Manejo de la hemorragia subaracnoidea y de los aneurismas cerebrales en las mini-unidades de Neurocirugía. Resultados de una auditoría
Management of subarachnoid hemorrage and cerebral aneurysms in a neurosurgical mini-unit. ResuIt of an audit
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Fandiño, M. García-Abeledo" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Fandiño" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "García-Abeledo" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014739871019X?idApp=UINPBA00004B" "url" => "/11301473/0000000900000002/v1_201305151509/S113014739871019X/v1_201305151509/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Manejo de la hemorragia subaracnoidea y de los aneurismas cerebrales en las mini-unidades de Neurocirugía. Resultados de una auditoría" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "141" "paginaFinal" => "151" ] ] "autores" => array:2 [ 0 => array:3 [ "autoresLista" => "J.M. González-Darder, J.L. Gil-Salú, J.A. Barcia" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "González-Darder" ] 1 => array:2 [ "nombre" => "J.L." "apellidos" => "Gil-Salú" ] 2 => array:2 [ "nombre" => "J.A." "apellidos" => "Barcia" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Sección de Neurocirugía, Hospital General de Castellón" ] ] ] 1 => array:3 [ "autoresLista" => "F. Soler" "autores" => array:1 [ 0 => array:3 [ "nombre" => "F." "apellidos" => "Soler" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio Valenciano de Salud y Servicio de Radiodiagnóstico, Clínica de Salud de Valencia" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Management of subarachnoid hemorrage and cerebral aneurysms in a neurosurgical mini-unit. ResuIt of an audit" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec163309" "palabras" => array:3 [ 0 => "Hemorragia subaracnoidea" 1 => "Aneurisma cerebral" 2 => "Planificación asistencial" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec163308" "palabras" => array:3 [ 0 => "Subarachnoid hemorrhage" 1 => "Cerebral aneurysm" 2 => "Resource utilization" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presenta el resultado de una auditoría acerca del tratamiento de la hemorragia subaracnoidea aguda (HSA) en una mini-unidad de Neurocirugía de reciente creación y según un protocolo asistencial adaptado al Centro. Los objetivos han sido determinar si se cumplen los mínimos necesarios para continuar con dicha actividad y detectar los aspectos que puedan incidir en una mejoría de la calidad asistencial.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudian 74 pacientes consecutivos de HSA atendidos en el período 1994–96. En 10 casos no se encontró patología aneurismática tras el estudio neurorradiológico (Grupo 1), 49 pacientes fueron intervenidos por aneurisma (Grupo 2A) y los 15 restantes, con aneurisma diagnosticado o sospechado, no fueron intervenidos (Grupo 2B). La mortalidad total en el momento de alta es del 16.2% y llega al 20.3% a los seis meses. Los buenos resultados (Glasgow Outcome Scale 1 ó 2) son del 59.4% al alta y del 71.6% a los seis meses. En el Grupo 1 no hay mortalidad y los resultados buenos son del 100%. La mortalidad postquirúrgica es del 8.2%, lo que supone un tercio de la del Grupo 2. Se estudiaron también una serie de indicadores asistenciales, como son el tiempo desde la HSA al ingreso y desde el ingreso a la angiografía e intervención, así como la estancia en Cuidados Intensivos y la estancia total.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La comparación de los datos obtenidos con los recogidos de la literatura demuestra que es posible proporcionar una asistencia de calidad a los pacientes con HSA en las mini-unidades de Neurocirugía. En nuestro medio, para llegar al tratamiento quirúrgico más precoz del aneurisma se debe reducir el tiempo de diagnóstico angiográfico y lograr una mayor disponibilidad de quirófano, ya que los pacientes acceden muy pronto al hospital tras la HSA.