{"id":117843,"date":"2015-10-07T00:00:00","date_gmt":"2015-10-07T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/estudio-comparativo-del-sa%c2%adndrome-coronario-agudo-laboral-y-no-laboral\/"},"modified":"2015-10-07T00:00:00","modified_gmt":"2015-10-07T00:00:00","slug":"estudio-comparativo-del-sa%c2%adndrome-coronario-agudo-laboral-y-no-laboral","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/medicina-del-trabajo\/estudio-comparativo-del-sa%c2%adndrome-coronario-agudo-laboral-y-no-laboral\/","title":{"rendered":"Estudio comparativo del s\u00edndrome coronario agudo laboral y no laboral"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Mar\u00eda  Teresa Pine Caceres <\/strong><\/h2>\n<p>Resumen  actualmente, las enfermedades cardiovasculares, dentro de las que incluimos el s\u00edndrome coronario agudo (sca), se encuentran entre las primeras causas de incapacidad temporal (it). En espa\u00f1a se registran cada a\u00f1o 23.000 bajas laborales por enfermedad cardiovascular, siendo la causa m\u00e1s frecuente de it tras la lumbalgia y la depresi\u00f3n.   el objetivo de este estudio es conocer si existen diferencias en la evoluci\u00f3n de los pacientes que sufren sca, dependiendo de si los procesos de it son considerados accidente laboral o enfermedad com\u00fan, tanto a nivel de la asistencia sanitaria que reciben los pacientes tratados por el sistema p\u00fablico de salud o por una mutua, el gasto por prestaciones econ\u00f3micas que generan los procesos de it en ambas contingencias, la situaci\u00f3n funcional final de los pacientes, y su reincorporaci\u00f3n al mundo laboral. Tambi\u00e9n analizamos el papel desempe\u00f1ado por la rehabilitaci\u00f3n card\u00edaca en este tipo de procesos.   para ello, hemos estudiado un total de 600 pacientes que iniciaron un proceso de it tras sufrir sca, 301 por contingencia com\u00fan (cc) y 299 por contingencia profesional (cp), y hemos comparado variables demogr\u00e1ficas (edad, sexo y comunidad aut\u00f3noma), cl\u00ednicas (hipertensi\u00f3n arterial, diabetes mellitus, dislipemia y h\u00e1bito tab\u00e1quico), laborales (tipo de trabajo, situaci\u00f3n de pago directo y secuelas) y funcionales (mets alcanzados en la ergometr\u00eda y fracci\u00f3n de eyecci\u00f3n medida mediante ecocardiograf\u00eda) de ambos grupos.      nuestros resultados muestran que el perfil demogr\u00e1fico es similar en ambos grupos, existiendo mayor n\u00famero de pacientes hipertensos, diab\u00e9ticos y en situaci\u00f3n de pago directo en el grupo de cc. El sector ocupacional m\u00e1s frecuente en ambos grupos es el formado por trabajadores de &quot;cuello azul&quot;, existiendo una asociaci\u00f3n entre los trabajos calificados como moderados en cuanto al esfuerzo f\u00edsico que requieren y el grupo de cp, y los calificados como pesados y el grupo de cc.    no hemos encontrado diferencias en cuanto a los resultados finales a nivel de secuelas concedidas y valores funcionales obtenidos, pero si en los d\u00edas de duraci\u00f3n; los procesos de cp tienen una duraci\u00f3n de 26,1 d\u00edas menos que los de cc. No hemos encontrado estudios publicados que comparen la duraci\u00f3n en d\u00edas de it y las secuelas en procesos de contingencia profesional y contingencia com\u00fan. M\u00e1s del 80% de los pacientes de ambos grupos, se reincorpora al trabajo que desempe\u00f1aba previamente a sufrir en evento card\u00edaco sin secuelas, y s\u00f3lo a menos del 20% se les concede una incapacidad permanente, siendo la incapacidad permanente total la m\u00e1s frecuente, sin que existan casos de incapacidad permanente parcial ni gran invalidez en ninguno de los dos grupos. Estos datos est\u00e1n en consonancia con los estudios sobre incapacidad permanente de valero y col. Y pin\u00e9 y col. (Valero y col., 2004; pin\u00e9 y col., 2008).  en cuanto a la rehabilitaci\u00f3n card\u00edaca, los pacientes que la realizan, tanto en contingencia profesional como en contingencia com\u00fan, mejoran los valores funcionales y tienen menos secuelas al t\u00e9rmino de la misma, pudiendo incorporase al trabajo que desempe\u00f1aban antes de sufrir el evento card\u00edaco.         en conclusi\u00f3n observamos que los procesos de it por sca considerados accidente de trabajo, tienen una duraci\u00f3n en d\u00edas inferior a aquellos considerados contingencia com\u00fan. Los pacientes que realizan rehabilitaci\u00f3n card\u00edaca, tanto en contingencia profesional como en contingencia com\u00fan, desarrollan mayor capacidad funcional y tienen menos secuelas que aquellos que no la realizan, de ah\u00ed el inter\u00e9s pr\u00e1ctico de la realizaci\u00f3n de este tratamiento en este tipo de pacientes.     