Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.

Autores:
Saavedra, Miguel Ángel
Jaime, Nelson Alfonso
Chávez, Christian Fabián
Orjuela, Juan Esteban
Rengifo, Ronald Raúl
Tipo de recurso:
Article of journal
Fecha de publicación:
2018
Institución:
Fundación Universitaria de Ciencias de la Salud - FUCS
Repositorio:
Repositorio Digital Institucional ReDi
Idioma:
spa
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oai:repositorio.fucsalud.edu.co:001/2111
Acceso en línea:
https://repositorio.fucsalud.edu.co/handle/001/2111
https://doi.org/10.31260/RepertMedCir.v27.n2.2018.179
Palabra clave:
Medicina de emergencia
servicios de emergencia médica
mortalidad hospitalaria
Fisiología aguda y evaluación de salud crónica
calidad de cuidado de la salud
emergency medicine
medical emergency services
in-hospital mortality
acute physiology and chronic health evaluation
health care quality
Rights
openAccess
License
Fundación Universitaria de Ciencias de la Salud FUCS - 2018
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network_name_str Repositorio Digital Institucional ReDi
repository_id_str
dc.title.spa.fl_str_mv Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
dc.title.translated.eng.fl_str_mv Predictive utility of mortality of the rapid scale of emergencies (REMS) in a Hospital of high complexity
title Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
spellingShingle Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
Medicina de emergencia
servicios de emergencia médica
mortalidad hospitalaria
Fisiología aguda y evaluación de salud crónica
calidad de cuidado de la salud
emergency medicine
medical emergency services
in-hospital mortality
acute physiology and chronic health evaluation
health care quality
title_short Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
title_full Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
title_fullStr Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
title_full_unstemmed Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
title_sort Utilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.
dc.creator.fl_str_mv Saavedra, Miguel Ángel
Jaime, Nelson Alfonso
Chávez, Christian Fabián
Orjuela, Juan Esteban
Rengifo, Ronald Raúl
dc.contributor.author.spa.fl_str_mv Saavedra, Miguel Ángel
Jaime, Nelson Alfonso
Chávez, Christian Fabián
Orjuela, Juan Esteban
Rengifo, Ronald Raúl
dc.subject.spa.fl_str_mv Medicina de emergencia
servicios de emergencia médica
mortalidad hospitalaria
Fisiología aguda y evaluación de salud crónica
calidad de cuidado de la salud
topic Medicina de emergencia
servicios de emergencia médica
mortalidad hospitalaria
Fisiología aguda y evaluación de salud crónica
calidad de cuidado de la salud
emergency medicine
medical emergency services
in-hospital mortality
acute physiology and chronic health evaluation
health care quality
dc.subject.eng.fl_str_mv emergency medicine
medical emergency services
in-hospital mortality
acute physiology and chronic health evaluation
health care quality
publishDate 2018
dc.date.accessioned.none.fl_str_mv 2018-08-15 00:00:00
2022-02-21T20:34:16Z
dc.date.issued.none.fl_str_mv 2018-08-15
dc.date.available.none.fl_str_mv 2018-08-15 00:00:00
2022-02-21T20:34:16Z
dc.type.spa.fl_str_mv Artículo de revista
dc.type.eng.fl_str_mv Journal article
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dc.identifier.issn.none.fl_str_mv 0121-7372
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dc.identifier.eissn.none.fl_str_mv 2462-991X
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url https://repositorio.fucsalud.edu.co/handle/001/2111
https://doi.org/10.31260/RepertMedCir.v27.n2.2018.179
