{"id":84308,"date":"2018-03-10T00:08:34","date_gmt":"2018-03-10T00:08:34","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/factores-de-riesgo-para-la-mediastinitis-tras-ciruga%c2%ada-carda%c2%adaca\/"},"modified":"2018-03-10T00:08:34","modified_gmt":"2018-03-10T00:08:34","slug":"factores-de-riesgo-para-la-mediastinitis-tras-ciruga%c2%ada-carda%c2%adaca","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/factores-de-riesgo-para-la-mediastinitis-tras-ciruga%c2%ada-carda%c2%adaca\/","title":{"rendered":"Factores de riesgo para la mediastinitis tras cirugia card\u00edaca"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Juan Martinez Hernandez <\/strong><\/h2>\n<p>Introducci\u00f3n: una mediastinitis postquir\u00fargica es la infecci\u00f3n profunda de cualquier punto del espacio limitado, por delante por el estern\u00f3n, por detr\u00e1s por la columna y lateralmente por las pleuras, con el antecedente reciente de cirugia cardiaca o tor\u00e1cica. Los g\u00e9rmenes causales m\u00e1s frecuentemente encontrados son estafilococos, enterobacterias y especies del g\u00e9nero pseudomonas. este cuadro infeccioso se asocia con una alta morbimortalidad.  objetivos: describir los casos de infecci\u00f3n profunda tras esternotom\u00eda habidos durante los a\u00f1os 1991 a 1995 en servicio de cirug\u00eda cardiaca de un hospital espa\u00f1ol universitario. Identificar los factores de riesgo predisponentes a la aparici\u00f3n de una mediastinitis u otra forma de infecci\u00f3n profunda tras cirug\u00eda card\u00edaca.  pacientes y m\u00e9todo: estudio de casos y controles. Selecci\u00f3n de los pacientes con infecci\u00f3n profunda de un per\u00edodo de 5 a\u00f1os(1991-1995) y los controles no infectados del mismo per\u00edodo de forma aleatoria. Estudio descriptivo, an\u00e1lisis univariente y multivariante.  resultados: se estudiaron 53 casos de infecci\u00f3n profunda y 144 controles. el microorganismo m\u00e1s frecuente fue staphylococcus aureus sensible a la meticilina(64,2%). El tratamiento antibi\u00f3tico m\u00e1s utilizado fue la cloxacilina y el tratamiento quir\u00fargico fue, al final del per\u00edodo, predominantemente limpieza quir\u00fargica y cierre con colgajos musculares. Fallecieron un 20,8% de los casos. En el an\u00e1lisis univariante se identificaron como factores de riesgo para la infecci\u00f3n la diabetes mellitus_or=2,35(1-5,49), la fiebre en el preoperatorio: or=6,12(1,2-34), el n\u00famero total de cirujanos participantes en las intervenciones (2,63 en los casos frente a 2,44 en los controles, p=0,04) y la presencia de uncirujano en concreto_or=2,69(1,4-5,16),p=0,004. en el analisis multivariente persiste la asociaci\u00f3n de la infecci\u00f3n con un cirujano: or=2,72(1,36-5,44),p=0,005. Asimismo, el volumen de sangre trans<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Factores de riesgo para la mediastinitis tras cirugia card\u00edaca<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Factores de riesgo para la mediastinitis tras cirugia card\u00edaca <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Juan Martinez Hernandez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Complutense de Madrid<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 27\/04\/2000<\/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>Rafael Enr\u00edquez De Salamanca<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: pedro Zarco gutierrez <\/li>\n<li>vicente Pastor aldeguer (vocal)<\/li>\n<li>Antonio  Jos\u00e9 Torres Garc\u00eda (vocal)<\/li>\n<li>angel Gil de Miguel (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Juan Martinez Hernandez Introducci\u00f3n: una mediastinitis postquir\u00fargica es la infecci\u00f3n profunda de cualquier punto del espacio limitado, [&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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