Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia

Introducción: En el mundo, incluyendo nuestra población, las enfermedades cardiovasculares siguen siendo la principal causa de muerte, la creación de escalas ha permitido realizar diagnósticos precoces que conllevan a tratamientos oportunos, por lo que queremos validar una escala clínica diagnóstica...

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Autores:
Romero Jiménez, Evasandrid
León Cifuentes, Reiner
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2024
Institución:
Universidad Libre
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RIU - Repositorio Institucional UniLibre
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oai:repository.unilibre.edu.co:10901/29574
Acceso en línea:
https://hdl.handle.net/10901/29574
Palabra clave:
Síndrome coronario agudo
Dolor en el pecho
Métodos diagnósticos
Servicios de emergencia
Angina inestable
Evaluación de riesgos
Infarto del miocardio
Acute coronary syndrome
Chest pain
Diagnostic methods
Emergency department
Unstable angina
Risk assessment
Myocardial infarction
Angina de pecho
Infarto del miocardio - diagnóstico
Angina inestable
Dolor en el pecho
Urgencias médicas
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dc.title.spa.fl_str_mv Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
dc.title.alternative.spa.fl_str_mv Validation of the EDACS Score for the prediction of ACS and MACE in the emergency department of a clinic in Barranquilla-Colombia
title Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
spellingShingle Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
Síndrome coronario agudo
Dolor en el pecho
Métodos diagnósticos
Servicios de emergencia
Angina inestable
Evaluación de riesgos
Infarto del miocardio
Acute coronary syndrome
Chest pain
Diagnostic methods
Emergency department
Unstable angina
Risk assessment
Myocardial infarction
Angina de pecho
Infarto del miocardio - diagnóstico
Angina inestable
Dolor en el pecho
Urgencias médicas
title_short Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
title_full Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
title_fullStr Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
title_full_unstemmed Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
title_sort Validación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-Colombia
dc.creator.fl_str_mv Romero Jiménez, Evasandrid
León Cifuentes, Reiner
dc.contributor.advisor.none.fl_str_mv Ortega Ramírez, Gustavo Andrés
Ardila Pereira, Laura Cecilia
dc.contributor.author.none.fl_str_mv Romero Jiménez, Evasandrid
León Cifuentes, Reiner
dc.subject.spa.fl_str_mv Síndrome coronario agudo
Dolor en el pecho
Métodos diagnósticos
Servicios de emergencia
Angina inestable
Evaluación de riesgos
Infarto del miocardio
topic Síndrome coronario agudo
Dolor en el pecho
Métodos diagnósticos
Servicios de emergencia
Angina inestable
Evaluación de riesgos
Infarto del miocardio
Acute coronary syndrome
Chest pain
Diagnostic methods
Emergency department
Unstable angina
Risk assessment
Myocardial infarction
Angina de pecho
Infarto del miocardio - diagnóstico
Angina inestable
Dolor en el pecho
Urgencias médicas
dc.subject.subjectenglish.spa.fl_str_mv Acute coronary syndrome
Chest pain
Diagnostic methods
Emergency department
Unstable angina
Risk assessment
Myocardial infarction
dc.subject.lemb.spa.fl_str_mv Angina de pecho
Infarto del miocardio - diagnóstico
Angina inestable
Dolor en el pecho
Urgencias médicas
description Introducción: En el mundo, incluyendo nuestra población, las enfermedades cardiovasculares siguen siendo la principal causa de muerte, la creación de escalas ha permitido realizar diagnósticos precoces que conllevan a tratamientos oportunos, por lo que queremos validar una escala clínica diagnóstica para esta enfermedad en nuestra población. Objetivo: Validar el Emergency Department assessment Chest Pain Score (EDACS) en la población de la ciudad de Barranquilla. Metodología: Se realizó un estudio de cohorte con 189 pacientes mayores a 18 años que consultaron al servicio de urgencias con dolor torácico de aparición menor a 24 horas con seguimiento durante 30 días del evento índice; los datos fueron tomados de historias clínicas de los pacientes de la Clínica General del Norte en Barranquilla, en el período 2023. Resultados: La población elegible final consistió en 189 pacientes seleccionados entre un total de 1543, quienes tenían historias clínicas completas y cumplían con todos los criterios de inclusión. En cuanto a la escala EDACS, los pacientes que presentaron MACE obtuvieron una puntuación promedio significativamente mayor (17.37 ± 5.43) en comparación con los pacientes sin MACE (14.18 ± 5.69) (p=0.0049). Se determinó que 14 es el punto de corte para la población colombiana, y la razón de probabilidades fue de 3.36, lo que sugiere que los pacientes con una puntuación EDACS de 14 o más tienen 3.36 veces más probabilidades de experimentar un MACE en comparación con aquellos con una puntuación menor a 14. Esta asociación también fue estadísticamente significativa (p=0.004), con un intervalo de confianza del 95% de 1.45 a 7.75. Conclusiones: La validación del EDACS score en nuestra población demuestra su alta sensibilidad para predecir MACE, reafirmando su utilidad clínica en el manejo del dolor torácico en el servicio de urgencias.
