Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos
Comorbidity is the existence of a clinical entity in addition to a disease under study. It occurs during a patient hospita-lization and generates longer hospitalization time, impacts therapeutic, medium and long-term disease prognosis as well as the health service demand. A quantitative study of ana...
- Autores:
-
Contreras Acevedo, Paola Jimena
Vargas, Luz Dalila
Sanjuanelo Corredor, Danny Wilson
Robayo, Juan Pablo
Niño Cardozo, Carmen Lucía
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2016
- Institución:
- Universidad de Ciencias Aplicadas y Ambientales U.D.C.A
- Repositorio:
- Repositorio Institucional UDCA
- Idioma:
- spa
- OAI Identifier:
- oai:repository.udca.edu.co:11158/1575
- Acceso en línea:
- https://revistas.udca.edu.co/index.php/ruadc/article/view/80
https://doi.org/10.31910/rudca.v19.n2.2016.80
- Palabra clave:
- Comorbilidad
Hospitalización
Anciano
Comorbilidad
Enfermedad crónica
Hospitalización
Tercera edad
- Rights
- openAccess
- License
- Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientales, 2016
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| dc.title.spa.fl_str_mv |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos |
| dc.title.alternative.spa.fl_str_mv |
Comorbidity of the patient hospitalized in geriatric´s service at San Carlos Hospital Foundation |
| title |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos |
| spellingShingle |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos Comorbilidad Hospitalización Anciano Comorbilidad Enfermedad crónica Hospitalización Tercera edad |
| title_short |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos |
| title_full |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos |
| title_fullStr |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos |
| title_full_unstemmed |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos |
| title_sort |
Comorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San Carlos |
| dc.creator.fl_str_mv |
Contreras Acevedo, Paola Jimena Vargas, Luz Dalila Sanjuanelo Corredor, Danny Wilson Robayo, Juan Pablo Niño Cardozo, Carmen Lucía |
| dc.contributor.author.spa.fl_str_mv |
Contreras Acevedo, Paola Jimena Vargas, Luz Dalila Sanjuanelo Corredor, Danny Wilson Robayo, Juan Pablo Niño Cardozo, Carmen Lucía |
| dc.subject.mesh.spa.fl_str_mv |
Comorbilidad |
| topic |
Comorbilidad Hospitalización Anciano Comorbilidad Enfermedad crónica Hospitalización Tercera edad |
| dc.subject.other.spa.fl_str_mv |
Hospitalización |
| dc.subject.proposal.spa.fl_str_mv |
Anciano Comorbilidad Enfermedad crónica Hospitalización |
| dc.subject.agrovoc.spa.fl_str_mv |
Tercera edad |
| description |
Comorbidity is the existence of a clinical entity in addition to a disease under study. It occurs during a patient hospita-lization and generates longer hospitalization time, impacts therapeutic, medium and long-term disease prognosis as well as the health service demand. A quantitative study of analytical, retrospective was carried out. Ninety-three medical records were reviewed and a variance analysis, using the programming language R, to determine the prevalence of comorbid diagnoses in the study population was performed. 151 discharge diagnoses were determined, being the most representative: Hypertension 10.4%, Chronic Obstructive Pulmonary Disease 6.1%, Type II Diabetes Mellitus 4.1%, and Urinary Tract Infection 3.6%. The prevalence analysis showed the presence of 32 diagnoses that led to the prolongation of hospital stay. Most importantly: Chronic Kidney Disease, Pneumonia Associated with Health Care, Recto Vaginal Fis-tula, Hypoalbuminemia, and Urinary obstruction. The data found indicated that comorbidity found in geriatric patients hospitalized in the Hospital San Carlos Foundation, correspond to sudden onset of chronic and acute illness during the hospital staying. Whether they are linked to the initial health status, is to be determined. |
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2016 |
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2016-07 |
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2019-06-20T15:39:17Z |
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2019-06-20T15:39:17Z |
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Artículo de revista |
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0123-4226 |
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https://revistas.udca.edu.co/index.php/ruadc/article/view/80 |
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https://doi.org/10.31910/rudca.v19.n2.2016.80 |
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305131 |
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0123-4226 305131 |
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https://revistas.udca.edu.co/index.php/ruadc/article/view/80 https://doi.org/10.31910/rudca.v19.n2.2016.80 |
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spa |