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dc.relation.references.spa.fl_str_mv Jones AE, Fitch MT, Kline JA. Operational performance of validated physiologic scoring systems for predicting in-hospital mortality among critically ill emergency department patients. Crit Care Med. 2005;33(5):974-8. 2. Singer AJ, Thode HC, Viccellio P, Pines JM. The association between length of emergency department boarding and mortality. Acad Emerg Med. 2011;18(12):1324-9. 3. Cattermole GN, Mak SK, Liow CH, Ho MF, Hung KY, Keung KM, et al. Derivation of a prognostic score for identifying critically ill patients in an emergency department resuscitation room. Resuscitation. 2009;80(9):1000-5. 4. Sun Y, Heng BH, Tay SY, Seow E. Predicting hospital admissions at emergency department triage using routine administrative data. Acad Emerg Med. 2011;18(8):844-50. 5. Olsson T, Terent A, Lind L. Charlson Comorbidity Index can add prognostic information to Rapid Emergency Medicine Score as a predictor of long-term mortality. Eur J Emerg Med. 2005;12(5):220-4. 6. Brabrand M, Folkestad L, Clausen NG, Knudsen T, Hallas J. Risk scoring systems for adults admitted to the emergency department: a systematic review. Scand J Trauma Resusc Emerg Med. 2010;18:8. 7. Vincent JL, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207. 8. Nguyen HB, Rivers EP, Havstad S, Knoblich B, Ressler JA, Muzzin AM, et al. Critical care in the emergency department: A physiologic assessment and outcome evaluation. Acad Emerg Med. 2000;7(12):1354-61. 9. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270(24):2957-63. 10. Lemeshow S, Teres D, Klar J, Avrunin JS, Gehlbach SH, Rapoport J. Mortality Probability Models (MPM II) based on an international cohort of intensive care unit patients. JAMA. 1993;270(20):2478-86. 11. Hyzy RC. ICU scoring and clinical decision making. Chest. 1995;107(6):1482-3. 12. Calle P, Cerro L, Valencia J, Jaimes F. Usefulness of severity scores in patients with suspected infection in the emergency department: a systematic review. J Emerg Med. 2012;42(4):379-91. 13. Kuo SH, Tsai CF, Li CR, Tsai SJ, Chao WN, Chan KS, et al. Rapid Emergency Medicine Score as a main predictor of mortality in Vibrio vulnificus-related patients. Am J Emerg Med. 2013;31(7):1037-41. 14. Macdonald SP, Arendts G, Fatovich DM, Brown SG. Comparison of PIRO, SOFA, and MEDS scores for predicting mortality in emergency department patients with severe sepsis and septic shock. Acad Emerg Med. 2014;21(11):1257-63. 15. Hilderink MJ, Roest AA, Hermans M, Keulemans YC, Stehouwer CD, Stassen PM. Predictive accuracy and feasibility of risk stratification scores for 28-day mortality of patients with sepsis in an emergency department. Eur J Emerg Med. 2015;22(5):331-7. 16. Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE. APACHE-acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med. 1981;9(8):591-7. 17. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-29. 18. Wagner DP, Draper EA. Acute physiology and chronic health evaluation (APACHE II) and Medicare reimbursement. Health Care Financ Rev. 1984;Suppl:91-105. 19. Rhee KJ, Fisher CJ, Willitis NH. The Rapid Acute Physiology Score. Am J Emerg Med. 1987;5(4):278-82. 20. Yu S, Leung S, Heo M, Soto GJ, Shah RT, Gunda S, et al. Comparison of risk prediction scoring systems for ward patients: a retrospective nested case-control study. Crit Care. 2014;18(3):R132. 21. Salluh JI, Soares M. ICU severity of illness scores: APACHE, SAPS and MPM. Curr Opin Crit Care. 2014;20(5):557-65. 22. Moseson EM, Zhuo H, Chu J, Stein JC, Matthay MA, Kangelaris KN, et al. Intensive care unit scoring systems outperform emergency department scoring systems for mortality prediction in critically ill patients: a prospective cohort study. J Intensive Care. 2014;2:40. 23. Sekulic AD, Trpkovic SV, Pavlovic AP, Marinkovic OM, Ilic AN. Scoring Systems in Assessing Survival of Critically Ill ICU Patients. Med Sci Monit. 2015;21:2621-9. 24. Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, et al. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 1991;100(6):1619-36. 25. Olsson T, Lind L. Comparison of the rapid emergency medicine score and APACHE II in nonsurgical emergency department patients. Acad Emerg Med. 2003;10(10):1040-8. 26. Olsson T, Terent A, Lind L. Rapid Emergency Medicine score: a new prognostic tool for in-hospital mortality in nonsurgical emergency department patients. J Intern Med. 2004;255(5):579-87. 27. Olsson T, Terent A, Lind L. Rapid Emergency Medicine Score can predict long-term mortality in nonsurgical emergency department patients. Acad Emerg Med. 2004;11(10):1008-13. 28. Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI. Performance of severity of illness scoring systems in emergency department patients with infection. Acad Emerg Med. 2007;14(8):709-14. 29. Bulut M, Cebicci H, Sigirli D, Sak A, Durmus O, Top AA, et al. The comparison of modified early warning score with rapid emergency medicine score: a prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department. Emerg Med J. 2014;31(6):476-81. 30. Ji CL, Zhou HR, Peng CH, Yang XL, Zhang Q. [Comparison of value of GRACE, APACHEII and REMS for early prognosis of death in patients with acute myocardial infarction]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013;25(11):660-3. 31. Polita JR, Gomez J, Friedman G, Ribeiro SP. Comparison of APACHE II and three abbreviated APACHE II scores for predicting outcome among emergency trauma patients. Rev Assoc Med Bras (1992). 2014;60(4):381-6. 32. Imhoff BF, Thompson NJ, Hastings MA, Nazir N, Moncure M, Cannon CM. Rapid Emergency Medicine Score (REMS) in the trauma population: a retrospective study. BMJ Open. 2014;4(5):e004738. 33. Nakhjavan-Shahraki B, Baikpour M, Yousefifard M, Nikseresht ZS, Abiri S, Mirzay Razaz J, et al. Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study. Emerg (Tehran). 2017;5(1):e30. 34. Miller RT, Nazir N, McDonald T, Cannon CM. The modified rapid emergency medicine score: A novel trauma triage tool to predict in-hospital mortality. Injury. 2017;48(9):1870-7. 35. Ma QB, Fu YW, Feng L, Zhai QR, Liang Y, Wu M, et al. Performance of Simplified Acute Physiology Score 3 In Predicting Hospital Mortality In Emergency Intensive Care Unit. Chin Med J (Engl). 2017;130(13):1544-51. 36. Alter SM, Infinger A, Swanson D, Studnek JR. Evaluating clinical care in the prehospital setting: Is Rapid Emergency Medicine Score the missing metric of EMS? The American journal of emergency medicine. 2017;35(2):218-21. 37. Aacharya RP, Gastmans C, Denier Y. Emergency department triage: an ethical analysis. BMC Emerg Med. 2011;11:16. 38. Christ M, Grossmann F, Winter D, Bingisser R, Platz E. Modern triage in the emergency department. Dtsch Arztebl Int. 2010;107(50):892-8. 39. Resolución 5596. Por la cual se definen los criterios técnicos para el Sistema de Selección y Clasificación de pacientes en los servicios de urgencias "Triage" Diario Oficial No. 49.739 (2015). 40. Goodacre S, Turner J, Nicholl J. Prediction of mortality among emergency medical admissions. Emerg Med J. 2006;23(5):372-5.
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https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/179/184
https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/179/197
https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/179/211
dc.relation.citationedition.spa.fl_str_mv Núm. 2 , Año 2018 : Mayo - Agosto
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dc.relation.citationvolume.spa.fl_str_mv 27
dc.relation.ispartofjournal.spa.fl_str_mv Revista Repertorio de Medicina y Cirugía
dc.rights.spa.fl_str_mv Fundación Universitaria de Ciencias de la Salud FUCS - 2018
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spelling Saavedra, Miguel Ángelb16d4eee77987ff3ecc216b815f49638500Jaime, Nelson Alfonsoc8529c5ac2a43074af1f7c2a5ea054e8500Chávez, Christian Fabiánebdb7a821c833e0dcbd2af7dac72ae74300Orjuela, Juan Esteban472f6705807363e0e69dc5d53e193a1f300Rengifo, Ronald Raúl88d5990c8e1e105187a329cb8d9879753002018-08-15 00:00:002022-02-21T20:34:16Z2018-08-152018-08-15 00:00:002022-02-21T20:34:16ZSociedad de Cirugía de Bogotá, Hospital de San José y Fundación Universitaria de Ciencias de la SaludFundación Universitaria de Ciencias de la Salud FUCS - 2018info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/4.0/http://purl.org/coar/access_right/c_abf2https://revistas.fucsalud.edu.co/index.php/repertorio/article/view/179Medicina de emergenciaservicios de emergencia médicamortalidad hospitalariaFisiología aguda y evaluación de salud crónicacalidad de cuidado de la saludemergency medicinemedical emergency servicesin-hospital mortalityacute physiology and chronic health evaluationhealth care qualityUtilidad predictiva de mortalidad de la escala rápida de emergencias (REMS) en un Hospital