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-07-26T21:03:25Z
dc.date.available.none.fl_str_mv 2024-07-26T21:03:25Z
dc.date.created.none.fl_str_mv 2024-06
dc.type.local.spa.fl_str_mv Tesis de Especialización
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url https://hdl.handle.net/10901/29574
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42. Dahal, T., Tamang, A., Shrestha, R., Rai, A., Tripathee, S. (2023). Efficacy of Chest Pain Severity and Clinical Assessment in an Emergency Department: A Quantitative Retrospective Study of 1200 Patients. IAR Journal of Clinical Research.
43. Aldous, S., Richards, A. M., Cullen, L., Troughton, R., Than, M. (2017). The EDACS-ADP Identifies Patients with Chest Pain Who Are at Very Low Risk of Acute Coronary Syndrome in the ED. Annals of Emergency Medicine, 70(5), 737-745.
Chapman, A. R., Adamson, P. D., Shah, A. S., Anand, A., Strachan, F. E., Ferry, A. V., ... & Mills, N. L. (2018). High-Sensitivity Cardiac Troponin and the Universal Definition of Myocardial Infarction. Circulation, 137(22), 2154-2164
45. Dahal, T., Tamang, A., Shrestha, R., Rai, A., Tripathee, S. (2023). Efficacy of Chest Pain Severity and Clinical Assessment in an Emergency Department: A Quantitative Retrospective Study of 1200 Patients. IAR Journal of Clinical Research.
46. Aldous, S., Richards, A. M., Cullen, L., Troughton, R., Than, M. (2017). The EDACS-ADP Identifies Patients with Chest Pain Who Are at Very Low Risk of Acute Coronary Syndrome in the ED. Annals of Emergency Medicine, 70(5), 737-745.
47. Chapman, A. R., Adamson, P. D., Shah, A. S., Anand, A., Strachan, F. E., Ferry, A. V., ... & Mills, N. L. (2018). High-Sensitivity Cardiac Troponin and the Universal Definition of Myocardial Infarction. Circulation, 137(22), 2154-2164
48. Zaboli, A., Ramezani, J., Jafarzadeh, S., Ramezani, M. (2022). Evaluation of EDACS Score Performance in an Italian Emergency Department: A Retrospective Study. Emergency Medicine Journal, 39(1), 55-60.
49. Neumann, J. T., Sörensen, N. A., Rübsamen, N., Ojeda, F., Renne, T., Krämer, B. K., ... & Blankenberg, S. (2018). Discrimination of Patients with Type 2 Myocardial Infarction and Acute Nonischemic Myocardial Injury. Circulation, 138(10), 1036-1045.
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spelling Ortega Ramírez, Gustavo AndrésArdila Pereira, Laura CeciliaRomero Jiménez, EvasandridLeón Cifuentes, ReinerBarranquilla2024-07-26T21:03:25Z2024-07-26T21:03:25Z2024-06https://hdl.handle.net/10901/29574Introducción: En el mundo, incluyendo nuestra población, las enfermedades cardiovasculares siguen siendo la principal causa de muerte, la creación de escalas ha permitido realizar diagnósticos precoces que conllevan a tratamientos oportunos, por lo que queremos validar una escala clínica diagnóstica para esta enfermedad en nuestra población. Objetivo: Validar el Emergency Department assessment Chest Pain Score (EDACS) en la población de la ciudad de Barranquilla. Metodología: Se realizó un estudio de cohorte con 189 pacientes mayores a 18 años que consultaron al servicio de urgencias con dolor torácico de aparición menor a 24 horas con seguimiento durante 30 días del evento índice; los datos fueron tomados de historias clínicas de los pacientes de la Clínica General del Norte en Barranquilla, en el período 2023. Resultados: La población elegible final consistió en 189 pacientes seleccionados entre un total de 1543, quienes tenían historias clínicas completas y cumplían con todos los criterios de inclusión. En cuanto a la escala EDACS, los pacientes que presentaron MACE obtuvieron una puntuación promedio significativamente mayor (17.37 ± 5.43) en comparación con los pacientes sin MACE (14.18 ± 5.69) (p=0.0049). Se determinó que 14 es el punto de corte para la población colombiana, y la razón de probabilidades fue de 3.36, lo que sugiere que los pacientes con una puntuación EDACS de 14 o más tienen 3.36 veces más probabilidades de experimentar un MACE en comparación con aquellos con una puntuación menor a 14. Esta asociación también fue estadísticamente significativa (p=0.004), con un intervalo de confianza del 95% de 1.45 a 7.75. Conclusiones: La validación del EDACS score