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spa |
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Revista UDCA : Actualidad & Divulgación Científica (Bogotá). -- Vol. 19, No. 2 (Jul.-Dic. 2016). -- páginas 267-273 |
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Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientales, 2016 |
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application/pdf |
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Fundación Hospital San Carlos (Bogotá, Colombia) |
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Bogotá : Universidad de Ciencias Aplicadas y Ambientales, 2016 |
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Universidad de Ciencias Aplicadas y Ambientales U.D.C.A |
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Contreras Acevedo, Paola JimenaVargas, Luz DalilaSanjuanelo Corredor, Danny WilsonRobayo, Juan PabloNiño Cardozo, Carmen LucíaFundación Hospital San Carlos (Bogotá, Colombia)2019-06-20T15:39:17Z2019-06-20T15:39:17Z2016-070123-4226https://revistas.udca.edu.co/index.php/ruadc/article/view/80https://doi.org/10.31910/rudca.v19.n2.2016.80305131Comorbidity is the existence of a clinical entity in addition to a disease under study. It occurs during a patient hospita-lization and generates longer hospitalization time, impacts therapeutic, medium and long-term disease prognosis as well as the health service demand. A quantitative study of analytical, retrospective was carried out. Ninety-three medical records were reviewed and a variance analysis, using the programming language R, to determine the prevalence of comorbid diagnoses in the study population was performed. 151 discharge diagnoses were determined, being the most representative: Hypertension 10.4%, Chronic Obstructive Pulmonary Disease 6.1%, Type II Diabetes Mellitus 4.1%, and Urinary Tract Infection 3.6%. The prevalence analysis showed the presence of 32 diagnoses that led to the prolongation of hospital stay. Most importantly: Chronic Kidney Disease, Pneumonia Associated with Health Care, Recto Vaginal Fis-tula, Hypoalbuminemia, and Urinary obstruction. The data found indicated that comorbidity found in geriatric patients hospitalized in the Hospital San Carlos Foundation, correspond to sudden onset of chronic and acute illness during the hospital staying. Whether they are linked to the initial health status, is to be determined.La comorbilidad es la existencia de una entidad clínica adicional a una enfermedad bajo estudio, que ocurre durante la hospitalización de un paciente. Genera prolongación en la estancia hospitalaria, impactando sobre la terapéutica, el pronóstico de la enfermedad a mediano y largo plazo y la demanda del servicio en salud. Se realizó un estudio cuantitativo de tipo analítico, retrospectivo. Se revisaron 93 historias clínicas y se aplicó un análisis de varianza, utilizando el lenguaje de programación R, para determinar la prevalencia de diagnósticos de comorbilidad en la población evaluada. Se identificaron 151 diagnósticos de egresos. Las más representativas fueron: Hipertensión Arterial: 10,4%; Enfermedad Pulmonar Obstructiva Crónica: 6,1%; Diabetes Mellitus Tipo II: 4,1%; Infección de Vías Urinarias: 3,6%. El análisis de la prevalencia mostró la presencia de 32 diagnósticos que prolongaron la estancia hospitalaria, principalmente: Enfermedad Renal Crónica, Neumonía Asociada al Cuidado de la Salud, Fístula Recto Vaginal, Hipoalbuminemia y Obstrucción Urinaria. La comorbilidad encontrada en pacientes geriátricos hospitalizados en la Fundación Hospital San Carlos corresponde a enfermedades agudas y crónicas de aparición repentina durante la estancia hospitalaria. Su vínculo con los estados de salud iniciales se debe aún establecer.Incluye referencias bibliográficasapplication/pdfspaBogotá : Universidad de Ciencias Aplicadas y Ambientales, 2016Revista UDCA : Actualidad & Divulgación Científica (Bogotá). -- Vol. 19, No. 2 (Jul.-Dic. 2016). -- páginas 267-273Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientales, 2016https://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/openAccessAtribución-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0)http://purl.org/coar/access_right/c_abf2ComorbilidadHospitalizaciónAncianoComorbilidadEnfermedad crónicaHospitalizaciónTercera edadComorbilidad del paciente hospitalizado en el servicio de geriatría en la Fundación Hospital San CarlosComorbidity of the patient hospitalized in geriatric´s service at San Carlos Hospital FoundationArtículo de 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en las Obras Colectivas;
b.	Distribuir copias o fonogramas de las Obras, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública, incluyéndolas como incorporadas en Obras Colectivas, según corresponda;
c.	Distribuir copias de las Obras Derivadas que se generen, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública.