de alta complejidad.Predictive utility of mortality of the rapid scale of emergencies (REMS) in a Hospital of high complexityapplication/pdftext/htmlapplication/epub+zipapplication/xmlArtículo de revistaJournal articlehttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionTexthttp://purl.org/coar/version/c_970fb48d4fbd8a8510.31260/RepertMedCir.v27.n2.2018.1790121-7372https://repositorio.fucsalud.edu.co/handle/001/21112462-991Xhttps://doi.org/10.31260/RepertMedCir.v27.n2.2018.179spaJones AE, Fitch MT, Kline JA. Operational performance of validated physiologic scoring systems for predicting in-hospital mortality among critically ill emergency department patients. Crit Care Med. 2005;33(5):974-8. 2. Singer AJ, Thode HC, Viccellio P, Pines JM. The association between length of emergency department boarding and mortality. Acad Emerg Med. 2011;18(12):1324-9. 3. Cattermole GN, Mak SK, Liow CH, Ho MF, Hung KY, Keung KM, et al. Derivation of a prognostic score for identifying critically ill patients in an emergency department resuscitation room. Resuscitation. 2009;80(9):1000-5. 4. Sun Y, Heng BH, Tay SY, Seow E. Predicting hospital admissions at emergency department triage using routine administrative data. Acad Emerg Med. 2011;18(8):844-50. 5. Olsson T, Terent A, Lind L. Charlson Comorbidity Index can add prognostic information to Rapid Emergency Medicine Score as a predictor of long-term mortality. Eur J Emerg Med. 2005;12(5):220-4. 6. Brabrand M, Folkestad L, Clausen NG, Knudsen T, Hallas J. Risk scoring systems for adults admitted to the emergency department: a systematic review. Scand J Trauma Resusc Emerg Med. 2010;18:8. 7. Vincent JL, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207. 8. Nguyen HB, Rivers EP, Havstad S, Knoblich B, Ressler JA, Muzzin AM, et al. Critical care in the emergency department: A physiologic assessment and outcome evaluation. Acad Emerg Med. 2000;7(12):1354-61. 9. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270(24):2957-63. 10. Lemeshow S, Teres D, Klar J, Avrunin JS, Gehlbach SH, Rapoport J. Mortality Probability Models (MPM II) based on an international cohort of intensive care unit patients. JAMA. 1993;270(20):2478-86. 11. Hyzy RC. ICU scoring and clinical decision making. Chest. 1995;107(6):1482-3. 12. Calle P, Cerro L, Valencia J, Jaimes F. Usefulness of severity scores in patients with suspected infection in the emergency department: a systematic review. J Emerg Med. 2012;42(4):379-91. 13. Kuo SH, Tsai CF, Li CR, Tsai SJ, Chao WN, Chan KS, et al. Rapid Emergency Medicine Score as a main predictor of mortality in Vibrio vulnificus-related patients. Am J Emerg Med. 2013;31(7):1037-41. 14. Macdonald SP, Arendts G, Fatovich DM, Brown SG. Comparison of PIRO, SOFA, and MEDS scores for predicting mortality in emergency department patients with severe sepsis and septic shock. Acad Emerg Med. 2014;21(11):1257-63. 15. Hilderink MJ, Roest AA, Hermans M, Keulemans YC, Stehouwer CD, Stassen PM. Predictive accuracy and feasibility of risk stratification scores for 28-day mortality of patients with sepsis in an emergency department. Eur J Emerg Med. 2015;22(5):331-7. 16. Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE. APACHE-acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med. 1981;9(8):591-7. 17. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-29. 18. Wagner DP, Draper EA. Acute physiology and chronic health evaluation (APACHE II) and Medicare reimbursement. Health Care Financ Rev. 1984;Suppl:91-105. 19. Rhee KJ, Fisher CJ, Willitis NH. The Rapid Acute Physiology Score. Am J Emerg Med. 1987;5(4):278-82. 20. Yu S, Leung S, Heo M, Soto GJ, Shah RT, Gunda S, et al. Comparison of risk prediction scoring systems for ward patients: a retrospective nested case-control study. Crit Care. 2014;18(3):R132. 21. Salluh JI, Soares M. ICU severity of illness scores: APACHE, SAPS and MPM. Curr Opin Crit Care. 2014;20(5):557-65. 22. Moseson EM, Zhuo H, Chu J, Stein JC, Matthay MA, Kangelaris KN, et al. Intensive care unit scoring systems outperform emergency department scoring systems for mortality prediction in critically ill patients: a prospective cohort study. J Intensive Care. 2014;2:40. 