{"id":105654,"date":"2018-03-11T10:29:19","date_gmt":"2018-03-11T10:29:19","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/aplicacion-de-la-revision-terciaria-en-el-manejo-inicial-del-paciente-politraumatizado\/"},"modified":"2018-03-11T10:29:19","modified_gmt":"2018-03-11T10:29:19","slug":"aplicacion-de-la-revision-terciaria-en-el-manejo-inicial-del-paciente-politraumatizado","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/cirugia\/aplicacion-de-la-revision-terciaria-en-el-manejo-inicial-del-paciente-politraumatizado\/","title":{"rendered":"Aplicaci\u00f3n de la revisi\u00f3n terciaria en el manejo inicial del paciente politraumatizado"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Sandra Montmany Vioque <\/strong><\/h2>\n<p>Se ha realizado un estudio epidemiol\u00f3gico, descriptivo y prospectivo comparando dos grupos de pacientes politraumatizados con el objetivo de reducir la incidencia de lesiones inadvertidas y de lesiones inadvertidas cl\u00ednicamente relevantes mediante la aplicaci\u00f3n de la revisi\u00f3n terciaria.  se comparan dos grupos homog\u00e9neos para todas las variables estudiadas excepto en el \u00edndice de severidad que es mayor en el grupo de pacientes donde se aplic\u00f3 la revisi\u00f3n terciaria. Se han inclu\u00eddo 119 pacientes con un iss medio de 25.57 realizando la revisi\u00f3n terciaria y 117 pacientes con un iss medio de 18.91 sin realizarla. al aplicar la revisi\u00f3n terciaria se ha reducido la incidencia de lesiones inadvertidas en un 62.34% pasando de un 40.17% de pacientes a un 15.13%. La incidencia de lesiones inadvertidas cl\u00ednicamente relevantes tambi\u00e9n se reduce al aplicar la revisi\u00f3n terciaria en un 80.24% pasando de un 17.09% a un 3.36% de pacientes.  esta reducci\u00f3n se produce al detectar, durante la revisi\u00f3n terciaria, lesiones que han pasado desapercibidas durante las revisiones primarias y secundarias en las primeras 24h del traumatismo, reexplorando cl\u00ednicamente el paciente, reevaluando las pruebas realizadas y realizando nuevas pruebas si es necesario. los principales errores evitables que conducen a la aparici\u00f3n de lesiones inadvertidas y de lesiones inadvertidas cl\u00ednicamente relevantes son los errores cl\u00ednicos y radiol\u00f3gicos. Mediante la revisi\u00f3n terciaria se produce una reducci\u00f3n de ambos errores, siendo m\u00e1s significativa la reducci\u00f3n del error radiol\u00f3gico. mediante un an\u00e1lisis multivariante se han analizado los factores de riesgo inevitables para la aparici\u00f3n de lesiones inadvertidas y de lesiones inadvertidas cl\u00ednicamente relevantes observ\u00e1ndose que la revisi\u00f3n terciaria constituye el principal factor de riesgo en la aparici\u00f3n de estas lesiones en caso de no ser realizada, superando incluso a factores tan establecidos como el estado hemodin\u00e1mico y la existencia de m\u00faltiples lesiones. la aplicaci\u00f3n de la revisi\u00f3n terciaria ha reducido la mortalidad en un 58.54% pasando del 10.25%  al 4.25%, disminuyendo tambi\u00e9n la morbilidad en un 17.53%.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Aplicaci\u00f3n de la revisi\u00f3n terciaria en el manejo inicial del paciente politraumatizado<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Aplicaci\u00f3n de la revisi\u00f3n terciaria en el manejo inicial del paciente politraumatizado <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Sandra Montmany Vioque <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Aut\u00f3noma de barcelona<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 14\/12\/2010<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Salvador Navarro Soto<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: pascual Parrilla paricio <\/li>\n<li>Francisco Baigorri gonz\u00e1lez (vocal)<\/li>\n<li>  (vocal)<\/li>\n<li>  (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Sandra Montmany Vioque Se ha realizado un estudio epidemiol\u00f3gico, descriptivo y prospectivo comparando dos grupos de pacientes [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[141],"tags":[13673,34764,29288,212991],"class_list":["post-105654","post","type-post","status-publish","format-standard","hentry","category-cirugia","tag-francisco-baigorri-gonzalez","tag-pascual-parrilla-paricio","tag-salvador-navarro-soto","tag-sandra-montmany-vioque"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/105654","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=105654"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/105654\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=105654"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=105654"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=105654"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}