In addition, a systematic literature review (SLR) was done. Results. In our cohort of patients, the etiology of SAH was due to aneurysms; 78,5%. The prevalence of hydrocephalus was found to be of 27,1%. Overall survival with a 12 month follow-up was of 65,7%. Average age of included patients was 55,5 ± 15 years, and most of them were women; 65,7%. Having Fisher 4 and Hunt-Hess III are significantly associated with hydrocephalus: adjusted OR: 2.93 95% CI: 1.51-5.65, P <0.001, adjusted OR: 2.83 95% CI: 1.31-6.17 P=0.008 respectively. The SRL showed an overall prevalence of hydrocephalus between 17 and 68% and mortality varied between 3.0% and 33%. 50% of the included studies significantly associated intraventricular hemorrhage ( Fisher 4) with hydrocephalus. Conclusion. Our results confirm current concepts on post-SAH hydrocephalus and the fact that is obstructive and secondary to Fisher 4 and having neurological impairment on admission (Hunt and Hess III).	eng
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dc.identifier.doi	https://doi.org/10.48713/10336_4515
dc.identifier.uri	http://repository.urosario.edu.co/handle/10336/4515
dc.language.iso	spa
dc.publisher	Universidad del Rosario	spa
dc.publisher.department	Facultad de medicina	spa
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dc.rights.cc	Atribución-NoComercial-SinDerivadas 2.5 Colombia	spa
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dc.source.instname	instname:Universidad del Rosario	spa
dc.source.reponame	reponame:Repositorio Institucional EdocUR	spa
dc.subject	Hemorragia subaracnoidea espontánea	spa
dc.subject	tomografía axial computarizada	spa
dc.subject	Hunt-Hess	spa
dc.subject	hidrocefalia aguda	spa
dc.subject	subaguda y crónica	spa
dc.subject	punción lumbar seriada	spa
dc.subject	ventriculostomía	spa
dc.subject	derivación ventriculoperitoneal	spa
dc.subject	fenestración de lámina terminalis	spa
dc.subject	revisión sistemática de la literatura.	spa
dc.subject.decs	ESCALA DE FISHER	spa
dc.subject.decs	ESCALA DE HUNT Y HESS	spa
dc.subject.decs	HEMORRAGIA SUBARACNOIDEA	spa
dc.subject.decs	HIDROCEFALIA	spa
dc.subject.decs	PUNCIÓN ESPINAL	spa
dc.subject.decs	TOMOGRAFÍA COMPUTARIZADA POR RAYOS X	spa
dc.subject.decs	VENTRICULOSTOMÍA	spa
dc.subject.keyword	Fisher Scale	eng
dc.subject.keyword	CT Scan	eng
dc.subject.keyword	Hunt-Hess	eng
dc.subject.keyword	acute	eng
dc.subject.keyword	subacute and chronic hydrocephalus	eng
dc.subject.keyword	lumbar puncture	eng
dc.subject.keyword	ventriculostomy	eng
dc.subject.keyword	ventriculoperitoneal shunt	eng
dc.subject.keyword	lamina terminalis fenestration	eng
dc.subject.keyword	systematic review of literature.	eng
dc.title	Grados altos en la Escala de Fisher predicen el desarrollo de hidrocefalia en pacientes con hemorragia subaracnoidea espontanea	spa
dc.type	bachelorThesis	eng
dc.type.hasVersion	info:eu-repo/semantics/acceptedVersion
dc.type.spa	Trabajo de grado	spa