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Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014; Analisis de las caracteristicas epidemiologicas y clinicas de los pacientes ingresados con diagnostico de evento cerebrovascular isquemico agudo en los servicios de medicina interna y neurologia del Hospital Mexico de marzo 2013 a marzo 2014

Thesis/Dissertation:

Abstract

Records of 100 patients were revised with diagnosis of ischemic cerebrovascular event in the neurology and internal medicine at the Hospital Mexico since March 2013 to March 2014. A total of 46 patients were men and 54 were women. The overall mean age was 69 years, for men have been 66 years and for women from 71. Patients of all provinces were entered main of San Jose with 56% followed by 19% Alajuela. The hospital management by specialty was distributed 60% to internal medicine and 40% neurology. The risk factors most frequently found were: hypertension 85%, diabetes mellitus 40%, smoking 35%, and dyslipidemia 35%. Overweight was observed in 23% of patients and 22% obese. As for the initial clinical manifestations documented in the first physical examination, the 6 most frequently found have been: faciobrachiocrural hemiparesis 60%, delirium 22%, dysarthria 22%, headache 20%, nausea and/or vomiting 17% and aphasia 15%. A total of 13% of patients have altered the consciousness and 5% have required ventilatory support for first 24 hours of evolution. 27% of patients have arrived within the first 3 hours of onset of symptoms, 11% between 3 to 4.5 hours and the remaining 62% beyond 4.5 hours of duration.  More>>
Publication Date:
Jul 01, 2014
Product Type:
Thesis/Dissertation
Resource Relation:
Other Information: Figs., tabs., refs.; Thesis (especialidad en medicina interna)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR SYSTEM; CENTRAL NERVOUS SYSTEM; COMPUTERIZED TOMOGRAPHY; EPIDEMIOLOGY; HOSPITALS; ISCHEMIA; NERVOUS SYSTEM DISEASES; NEUROLOGY; PATIENTS; STATISTICAL DATA; ULTRASONOGRAPHY
OSTI ID:
22444411
Research Organizations:
Universidad de Costa Rica, Sistema de Estudios de Posgrado (Costa Rica)
Country of Origin:
Costa Rica
Language:
Spanish
Other Identifying Numbers:
TRN: CR1600002013952
Availability:
Available from Biblioteca Luis Demetrio Tinoco, Universidad de Costa Rica
Submitting Site:
INIS
Size:
81 page(s)
Announcement Date:
Mar 14, 2016

Thesis/Dissertation:

