{"id":28065,"date":"2018-03-09T09:20:36","date_gmt":"2018-03-09T09:20:36","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/epidemiologia-y-factores-pronosticos-en-demencias-avanzadas\/"},"modified":"2018-03-09T09:20:36","modified_gmt":"2018-03-09T09:20:36","slug":"epidemiologia-y-factores-pronosticos-en-demencias-avanzadas","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/malaga\/epidemiologia-y-factores-pronosticos-en-demencias-avanzadas\/","title":{"rendered":"Epidemiolog\u00eda y factores pronosticos en demencias avanzadas."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Baldomero Alvarez Fernandez <\/strong><\/h2>\n<p>Objetivos: analizar en pacientes ancianos con demencia avanzada la supervivecia e identificar los factores que la determinan.  pacientes y m\u00e9todo: estudi prospectivo de seguimiento que incluy\u00f3 67 pacientes de edad igual o superior a 65 a\u00f1os con demencia seg\u00fan cirterios dsm iv, en un estadio 7a o superior de la escala fast. Se analizaron variables sociodemogr\u00e1ficas, estadio en la escala fast e \u00edndice de katz, lenguaje, degluci\u00f3n, dieta, estado nutricional (mediante par\u00e1metros antropom\u00e9tricos y anal\u00edticos), patolog\u00edas asociadas, y complicaciones m\u00e9dicas en los \u00faltimos doce meses. La supervivencia se analiz\u00f3 mediante el m\u00e9todo de kaplan-meier. los factores pron\u00f3sticos de supervivencia se identificaron mediante el modelo de riesgos proporcionales o regresi\u00f3n de cox.  resultados: los pacientes fueron seguidos un tiempo medio de 832 d\u00edas. la edad media fue de 82,2+-6,7 a\u00f1os, siendo el 92,5% mujeres. Un 71,6% de los pacientes presentaba alguna comorbilidad, siendo la mas frecuente la hipertensi\u00f3n arterial (22,4%). Cincuenta y dos pacientes (77,6%) presentaron alg\u00fan evento cl\u00ednico relevante (neumon\u00eda, infecci\u00f3n urinaria, acv, \u00falcera por presi\u00f3n, deshidrataci\u00f3n, sepsis y otros). Fallecieron 25 (37,3%) pacientes. la supervivencia media fue de 96,7% semanas (676,8 d\u00edas; ic95%:600,6-752,9d\u00edas).  en el an\u00e1lisis multivariante los principales factores pron\u00f3sticos independientes de supervivencias fueron: padecer neumon\u00eda en el \u00faltimo a\u00f1o (rr:3,7; p=0,001), ser portador de sonda nasog\u00e1strica permanente (rr:3,5; p=0,03) y tener unas cifras alb\u00famina s\u00e9rica inferior de 3,5 g\/dl (rr:2,9; p=0,028)  conclusiones: en los pacientes con demencia avanzada la presencia de hipoalbuminemia y\/o el desarrollo de neumon\u00eda determinan la supervivencia. La nutrici\u00f3n artificial por sonda nasog\u00e1strica disminuye la supervivencia en este tipo de pacientes.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Epidemiolog\u00eda y factores pronosticos en demencias avanzadas.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Epidemiolog\u00eda y factores pronosticos en demencias avanzadas. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Baldomero Alvarez Fernandez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 M\u00e1laga<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 26\/12\/2003<\/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> Garcia Ordo\u00f1ez Miguel Angel<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Jos\u00e9 manuel Ribera casado <\/li>\n<li>ricardo G\u00f3mez huelgas (vocal)<\/li>\n<li>Francisco Guillen llera (vocal)<\/li>\n<li> Burgos moreno Jos\u00e9 Luis (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Baldomero Alvarez Fernandez Objetivos: analizar en pacientes ancianos con demencia avanzada la supervivecia e identificar los factores [&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":[7834],"tags":[80205,80208,80207,80206,22803,77837],"class_list":["post-28065","post","type-post","status-publish","format-standard","hentry","category-malaga","tag-baldomero-alvarez-fernandez","tag-burgos-moreno-jose-luis","tag-francisco-guillen-llera","tag-garcia-ordonez-miguel-angel","tag-jose-manuel-ribera-casado","tag-ricardo-gomez-huelgas"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/28065","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=28065"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/28065\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=28065"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=28065"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=28065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}