en nuestra población demuestra su alta sensibilidad para predecir MACE, reafirmando su utilidad clínica en el manejo del dolor torácico en el servicio de urgencias.Universidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud y Exactas y Naturales -- Especialización en Medicina InternaBackground: In the world, including our population, cardiovascular diseases remain the leading cause of death, the creation of scales has allowed early diagnoses that lead to timely treatments, so we want to validate a clinical diagnostic scale for this disease in our population. Objective: To validate the EDACS score in our population. Methodology: A cohort study was conducted with 189 patients over 18 years of age consulting the emergency department with chest pain of onset < 24 h with follow-up for 30 days of the index event; data were taken from medical records patients at the Clínica General del Norte in Barranquilla, in the period 2023. Results: The final eligible population consisted of 189 patients out of 1543, with complete medical records and who met all inclusion criteria. On the EDACS scale, patients with MACE had a significantly higher mean score (17.37 ± 5.43) compared to patients without MACE (14.18 ± 5.69) (p=0.0049). 14 is considered the Colombian cut-off point, the odds ratio was 3.36, suggesting that patients with an EDACS score of 14 or more are 3.36 times more likely to experience a MACE compared to those with a score less than 14. This association was also statistically significant (p=0.004), with a 95% confidence interval of 1.45 to 7.75. Conclusions: The validation of the EDACS score in our population demonstrates its high sensitivity to predict MACE, reaffirming its clinical usefulness in the management of chest pain in the emergency department.PDFhttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Atribución-NoComercial-SinDerivadas 2.5 Colombiainfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Síndrome coronario agudoDolor en el pechoMétodos diagnósticosServicios de emergenciaAngina inestableEvaluación de riesgosInfarto del miocardioAcute coronary syndromeChest painDiagnostic methodsEmergency departmentUnstable anginaRisk assessmentMyocardial infarctionAngina de pechoInfarto del miocardio - diagnósticoAngina inestableDolor en el pechoUrgencias médicasValidación del EDACS Score para la predicción del SCA y MACE en el servicio de urgencias de una clínica de Barranquilla-ColombiaValidation of the EDACS Score for the prediction of ACS and MACE in the emergency department of a clinic in Barranquilla-ColombiaTesis de Especializaciónhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisMakki N, Brennan TM, Girotra S. 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Por la cual se crea el sistema de seguridad social integral y se dictan otras disposiciones: Diario Oficial No. 41.148, 23 de diciembre de 1993.Congreso de Colombia. Ley 1751 de 2015. Por medio de la cual se regula el derecho fundamental a la salud y se dictan otras disposiciones: Diario Oficial No. 49.427, 16 de febrero de 2015.THUMBNAILROMERO.pdf.jpgROMERO.pdf.jpgPortadaimage/jpeg55809http://repository.unilibre.edu.co/bitstream/10901/29574/4/ROMERO.pdf.jpgf9ffd00d9901ef4fbd07d277199a11c8MD54FORMULARIO AUTORIZACIÓN.pdf.jpgFORMULARIO AUTORIZACIÓN.pdf.jpgIM Thumbnailimage/jpeg27458http://repository.unilibre.edu.co/bitstream/10901/29574/5/FORMULARIO%20AUTORIZACI%c3%93N.pdf.jpg76cd18f206411d024f5fd851260b720dMD55LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repository.unilibre.edu.co/bitstream/10901/29574/3/license.txt8a4605be74aa9ea9d79846c1fba20a33MD53ORIGINALROMEROROMEROArchivo del trabajo de grado para descargarapplication/pdf2163468http://repository.unilibre.edu.co/bitstream/10901/29574/1/ROMEROf8f408a7c8f003b6f3b8ae8c8d2f5197MD51FORMULARIO AUTORIZACIÓN.pdfFORMULARIO AUTORIZACIÓN.pdfAutorización para la publicaciónapplication/pdf11454715http://repository.unilibre.edu.co/bitstream/10901/29574/2/FORMULARIO%20AUTORIZACI%c3%93N.pdf20333c6f0a1e102398ff5a2fd1f6fd22MD5210901/29574oai:repository.unilibre.edu.co:10901/295742024-09-29 06:01:19.386Repositorio Institucional Unilibrerepositorio@unilibrebog.edu.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