Citation Formats

Araya Gonzalez, Manuel Alberto. Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014; Analisis de las caracteristicas epidemiologicas y clinicas de los pacientes ingresados con diagnostico de evento cerebrovascular isquemico agudo en los servicios de medicina interna y neurologia del Hospital Mexico de marzo 2013 a marzo 2014. Costa Rica: N. p., 2014. Web.
Araya Gonzalez, Manuel Alberto. Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014; Analisis de las caracteristicas epidemiologicas y clinicas de los pacientes ingresados con diagnostico de evento cerebrovascular isquemico agudo en los servicios de medicina interna y neurologia del Hospital Mexico de marzo 2013 a marzo 2014. Costa Rica.
Araya Gonzalez, Manuel Alberto. 2014. "Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014; Analisis de las caracteristicas epidemiologicas y clinicas de los pacientes ingresados con diagnostico de evento cerebrovascular isquemico agudo en los servicios de medicina interna y neurologia del Hospital Mexico de marzo 2013 a marzo 2014." Costa Rica.
@misc{etde_22444411,
title = {Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014; Analisis de las caracteristicas epidemiologicas y clinicas de los pacientes ingresados con diagnostico de evento cerebrovascular isquemico agudo en los servicios de medicina interna y neurologia del Hospital Mexico de marzo 2013 a marzo 2014}
author = {Araya Gonzalez, Manuel Alberto}
abstractNote = {Records of 100 patients were revised with diagnosis of ischemic cerebrovascular event in the neurology and internal medicine at the Hospital Mexico since March 2013 to March 2014. A total of 46 patients were men and 54 were women. The overall mean age was 69 years, for men have been 66 years and for women from 71. Patients of all provinces were entered main of San Jose with 56% followed by 19% Alajuela. The hospital management by specialty was distributed 60% to internal medicine and 40% neurology. The risk factors most frequently found were: hypertension 85%, diabetes mellitus 40%, smoking 35%, and dyslipidemia 35%. Overweight was observed in 23% of patients and 22% obese. As for the initial clinical manifestations documented in the first physical examination, the 6 most frequently found have been: faciobrachiocrural hemiparesis 60%, delirium 22%, dysarthria 22%, headache 20%, nausea and/or vomiting 17% and aphasia 15%. A total of 13% of patients have altered the consciousness and 5% have required ventilatory support for first 24 hours of evolution. 27% of patients have arrived within the first 3 hours of onset of symptoms, 11% between 3 to 4.5 hours and the remaining 62% beyond 4.5 hours of duration. 70% of patients have had 1 or more comorbidities prior to the event, the top 5 have been: ischemic heart disease 31%, 29% atrial fibrillation, cerebrovascular disease 19%, 16% chronic kidney disease and congestive heart failure by 12%. Regarding the topographic classification of stokes, 16% were TACI, PACI 46%, 27% LACI and POCI only 11%. The average NIHSS scale has been 9 points to admission, 10 to 48 hours and 6 points at the time of discharge. Regarding brain scan on admission to 98% of the patients were performed while that between 48-72 hours alone to 74%. The most common initial tomographic CT findings have been: 49% lucency of more than 1/3 of middle cerebral artery territory, without alteration 46%, 8% cerebral edema data and 8% midline deviation. Hemorrhagic transformation was documented in 6% of cases. 70% of patients were performed Doppler ultrasound of neck vessels. Without injuries 82%, 9% with obstruction between 50-70% and 9% with over 70% lumen obstruction. Echocardiography was performed in 54% of cases and 76% was obtained left ventricular hypertrophy, left atrial dilation 37% and 2% intramural thrombus. With respect to functionality 81% of patients had no or minimal dependence upon admission, to the time of discharge 74% have had moderated to severe disability, 12% mild and only 14% had no disability or this was minimal. 51% of patients have presented one or more complications during hospitalization, the 5 most frequent have been: bronchopneumonia 25%, bronchial aspiration and urinary tract infection 19%, 16% cognitive impairment and 10% cardiac arrhythmias. The average overall stay has been 13 days. Internal medicine has been 14± days and in neurology has been 12 ± days. The mortally rate has been 19% while 71% of patients were discharged to home and 10% were moved to the medical center. (author) [Spanish] Expedientes de 100 pacientes internos fueron revisados con el diagnostico de evento cerebrovascular isquemico, en los servicios de neurologia y medicina interna del Hospital Mexico desde marzo del 2013 hasta marzo del 2014. Del total de pacientes 46 eran hombres y 54 eran mujeres. La edad promedio en general era de 69 anos, para los hombres ha sido de 66 anos y para las mujeres de 71. Pacientes de todas las provincias fueron ingresados, principalmente de San Jose con un 56% y Alajuela con un 19%. El manejo intrahospitalario segun especialidad fue distribuido en 60% medicina interna y 40% neurologia. Los factores de riesgo mas frecuentemente encontrados han sido: hipertension arterial 85%, diabetes mellitus 40%, tabaquismo 35%, dislipidemia 35%. El sobrepeso fue observado en 23% de los pacientes y la obesidad en 22%. En cuanto a las manifestaciones clinicas iniciales documentadas en la primera exploracion fisica, las 6 mas frecuentemente encontradas han sido: hemiparesia faciobraquiocrural 60%, sindrome confusional 22%, disartria 22%, cefalea 20%, nauseas y/o vomito 17% y afasia en 15%. Un total de 13% de los pacientes han presentado alteracion de la consciencia y 5% ha necesitado soporte ventilatorio en las primeras 24 horas evolucion. El 27% de los pacientes han llegado en las primeras 3 horas de iniciado los sintomas, un 11% entre las 3 a 4.5 horas y el restante 62% mas alla de las 4.5 horas de evolucion. El 70% de los pacientes han tenido 1 o mas comorbilidades previas al evento, las 5 principales han sido: cardiopatia isquemica 31%, fibrilacion atrial 29%, enfermedad cerebrovascular 19%, enfermedad renal cronica 16% e insuficiencia cardiaca congestiva un 12%. En cuanto a la clasificacion topografica de los ictus, un 16% eran TACI, un 46% PACI, un 27% LACI y solo un 11% PoCI. El promedio de la escala de NIHSS ha sido de 9 puntos al ingreso, 10 a las 48 horas y 6 puntos al momento de egreso. Con respecto a la tomografia de cerebro al ingreso a 98% de los pacientes les fue realizada mientras que entre las 48 a 72 horas solo al 74%. Los hallazgos tomograficos mas frecuentes en el TAC inicial han sido: 49% hipodensidad de mas de 1/3 de territorio de arteria cerebral media, 46% sin alteraciones, 8% datos de edema cerebral y desviacion en la linea media. La transformacion hemorragica fue documentada en 6% de los casos. Al 70% de los pacientes les fue realizado ultrasonido Doppler de vasos del cuello. El 82% sin lesiones, un 9% con obstruccion entre 50-70% y 9% con mas de 70% obstruccion del lumen. La ecocardiografia fue realizada en 54% de los casos y fue obtenida 76% hipertrofia ventricular izquierda, 37% delitacion atrio izquierdo y 2% trombo intramural. Con respecto a la funcionalidad el 81% de los pacientes tenian ninguna o minima dependencia al momento de ingreso, para el momento de egreso 74% habian tenido discapacidad de moderada a severa, 12% leve y apenas un 14% se mostraba sin discapacidad o esta era minima. El 51% de los pacientes han presentado 1 o mas complicaciones durante su internamiento, las 5 mas frecuentes han sido: bronconeumonia 25%, broncoaspiracion e infeccion del tracto urinario 19%, deterioro cognitivo 16% y arritmias cardiacas 10%. La estancia promedio en general ha sido 13 dias. En medicina interna ha sido de 14± dias y en neurologia han sido 12± dias. La tasa de mortalidad ha sido de 19% mientras que 71% de los pacientes fueron egresados a casa y el 10% fue trasladado de centro medico. (autor)}
place = {Costa Rica}
year = {2014}
month = {Jul}
}