{"id":108366,"date":"2011-12-05T00:00:00","date_gmt":"2011-12-05T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/ictus-hemorragico-monitorizacion-de-24-horas-de-la-presion-arterial-y-su-valor-pronostico-sobre-dependencia-y-mortalidad\/"},"modified":"2011-12-05T00:00:00","modified_gmt":"2011-12-05T00:00:00","slug":"ictus-hemorragico-monitorizacion-de-24-horas-de-la-presion-arterial-y-su-valor-pronostico-sobre-dependencia-y-mortalidad","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/ictus-hemorragico-monitorizacion-de-24-horas-de-la-presion-arterial-y-su-valor-pronostico-sobre-dependencia-y-mortalidad\/","title":{"rendered":"Ictus hemorr\u00e1gico: monitorizaci\u00f3n de 24 horas de la presi\u00f3n arterial y su valor pron\u00f3stico sobre dependencia y mortalidad"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Antonio  Manuel Mart\u00edn Castillo <\/strong><\/h2>\n<p>Autor: antonio manuel mart\u00edn castillo  directores:  carlos p\u00e9rez de oteyza jos\u00e9 luis rodriguez g arc\u00eda jos\u00e9 mar\u00eda tenias burillo   introducci\u00f3n  en el ictus hemorr\u00e1gico no existe evidencia concluyente sobre la relaci\u00f3n entre las cifras de presi\u00f3n arterial (pa) y el pron\u00f3stico funcional a corto plazo. Los objetivos de nuestro estudio son evaluar si existe relaci\u00f3n entre los valores de pa obtenidos mediante monitorizaci\u00f3n de 24 horas y la evoluci\u00f3n cl\u00ednica a corto plazo del ictus hemorr\u00e1gico, as\u00ed como tratar de establecer un modelo predictivo con valor pron\u00f3stico en estos pacientes.    materi al y m\u00e9todos  estudio observacional, de cohortes, y prospectivo, realizado en el servicio de medicina interna del hospital general la mancha centro, en pacientes con diagn\u00f3stico de ictus hemorr\u00e1gico agudo, a los cuales se les realiz\u00f3 una monitorizaci \u00f3n de pa durante las primeras 24 horas tras el inicio del cuadro. Adem\u00e1s se recogieron otras variables de tipo cl\u00ednico, anal\u00edtico, radiol\u00f3gico y ecocardiogr\u00e1fico. Como variable dependiente se utiliz\u00f3 la escala modificada de rankin, aplicada a los sie te d\u00edas tras el ingreso, para valorar el pron\u00f3stico a corto plazo (dependencia y mortalidad).   resultados  sobre los 63 pacientes incluidos, se encontr\u00f3 asociaci\u00f3n significativa con respecto al grado de dependencia y mortalidad para los siguientes f actores predictores: pas (presi\u00f3n arterial sist\u00f3lica) (p 0,011), pam (presi\u00f3n arterial media) (p 0,011), fc (frecuencia cardiaca) (p 0,004), edad (p 0,048), escala nihss > 7 (p \u00ed\u00a7 0,0005), tama\u00f1o del hematoma > 3 cm (p 0,001) y glucemia al ingreso (p 0,001). No se observ\u00f3 relaci\u00f3n entre el patr\u00f3n dipper \/ no dipper y el pron\u00f3stico, y tampoco se encontr\u00f3 concordancia entre las cifras de pa obtenidas mediante toma cl\u00ednica aislada y las obtenidas mediante monitorizaci\u00f3n de 24 horas. Se elabor\u00f3 un mo delo predictivo a partir de las cuatro variables con mayor significaci\u00f3n estad\u00edstica: edad > 65 a\u00f1os, escala nihss > 7, tama\u00f1o del hematoma > 3 cm, glucemia al ingreso > 140 mg\/dl, que obtuvo un \u00e1rea bajo la curva de 0,92.    conclusiones  en el ictu s hemorr\u00e1gico se confirma la relaci\u00f3n entre pa medida mediante monitorizaci\u00f3n de 24 horas y el pron\u00f3stico a corto plazo (dependencia y mortalidad). Existen otros factores predictores (edad, escala nihss, tama\u00f1o del hematoma, y glucemia) con los cuale<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Ictus hemorr\u00e1gico: monitorizaci\u00f3n de 24 horas de la presi\u00f3n arterial y su valor pron\u00f3stico sobre dependencia y mortalidad<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Ictus hemorr\u00e1gico: monitorizaci\u00f3n de 24 horas de la presi\u00f3n arterial y su valor pron\u00f3stico sobre dependencia y mortalidad <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Antonio  Manuel Mart\u00edn Castillo <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Complutense de Madrid<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 12\/05\/2011<\/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>Jos\u00e9 Mar\u00eda Tenias Burillo<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Jes\u00fas Millan nu\u00f1ez cortes <\/li>\n<li>Jos\u00e9 Barber\u00e1n l\u00f3pez (vocal)<\/li>\n<li>Manuel Rodriguez zapata (vocal)<\/li>\n<li>Mar\u00eda antonia Men\u00e9ndez mart\u00ednez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Antonio Manuel Mart\u00edn Castillo Autor: antonio manuel mart\u00edn castillo directores: carlos p\u00e9rez de oteyza jos\u00e9 luis rodriguez [&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 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