abstract   nowadays, cardiovascular diseases, along which we include the acute coronary syndrome (acs), are among the main causes of temporary disability (td). Every year in spain there are 23.000 sick leaves registered due to cardiovascular disease, being the most frequent cause of td after lumbalgia and depression.  the main objective this study seeks is to find out if there are differences in the evolution of patients with acs taking into account both td processes: occupational accident or common disease to be able to offer a more accurate result, this study also considers the healthcare received by patients in the public health system or in mutual insurance companies, the expenditures for economic benefits derived from td processes in both contingencies and the final functional situation of the patients and their reincorporation to the work market. The role played by heart rehabilitation in this type of processes is also analyzed.  to do so, we have studied a total of 600 patients that started a td process after suffering an acs, 301 caused by common disease and 299 caused by occupational accident. We have compared different variables like demographics (age, gender and autonomous community), clinics (high blood pressure, diabetes mellitus, dyslipidemia and smoke habit), labor (type of work, direct payment situation and sequels) and functional (mets achieved in ergometry and ejection fraction measured by echocardiography) in both groups.  our results show that the demographic profile is similar in both groups, existing a higher number of high blood pressure, diabetic and in direct payment situation patients in the common disease group. The most frequent occupational field involved in both groups is the one formed by &quot;blue neck&quot; workers (operators, officials, mechanics\u00c2\u00bf), existing a link between the jobs    qualified as moderate in terms of required physical effort and the occupational accident group and those qualified as heavy and the common disease group.   we have not observed differences as far as final results are concerned in terms of sequels granted and functional values obtained. And although we have not found published research on this data, differences exist in terms of days of duration: occupational accidents processes last 26.1 days less than common disease processes. More than 80% of patients in both groups undergo a non-sequel cardiac event and go back to their previously performed job, and only less than 20% are granted a permanent disability. This data is similar to the jim\u00e9nez et al. Research (jim\u00e9nez et al., 2008), being the total permanent disability the most frequent, and not existing any partial permanent disability or severe disability in neither group. This data is consistent with the researches on permanent disability of valero et al. And pin\u00e9 et al. (Valero et al., 2004; pin\u00e9 et al., 2008).  when it comes to heart rehabilitation, all patients that conduct it in both groups, occupational accident and common disease, improve their functional values and have less sequels when finishing it, being able to go back to their previously performed job before suffering the cardiac event.  in conclusion we have observed that td processes caused by acs considered occupational accidents have a lesser duration in days than those considered common disease. Patients conducting heart rehabilitation, both in the occupational accident group and the common disease group, develop a higher functional ability and have less sequels than those not conducting it, hence the practical interest in the performance of this treatment in this kind of patients.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Estudio comparativo del s\u00edndrome coronario agudo laboral y no laboral<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Estudio comparativo del s\u00edndrome coronario agudo laboral y no laboral <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Mar\u00eda  Teresa Pine Caceres <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 10\/07\/2015<\/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>Jer\u00f3nimo P\u00e9rez Salmer\u00f3n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: manuel Canteras jordana <\/li>\n<li>pedro ignacio Santos garcia (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 Mar\u00eda Teresa Pine Caceres Resumen actualmente, las enfermedades cardiovasculares, dentro de las que incluimos el s\u00edndrome coronario [&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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