Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019

ilustraciones, diagramas

Autores:
Maldonado-Cañón, Kevin
Tipo de recurso:
Fecha de publicación:
2023
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/84236
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/84236
https://repositorio.unal.edu.co/
Palabra clave:
610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
Análisis de Supervivencia
Prótesis Valvulares Cardíacas
Survival Analysis
Heart Valve Prosthesis
Enfermedades de las Válvulas Cardíacas
Prótesis Valvulares Cardíacas
Implantación de Prótesis de Válvulas Cardíacas
Reemplazo Valvular
Hospitales de Enseñanza
Hospitales Universitarios
Heart Valve Diseases
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Valve Replacement
Teaching Hospitals
University Hospitals
Rights
openAccess
License
Atribución-NoComercial-SinDerivadas 4.0 Internacional
id UNACIONAL2_ceb068a9ca64c11470a17557fdfde29c
oai_identifier_str oai:repositorio.unal.edu.co:unal/84236
network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
dc.title.translated.eng.fl_str_mv Influence of being operated on in a University Hospital on the survival of patients undergoing a valve replacement procedure affiliated with the contributory regime in Colombia between 2016 and 2019
title Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
spellingShingle Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
Análisis de Supervivencia
Prótesis Valvulares Cardíacas
Survival Analysis
Heart Valve Prosthesis
Enfermedades de las Válvulas Cardíacas
Prótesis Valvulares Cardíacas
Implantación de Prótesis de Válvulas Cardíacas
Reemplazo Valvular
Hospitales de Enseñanza
Hospitales Universitarios
Heart Valve Diseases
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Valve Replacement
Teaching Hospitals
University Hospitals
title_short Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
title_full Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
title_fullStr Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
title_full_unstemmed Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
title_sort Influencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019
dc.creator.fl_str_mv Maldonado-Cañón, Kevin
dc.contributor.advisor.none.fl_str_mv Buitrago, Giancarlo
dc.contributor.author.none.fl_str_mv Maldonado-Cañón, Kevin
dc.contributor.orcid.spa.fl_str_mv Kevin Maldonado Cañón [0000000316495290]
dc.contributor.cvlac.spa.fl_str_mv Kevin Maldonado Cañón [0001889706]
dc.contributor.researchgate.spa.fl_str_mv Kevin-Maldonado-Canon [2179280748]
dc.subject.ddc.spa.fl_str_mv 610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
topic 610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
Análisis de Supervivencia
Prótesis Valvulares Cardíacas
Survival Analysis
Heart Valve Prosthesis
Enfermedades de las Válvulas Cardíacas
Prótesis Valvulares Cardíacas
Implantación de Prótesis de Válvulas Cardíacas
Reemplazo Valvular
Hospitales de Enseñanza
Hospitales Universitarios
Heart Valve Diseases
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Valve Replacement
Teaching Hospitals
University Hospitals
dc.subject.decs.spa.fl_str_mv Análisis de Supervivencia
Prótesis Valvulares Cardíacas
dc.subject.decs.eng.fl_str_mv Survival Analysis
Heart Valve Prosthesis
dc.subject.proposal.spa.fl_str_mv Enfermedades de las Válvulas Cardíacas
Prótesis Valvulares Cardíacas
Implantación de Prótesis de Válvulas Cardíacas
Reemplazo Valvular
Hospitales de Enseñanza
Hospitales Universitarios
dc.subject.proposal.eng.fl_str_mv Heart Valve Diseases
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Valve Replacement
Teaching Hospitals
University Hospitals
description ilustraciones, diagramas
publishDate 2023
dc.date.accessioned.none.fl_str_mv 2023-07-19T19:19:01Z
dc.date.available.none.fl_str_mv 2023-07-19T19:19:01Z
dc.date.issued.none.fl_str_mv 2023-07-17
dc.type.spa.fl_str_mv Trabajo de grado - Maestría
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.content.spa.fl_str_mv Text
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/84236
dc.identifier.instname.spa.fl_str_mv Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv https://repositorio.unal.edu.co/
url https://repositorio.unal.edu.co/handle/unal/84236
https://repositorio.unal.edu.co/
identifier_str_mv Universidad Nacional de Colombia
Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv spa
language spa
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dc.publisher.spa.fl_str_mv Universidad Nacional de Colombia
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dc.publisher.faculty.spa.fl_str_mv Facultad de Medicina
dc.publisher.place.spa.fl_str_mv Bogotá, Colombia
dc.publisher.branch.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá
institution Universidad Nacional de Colombia
