Seguimiento a pacientes que asisten al programa de recuperación cardíaca de la IPS salud social en la ciudad de Barranquilla en el año 2017
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Fecha
2017
Autores
Beleño Cruz, Edinson
Moreno De La Cruz, William
Núñez Olmos, Daniela
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Editor
Ediciones Univerisidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Antecedentes: La falla cardiaca es una patología frecuente, de alto costo y que conlleva a complicaciones severas, afecta a cualquier población debido a su etiología diversa, estas incluyen desde alteraciones estructurales hasta estilos de vida, dentro de los síntomas principales se encuentran la falta de aire durante el ejercicio o en reposo, adinamia y signos como taquicardia, taquipnea, hepatomegalia, derrame pleural y estertores pulmonares. Estos se reflejan en la calidad de vida de las personas que la padecen, y afecta a ambos sexos. En este proyecto de investigación se encontrará información referente al seguimiento a pacientes que asisten al programa de recuperación cardíaca y cómo las actividades ejecutadas con ayuda del grupo de especialistas y los diferentes servicios que brinda el Programa como el hospital día tienen una repercusión positiva en la compensación de aquellos pacientes que no lo estén, este seguimiento será medido a partir de los valores de Pro-BNP y la Fracción de eyección ventricular con la que ingresen y el que sea realizado de control, otro de los indicadores será la clase funcional en la que se encuentre el paciente y que permitirá determinar la eficacia del tratamiento, esto se verá reflejado en la disminución de las rehospitalizaciones por descompensación y en la proporción de mortalidad en pacientes pertenecientes al Programa. Objetivos: Realizar seguimiento a pacientes que asisten al programa de recuperación cardíaca de la IPS Salud Social de la ciudad de Barranquilla en el año 2017. Materiales y Métodos: Investigación descriptiva observacional prospectiva: Se realizará la caracterización de la evolución de los pacientes que asisten al Programa de Falla Cardíaca en la IPS Salud Social en la ciudad de
Barranquilla durante el año 2017. Investigación de campo: Se realizará en la IPS
Salud Social de la ciudad de Barranquilla, en el cual evaluaremos variables
cualitativas tales como el género de los pacientes, el Pro-BNP si está normal o
alterado, y la clase funcional según la NYHA. Además se evaluarán variables
cuantitativas tales como la proporción de pacientes que asisten al Hospital día, la
proporción de rehospitalizaciones, de pacientes compensados y de mortalidad. El
instrumento de recolección de la información será la base de datos de las historias
clínicas de los pacientes que asisten al programa de falla cardíaca de la IPS Salud
Social.
Resultados: El 58% de los pacientes eran hombres. El 43% de los pacientes tenían
edades comprendidas entre 51 a 70 años y el 41% entre 71 y 90 años. El 96% de
los pacientes tenían el PRO BNP alterado al inicio del tratamiento. El 75% de los
pacientes tenían el PRO BNP alterado a los 6 meses de inicio del tratamiento. Hubo
una sobrevida del 98% a los 6 meses de iniciado el tratamiento.
Conclusiones: La mortalidad atribuible a la falla cardíaca depende de factores
como la severidad, el compromiso de la fracción de eyección, la etiología, el
tratamiento y el momento del diagnóstico. El riesgo de muerte a cinco años varía
según el estadio; así, para el A es del 3%, para el B es del 4%, para el C es del 25%
y para el D es del 80. Los modelos de atención especializados en insuficiencia
cardiaca emergen como una estrategia para mejorar el pronóstico de estos
pacientes.