Los derechos mencionados anteriormente pueden ser ejercidos en todos los medios y formatos, actualmente conocidos o que se inventen en el futuro. Los derechos antes mencionados incluyen el derecho a realizar dichas modificaciones en la medida que sean técnicamente necesarias para ejercer los derechos en otro medio o formatos, pero de otra manera usted no está autorizado para realizar obras derivadas.Todos los derechos no otorgados expresamente por el Licenciante quedan por este medio reservados, incluyendo pero sin limitarse a aquellos que se mencionan en las secciones 4(d) y 4(e).
4. Restricciones.
La licencia otorgada en la anterior Sección 3 está expresamente sujeta y limitada por las siguientes restricciones:
a.	Usted puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra sólo bajo las condiciones de esta Licencia, y Usted debe incluir una copia de esta licencia o del Identificador Universal de Recursos de la misma con cada copia de la Obra que distribuya, exhiba públicamente, ejecute públicamente o ponga a disposición pública. No es posible ofrecer o imponer ninguna condición sobre la Obra que altere o limite las condiciones de esta Licencia o el ejercicio de los derechos de los destinatarios otorgados en este documento. No es posible sublicenciar la Obra. Usted debe mantener intactos todos los avisos que hagan referencia a esta Licencia y a la cláusula de limitación de garantías. Usted no puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra con alguna medida tecnológica que controle el acceso o la utilización de ella de una forma que sea inconsistente con las condiciones de esta Licencia. Lo anterior se aplica a la Obra incorporada a una Obra Colectiva, pero esto no exige que la Obra Colectiva aparte de la obra misma quede sujeta a las condiciones de esta Licencia. Si Usted crea una Obra Colectiva, previo aviso de cualquier Licenciante debe, en la medida de lo posible, eliminar de la Obra Colectiva cualquier referencia a dicho Licenciante o al Autor Original, según lo solicitado por el Licenciante y conforme lo exige la cláusula 4(c).
b.	Usted no puede ejercer ninguno de los derechos que le han sido otorgados en la Sección 3 precedente de modo que estén principalmente destinados o directamente dirigidos a conseguir un provecho comercial o una compensación monetaria privada. El intercambio de la Obra por otras obras protegidas por derechos de autor, ya sea a través de un sistema para compartir archivos digitales (digital file-sharing) o de cualquier otra manera no será considerado como estar destinado principalmente o dirigido directamente a conseguir un provecho comercial o una compensación monetaria privada, siempre que no se realice un pago mediante una compensación monetaria en relación con el intercambio de obras protegidas por el derecho de autor.
c.	Si usted distribuye, exhibe públicamente, ejecuta públicamente o ejecuta públicamente en forma digital la Obra o cualquier Obra Derivada u Obra Colectiva, Usted debe mantener intacta toda la información de derecho de autor de la Obra y proporcionar, de forma razonable según el medio o manera que Usted esté utilizando: (i) el nombre del Autor Original si está provisto (o seudónimo, si fuere aplicable), y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.
d.	Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:
i.	Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.
ii.	Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.
e.	Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, Acinpro), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.
5. Representaciones, Garantías y Limitaciones de Responsabilidad.
A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.
6. Limitación de responsabilidad.
A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.
7. Término.
a.	Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.
b.	Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.
8. Varios.
a.	Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.
b.	Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.
c.	Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.
d.	Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.

 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