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The results of an auditory on the treatment of acute subarachnoid hemorrhage (SAH) in a new Neurosurgical mini-Unit are presented. A management protocol suited for our Center was developed. The objectives of the study were assess if our Neurosurgical Unit reaches the standards for treatment of SAH and investigate if there are deficiencies to be ameliorated.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A consecutive series of 74 patients with SAH treated between 1994–96 are included. In 10 cases neuroradiological studies did not found any vascular lesion (Group 1), in 49 patients an aneurysm was found and surgically treatet (Group 2A) and 15 patients with evidence or suspected aneurysm were no surgically treated (Group 2B). At the end of hospitalization the total mortality was 16.2% and 59.4% exhibited a good recovery (Glasgow Outcome Scale 1 or 2). At the six moth evaluation mortality was 20.3% and good recovery 71.6%. There was no mortality in Group 1, with a 100% of favourable outcome. Postoperative mortality was 8.2% being a third of the Group 2. Sorne other sanitary indicators were studied: time from SAH to admission, from admission to aneurysmal diagnosis and surgical treatment, intensive care unit and hospital length stay.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Comparison of our results with those obtaind from national and international literature shows that it is possible give a good quality assistance to patients with acute SAH in Neurosurgical mini-Units. Considering the earIy referal of the patients to our Hospital, a reduction in the time of aneurysmal diagnosis and more operative room disponihility should be necessary to achieve a more earIy surgical treatment of aneurysms.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">González-Darder, J.M.; Gil-Salú, J.L.; Barcia, J.A.; Soler, F.: Manejo de la hemorragia subaracnoidea y de los aneurismas cerebrales en las mini-unidades de neurocirugía. Resultados de una auditoría. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 1 | 6 | 7 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 13 | 6 | 19 |
| 2018 Enero | 15 | 12 | 27 |
| 2017 Diciembre | 11 | 14 | 25 |
| 2017 Noviembre | 12 | 47 | 59 |
| 2017 Octubre | 10 | 31 | 41 |
| 2017 Septiembre | 11 | 31 | 42 |
| 2017 Agosto | 8 | 22 | 30 |
| 2017 Julio | 11 | 21 | 32 |
| 2017 Junio | 19 | 45 | 64 |
| 2017 Mayo | 13 | 26 | 39 |
| 2017 Abril | 12 | 29 | 41 |
| 2017 Marzo | 12 | 41 | 53 |
| 2017 Febrero | 5 | 19 | 24 |
| 2017 Enero | 6 | 17 | 23 |
| 2016 Diciembre | 16 | 21 | 37 |
| 2016 Noviembre | 22 | 32 | 54 |
| 2016 Octubre | 34 | 27 | 61 |
| 2016 Septiembre | 29 | 29 | 58 |
| 2016 Agosto | 58 | 48 | 106 |
| 2016 Julio | 27 | 36 | 63 |
| 2015 Diciembre | 5 | 0 | 5 |
| 2015 Julio | 4 | 7 | 11 |
| 2015 Junio | 14 | 9 | 23 |
| 2015 Mayo | 25 | 18 | 43 |
| 2015 Abril | 16 | 18 | 34 |
| 2015 Marzo | 14 | 21 | 35 |
| 2015 Febrero | 13 | 14 | 27 |
| 2015 Enero | 18 | 14 | 32 |
| 2014 Diciembre | 18 | 22 | 40 |
| 2014 Noviembre | 21 | 17 | 38 |
| 2014 Octubre | 18 | 24 | 42 |
| 2014 Septiembre | 20 | 30 | 50 |
| 2014 Agosto | 22 | 22 | 44 |
| 2014 Julio | 28 | 20 | 48 |
| 2014 Junio | 27 | 23 | 50 |
| 2014 Mayo | 21 | 30 | 51 |
| 2014 Abril | 16 | 13 | 29 |
| 2014 Marzo | 19 | 27 | 46 |
| 2014 Febrero | 19 | 26 | 45 |
| 2014 Enero | 22 | 11 | 33 |
| 2013 Diciembre | 22 | 13 | 35 |
| 2013 Noviembre | 16 | 15 | 31 |
| 2013 Octubre | 35 | 8 | 43 |
| 2013 Septiembre | 29 | 15 | 44 |
| 2013 Agosto | 35 | 15 | 50 |
| 2013 Julio | 29 | 10 | 39 |
| 2013 Junio | 18 | 14 | 32 |
| 2013 Mayo | 13 | 15 | 28 |
| 2013 Abril | 9 | 15 | 24 |
| 2013 Marzo | 7 | 11 | 18 |
| 2013 Febrero | 8 | 17 | 25 |
| 2013 Enero | 17 | 10 | 27 |
| 2012 Diciembre | 5 | 15 | 20 |
| 2012 Noviembre | 1 | 6 | 7 |
| 2012 Octubre | 0 | 3 | 3 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 7 | 0 | 7 |
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