Background: Heart failure is a frequent pathology, of high cost and that leads to severe complications, affects any population due to its diverse etiology, these include structural alterations to lifestyles, within the main symptoms are the lack of air during exercise or at rest, adynamia and signs such as tachycardia, tachypnea, hepatomegaly, pleural effusion and pulmonary rales. These are reflected in the quality of life of the people who suffer from it, and it affects both sexes. In this research project you will find information regarding the follow-up of patients attending the cardiac recovery program and how the activities carried out with the help of the group of specialists and the different services provided by the Program, such as the day hospital, have a positive impact on compensation of those patients who are not, this follow-up will be measured from the values of Pro-BNP and the fraction of ventricular ejection with which they enter and that which is made of control, another of the indicators will be the functional class in which the patient is located and that will allow to determine the efficacy of the treatment, this will be reflected in the decrease of rehospitalizations due to decompensation and in the proportion of mortality in patients belonging to the Program. Objective: Follow up patients who attend the cardiac recovery program of the IPS Salud Social of the city of Barranquilla in 2017. Materials and Methods: Prospective observational descriptive research: Characterization of the evolution of patients attending the Cardiac Failure Program in the IPS Salud Social in the city of Barranquilla during the year 2017 will be carried out. Field research: It will be carried out in the IPS Social Health of the city of Barranquilla, in which we will evaluate qualitative variables such as the gender of the patients, the Pro-BNP if it is normal or altered, and the functional class according to the NYHA. In addition, quantitative variables such as the proportion of patients attending the day hospital, the proportion of rehospitalizations, compensated patients and mortality will be evaluated. The information collection instrument will be the database of the medical records of patients who attend the IPS Salud Social's heart failure program. Results: 58% of the patients were men. 43% of the patients were between the ages of 51 and 70 and 41% between 71 and 90 years old. 96% of the patients had the PRO BNP altered at the beginning of the treatment. 75% of the patients had the BNP PRO altered at 6 months after starting treatment. There was a 98% survival 6 months after the start of treatment. Conclusions: Mortality attributable to heart failure depends on factors such as severity, ejection fraction compromise, etiology, treatment, and time of diagnosis. The risk of death at five years varies according to the stage; thus, for A it is 3%, for B it is 4%, for C it is 25% and for D it is 80. Specialized attention models in heart failure emerge as a strategy to improve the prognosis of these patients.
Background: Heart failure is a frequent pathology, of high cost and that leads to severe complications, affects any population due to its diverse etiology, these include structural alterations to lifestyles, within the main symptoms are the lack of air during exercise or at rest, adynamia and signs such as tachycardia, tachypnea, hepatomegaly, pleural effusion and pulmonary rales. These are reflected in the quality of life of the people who suffer from it, and it affects both sexes. In this research project you will find information regarding the follow-up of patients attending the cardiac recovery program and how the activities carried out with the help of the group of specialists and the different services provided by the Program, such as the day hospital, have a positive impact on compensation of those patients who are not, this follow-up will be measured from the values of Pro-BNP and the fraction of ventricular ejection with which they enter and that which is made of control, another of the indicators will be the functional class in which the patient is located and that will allow to determine the efficacy of the treatment, this will be reflected in the decrease of rehospitalizations due to decompensation and in the proportion of mortality in patients belonging to the Program. Objective: Follow up patients who attend the cardiac recovery program of the IPS Salud Social of the city of Barranquilla in 2017. Materials and Methods: Prospective observational descriptive research: Characterization of the evolution of patients attending the Cardiac Failure Program in the IPS Salud Social in the city of Barranquilla during the year 2017 will be carried out. Field research: It will be carried out in the IPS Social Health of the city of Barranquilla, in which we will evaluate qualitative variables such as the gender of the patients, the Pro-BNP if it is normal or altered, and the functional class according to the NYHA. In addition, quantitative variables such as the proportion of patients attending the day hospital, the proportion of rehospitalizations, compensated patients and mortality will be evaluated. The information collection instrument will be the database of the medical records of patients who attend the IPS Salud Social's heart failure program. Results: 58% of the patients were men. 43% of the patients were between the ages of 51 and 70 and 41% between 71 and 90 years old. 96% of the patients had the PRO BNP altered at the beginning of the treatment. 75% of the patients had the BNP PRO altered at 6 months after starting treatment. There was a 98% survival 6 months after the start of treatment. Conclusions: Mortality attributable to heart failure depends on factors such as severity, ejection fraction compromise, etiology, treatment, and time of diagnosis. The risk of death at five years varies according to the stage; thus, for A it is 3%, for B it is 4%, for C it is 25% and for D it is 80. Specialized attention models in heart failure emerge as a strategy to improve the prognosis of these patients.
Descripción
Palabras clave
Falla cardíaca, Fracción de eyección ventricular, Péptido Natriurético tipo B, Mortalidad. Hospitalización, Heart failure, Ventricular ejection fraction, Peptide Natriuretic type B, Mortality. Hospitalization