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spelling Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Buitrago, Giancarlo19a82f19b8c97c639a7055263d101c08Maldonado-Cañón, Kevinec00bb8bb760235f498d19dd0593211eKevin Maldonado Cañón [0000000316495290]Kevin Maldonado Cañón [0001889706]Kevin-Maldonado-Canon [2179280748]2023-07-19T19:19:01Z2023-07-19T19:19:01Z2023-07-17https://repositorio.unal.edu.co/handle/unal/84236Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, diagramasObjetivos: Determinar la asociación de ser intervenido en un hospital universitario con la supervivencia en pacientes afiliados al régimen contributivo en Colombia llevados por primera vez a reemplazo valvular entre 2016 y 2019. Materiales y Métodos: Estudio retrospectivo de cohortes basado en registros administrativos. Como desenlaces se presentan el tiempo al evento de muerte y las incidencias acumuladas de muerte, reingreso y re-intervención. Se configura una muestra artificial mediante la ponderación de la probabilidad inversa del tratamiento por puntajes de propensión para estimar el efecto marginal de la exposición ajustado por variables sociodemográficas, comorbilidades, vía y peso de la intervención. Resultados: De una muestra de 3,690 procedimientos correspondientes a 3,551 pacientes, 1,065 (30%) fueron intervenidos en un hospital universitario. La mediana de edad fue 64.9 (18.1-91.5), siendo 38.6% de los pacientes ≤60 años y 6.8% ≥80 años. Las incidencias acumuladas de muerte a 30, 90 días y un año fueron de 5.9%, 8% y 10.9%, respectivamente. 23.7% presentaron un reingreso a 90 días y 3.8% una reintervención al año. Los pacientes intervenidos en un hospital universitario tienen menor riesgo de muerte a 30 días (OR 0.51; IC95% 0.29-0.92); sin embargo, no se identificó asociación alguna con la supervivencia en términos de tiempo al evento de muerte (HR 1.09, IC95% 0.80-1.50), o con los demás desenlaces. Conclusiones: Se presenta un punto de partida hacia la investigación de una exposición no estudiada en nuestro país con potencial valor no solo para la medicina clínica cardiovascular, sino para el entendimiento del hospital universitario como hipóstasis de una sinergia académico-asistencial. (Texto tomado de la fuente)Objectives: We aim to evaluate the association of being operated on in a university hospital with the survival of patients affiliated with the contributory regime in Colombia who underwent a first heart-valve replacement between 2016 and 2019. Materials and Methods: A retrospective cohort study based on administrative records was conducted. The time-to-death event and cumulative incidences of death, readmission, and re-operation are presented as outcomes. An artificial sample is configured through the Inverse Probability of Treatment Weighting to estimate the marginal effect of exposure, adjusting for sociodemographic variables, comorbidities, technique, and weight of the intervention. Results: From a sample of 3,690 procedures corresponding to 3,551 patients, 1,065 (30%) were operated on in a university hospital. The median age was 64.9 (18.1-91.5), 38.6% of patients were ≤60 years, and 6.8% ≥80 years. The cumulative incidences of death at 30, 90 days, and one year were 5.9%, 8%, and 10.9%, respectively. In addition, 23.7% presented a readmission within 90 days and 3.8% a reintervention within a year. Odds of 30-day mortality are lower for patients operated on in a university hospital (OR 0.51; 95%CI 0.29-0.92); however, no association was identified with the survival in terms of time-to-event (death) (HR 1.09, 95%CI 0.80-1.50), or with the other outcomes. Conclusions: We presented a first step towards researching an exposure that has not been studied in our country with potential value not only for cardiovascular medicine but also for understanding the university hospitals as the essential nature of reality of an academic-clinical synergy.MaestríaMagíster en Ciencias Epidemiología Clínicaxii, 82 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Maestría en Epidemiología ClínicaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiologíaAnálisis de SupervivenciaPrótesis Valvulares CardíacasSurvival AnalysisHeart Valve ProsthesisEnfermedades de las Válvulas CardíacasPrótesis Valvulares CardíacasImplantación de Prótesis de Válvulas CardíacasReemplazo ValvularHospitales de EnseñanzaHospitales UniversitariosHeart Valve DiseasesHeart Valve ProsthesisHeart Valve Prosthesis ImplantationValve ReplacementTeaching HospitalsUniversity HospitalsInfluencia de ser intervenido en un Hospital Universitario en la supervivencia de pacientes llevados a procedimiento de reemplazo valvular afiliados al régimen contributivo en Colombia entre 2016 y 2019Influence of being operated on in a University Hospital on the survival of patients undergoing a valve replacement procedure affiliated with the contributory regime in Colombia between 2016 and 2019Trabajo de grado - Maestríainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMDayan V, Garcia-Villarreal OA, Escobar A, Ferrari J, Quintana E, Marin-Cuartas M, et al. 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Milbank Q. 2021 Mar 22;99(1):273–327.EstudiantesInvestigadoresMaestrosMedios de comunicaciónPúblico generalORIGINALInfluencia Hospital Universitario en reemplazo valvular en Colombia _ Tesis EpiClínica.pdfInfluencia Hospital Universitario en reemplazo valvular en Colombia _ Tesis EpiClínica.pdfTesis de Maestría en Epidemiología Clínicaapplication/pdf2493652https://repositorio.unal.edu.co/bitstream/unal/84236/2/Influencia%20Hospital%20Universitario%20en%20reemplazo%20valvular%20en%20Colombia%20_%20Tesis%20EpiCli%cc%81nica.pdff1cf9e2ae9bcc13ab93453ce6ad37e4fMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-85879https://repositorio.unal.edu.co/bitstream/unal/84236/1/license.txteb34b1cf90b7e1103fc9dfd26be24b4aMD51THUMBNAILInfluencia Hospital Universitario en reemplazo valvular en Colombia _ Tesis EpiClínica.pdf.jpgInfluencia Hospital Universitario en reemplazo valvular en Colombia _ Tesis EpiClínica.pdf.jpgGenerated 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