Asociación entre la capacidad funcional medida con el índice DASI y la ocurrencia de complicaciones posoperatorias en un hospital universitario en Bogotá, Colombia
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Mahecha Pulido, María Paula
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Escobar Suárez, Bibiana Jeannette
Guevara Cruz, Oscar Alexander
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Trabajo de grado - Especialidad Médica
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EspañolFecha de publicación
2021-01-06
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Contexto y objetivo: La capacidad funcional calculada por el Duke Activity Status Index (DASI) predice las complicaciones cardiovasculares posoperatorias. La evidencia sobre la asociación entre este índice y el riesgo de complicaciones no cardiacas es escasa. Se realizó un estudio de cohorte retrospectiva para estimar la asociación entre el DASI y la ocurrencia de reintervención quirúrgica no planeada, ingreso a UCI no planeado y/o estancia hospitalaria ≥ 5 días. Métodos: Entre mayo de 2016 y octubre de 2019 se incluyeron pacientes mayores de 16 años, llevados a cirugía electiva, cuya valoración preanestésica incluía DASI. Se excluyeron aquellos con trastornos psiquiátricos/cognitivos o condiciones físicas que impidieran la evaluación del DASI. Se comparó la ocurrencia del desenlace entre aquellos con DASI mayor y menor de 34 puntos. Resultados: Se evaluaron 9348 pacientes potencialmente elegibles; sólo 293 cumplieron con los criterios de elegibilidad, por lo tanto, no se alcanzó el tamaño de muestra esperado. Se reportan los análisis univariado y bivariado realizados de forma exploratoria. La mediana de edad fue de 50.3 años y el 67.6% eran mujeres. La mayoría fueron ASA II (51.2%) y la mediana del DASI fue de 50.7. El Odds Ratio (OR) crudo para la asociación entre DASI < 34 puntos y el desenlace compuesto fue de 3.57 (IC95%: 1.21-10.58). Conclusiones: Como no se alcanzó el tamaño de muestra esperado, no es posible confirmar la asociación entre el índice DASI y la ocurrencia de complicaciones posoperatorias en pacientes llevados a cirugía electiva en el Hospital Universitario Nacional de Colombia.
Background and objective: Functional capacity assessed with the Duke Activity Status Index (DASI) predicts postoperative cardiovascular complications. The evidence regarding the association between this index and the risk of non-cardiac complications is limited. A retrospective cohort study was conducted to estimate the association between DASI and the occurrence of unplanned reoperation, unplanned ICU admission and / or hospital stay ≥ 5 days. Methods: Between May 2016 and October 2019, patients older than 16 years, undergoing elective surgery, whose pre-anesthetic evaluation included DASI were studied. Those with psychiatric / cognitive disorders or physical conditions that prevented the DASI assessment were excluded. The occurrence of the outcome was compared between those with DASI greater and less than 34 points. Results: 9348 potentially eligible patients were evaluated; only 293 met the eligibility criteria, then, the expected sample size was not reached. Exploratory univariate and bivariate analyzes are reported. The median age was 50.3 years and 67.6% were women. Most were ASA II (51.2%) and the median DASI was 50.7. The crude Odds Ratio (OR) for the association between DASI <34 points and the composite outcome was 3.574 (95% CI: 1.207-10.581). Conclusions: As the expected sample size was not reached, it is not possible to confirm the association between the DASI and the occurrence of postoperative complications in patients undergoing elective surgery at the National University Hospital of Colombia.
Background and objective: Functional capacity assessed with the Duke Activity Status Index (DASI) predicts postoperative cardiovascular complications. The evidence regarding the association between this index and the risk of non-cardiac complications is limited. A retrospective cohort study was conducted to estimate the association between DASI and the occurrence of unplanned reoperation, unplanned ICU admission and / or hospital stay ≥ 5 days. Methods: Between May 2016 and October 2019, patients older than 16 years, undergoing elective surgery, whose pre-anesthetic evaluation included DASI were studied. Those with psychiatric / cognitive disorders or physical conditions that prevented the DASI assessment were excluded. The occurrence of the outcome was compared between those with DASI greater and less than 34 points. Results: 9348 potentially eligible patients were evaluated; only 293 met the eligibility criteria, then, the expected sample size was not reached. Exploratory univariate and bivariate analyzes are reported. The median age was 50.3 years and 67.6% were women. Most were ASA II (51.2%) and the median DASI was 50.7. The crude Odds Ratio (OR) for the association between DASI <34 points and the composite outcome was 3.574 (95% CI: 1.207-10.581). Conclusions: As the expected sample size was not reached, it is not possible to confirm the association between the DASI and the occurrence of postoperative complications in patients undergoing elective surgery at the National University Hospital of Colombia.
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Mahecha Pulido, M.P., 2021. Asociación entre la capacidad funcional medida con el índice DASI y la ocurrencia de complicaciones posoperatorias en un hospital universitario en Bogotá, Colombia. Especilidad en Anestesiología y reanimación. Universidad Nacional de Colombia.