23. Sekulic AD, Trpkovic SV, Pavlovic AP, Marinkovic OM, Ilic AN. Scoring Systems in Assessing Survival of Critically Ill ICU Patients. Med Sci Monit. 2015;21:2621-9. 24. Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, et al. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 1991;100(6):1619-36. 25. Olsson T, Lind L. Comparison of the rapid emergency medicine score and APACHE II in nonsurgical emergency department patients. Acad Emerg Med. 2003;10(10):1040-8. 26. Olsson T, Terent A, Lind L. Rapid Emergency Medicine score: a new prognostic tool for in-hospital mortality in nonsurgical emergency department patients. J Intern Med. 2004;255(5):579-87. 27. Olsson T, Terent A, Lind L. Rapid Emergency Medicine Score can predict long-term mortality in nonsurgical emergency department patients. Acad Emerg Med. 2004;11(10):1008-13. 28. Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI. Performance of severity of illness scoring systems in emergency department patients with infection. Acad Emerg Med. 2007;14(8):709-14. 29. Bulut M, Cebicci H, Sigirli D, Sak A, Durmus O, Top AA, et al. The comparison of modified early warning score with rapid emergency medicine score: a prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department. Emerg Med J. 2014;31(6):476-81. 30. Ji CL, Zhou HR, Peng CH, Yang XL, Zhang Q. [Comparison of value of GRACE, APACHEII and REMS for early prognosis of death in patients with acute myocardial infarction]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013;25(11):660-3. 31. Polita JR, Gomez J, Friedman G, Ribeiro SP. Comparison of APACHE II and three abbreviated APACHE II scores for predicting outcome among emergency trauma patients. Rev Assoc Med Bras (1992). 2014;60(4):381-6. 32. Imhoff BF, Thompson NJ, Hastings MA, Nazir N, Moncure M, Cannon CM. Rapid Emergency Medicine Score (REMS) in the trauma population: a retrospective study. BMJ Open. 2014;4(5):e004738. 33. Nakhjavan-Shahraki B, Baikpour M, Yousefifard M, Nikseresht ZS, Abiri S, Mirzay Razaz J, et al. Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study. Emerg (Tehran). 2017;5(1):e30. 34. Miller RT, Nazir N, McDonald T, Cannon CM. The modified rapid emergency medicine score: A novel trauma triage tool to predict in-hospital mortality. Injury. 2017;48(9):1870-7. 35. Ma QB, Fu YW, Feng L, Zhai QR, Liang Y, Wu M, et al. Performance of Simplified Acute Physiology Score 3 In Predicting Hospital Mortality In Emergency Intensive Care Unit. Chin Med J (Engl). 2017;130(13):1544-51. 36. Alter SM, Infinger A, Swanson D, Studnek JR. Evaluating clinical care in the prehospital setting: Is Rapid Emergency Medicine Score the missing metric of EMS? The American journal of emergency medicine. 2017;35(2):218-21. 37. Aacharya RP, Gastmans C, Denier Y. Emergency department triage: an ethical analysis. BMC Emerg Med. 2011;11:16. 38. Christ M, Grossmann F, Winter D, Bingisser R, Platz E. Modern triage in the emergency department. Dtsch Arztebl Int. 2010;107(50):892-8. 39. Resolución 5596. Por la cual se definen los criterios técnicos para el Sistema de Selección y Clasificación de pacientes en los servicios de urgencias "Triage" Diario Oficial No. 49.739 (2015). 40. Goodacre S, Turner J, Nicholl J. Prediction of mortality among emergency medical admissions. Emerg Med J. 2006;23(5):372-5.https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/179/170https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/179/184https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/179/197https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/179/211Núm. 2 , Año 2018 : Mayo - Agosto227Revista Repertorio de Medicina y CirugíaOREORE.xmltext/xml2627https://repositorio.fucsalud.edu.co/bitstreams/11ee557c-4279-4c65-9144-f7fb72149f8d/download686eb35dffd81ecb62468ffd8fd74185MD51001/2111oai:repositorio.fucsalud.edu.co:001/21112022-02-21 15:34:16.272https://creativecommons.org/licenses/by-nc-sa/4.0/Fundación Universitaria de Ciencias de la Salud FUCS - 2018metadata.onlyhttps://repositorio.fucsalud.edu.coRepositorio Digital de la Fundación Universitaria de Ciencias de la Saludredi@fucsalud.edu.co