Factores de riesgo en cirugía geriátrica: utilidad del índice Reiss

Revista multidisciplinar de gerontología, ISSN 1139-0921, Vol. 12, Nº. 2, 2002, pags. 72-78 01/2002;
Source: OAI

ABSTRACT Fundamentos: Los índices de riesgo aplicados a la cirugía permiten modular el tipo de estrategia quirúrgica para mejorar el pronóstico postoperatorio. En cirugía geriátrica donde la morbimortalidad es más elevada, el uso estos índices puede considerarse base del protocolo preoperatorio. Comparamos dos índices, uno muy usado, ASA y otro propuesto más reciente, Reiss y valoramos su efectividad en la predicción postoperatoria de complicaciones Métodos: 276 pacientes mayores de 65 años han sido incluidos en el estudio. En el preoperatorio fueron evaluados según el índice ASA y Reiss y durante el postoperatorio fueron registradas las complicaciones y la incidencia y causa de mortalidad. Se ha efectuado un estudio estadístico descriptivo y otro analítico, utilizando el test Chi cuadrado y coeficientes de correlación para analizar cual de los índices valora mejor la morbimortalidad de nuestros pacientes. Resultados: No observó correlación significativa entre le clasificación ASA y las complicaciones postoperatorias pero sí entre la gradación de este índice de riesgo y la mortalidad registrada. Respecto al índice Reiss se esta-bleció una correlación significativa con la incidencia de la morbilidad y mortalidad postoperatoria. No hay correlación significativa entre los resultados de ambos índices Conclusiones: El índice de riesgo quirúrgico de Reiss es más idóneo respecto al ASA para valorar el pronóstico postoperatorio en cirugía geriátrica, ya que además de valorar el estado de salud del paciente, el índice Reiss tiene en cuenta otros factores como el tipo de intervención quirúrgica y la patología.

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