Por favor, use este identificador para citar o enlazar este ítem: http://dspace.udla.edu.ec/handle/33000/11082
Tipo de material : bachelorThesis
Título : La Asociación entre la etnia y la mortalidad intrahospitalaria en pacientes con accidente cerebrovascular (ACV) de tipo isquémico tratados con trombolíticos (r-tpa) en Florida del 2008 al 2012
Autor : Campaña Nina, Patricia Estefanía
Meza Benavides, Karen Dennise
Tutor : Gia Bustamante, Jaime Francisco
Palabras clave : DERRAME CEREBRAL;TROMBÓLISIS;FLORIDA-ESTADOS UNIDOS;ACCIDENTE CEREBROVASCULAR ISQUÉMICO
Fecha de publicación : 2019
Editorial : Quito: Universidad de las Américas, 2019
Citación : Campaña Nina, P. E.; Meza Benavides, K. D. (2019). La Asociación entre la etnia y la mortalidad intrahospitalaria en pacientes con accidente cerebrovascular (ACV) de tipo isquémico tratados con trombolíticos (r-TPA) en Florida del 2008 al 2012 (Tesis de pregrado). Universidad de las Américas, Quito.
Resumen : Antecedentes: Aproximadamente 130 000 americanos mueren por esta Accidente Cerebrovascular, el 60 por ciento de las defunciones ocurren fuera del ambiente hospitalario…
Descripción : Background: Published literature suggests an association between Mexican-descent Hispanic ethnicity and in-hospital mortality in patients with Acute Ischemic Stroke (AIS) treated with Tissue-Plasminogen Activator (r-TPA) in California, Arizona, New Mexico, and Texas; There was an increased risk of in-hospital mortality among Hispanics treated with r-TPA for AIS, compared to non-Hispanic patients. However, there are limited studies concerning the association of Hispanics living in Florida (Cuban, Puerto Rican, and Latin America) and their risk of mortality after r- TPA treatment for AIS. The main purpose of our research is to investigate the association of ethnicity and in-hospital mortality in Florida AIS patients treated with thrombolytic therapy. By the year 2 060, minority groups will represent 60 percent of America population, therefore the occurrence of this disease is a matter of public health. In Ecuador since there is no information about the epidemiology of ACV, we know little about the disease behavior. Methods: We conducted a secondary analysis of the data collected from the Florida Agency for Health Care Administration (FL-AHCA) 2008-2012 database for Stroke. Our exposure variable was ethnicity (Hispanic vs. non-Hispanic) in patients with AIS treated with r-TPA and our outcome was in-hospital mortality (discharge status). We included greater or equal 18 years old patients hospitalized with a diagnosis of AIS (ICD-9 codes 434, 436) who were administered r-TPA (ICD-9 procedure code 9910). We used a logistic regression analysis to adjust for potential confounders. The statistical significant level was set at an alpha level of 0,05. Results: During the study years, 8 277 AIS patients (average age 74 years, 49 percent males, 11 percent Hispanics) were treated with r-TPA. Overall, 638 (7,9 percent) patients died. After adjusting for age, gender, and other potential confounding variables (Diabetes Mellitus type II, Hypertension, Auricular Fibrillation and Myocardial Infarction). Hispanics were 32 percent more likely to suffer in-hospital mortality compared to non- Hispanics (OR: 1.32; 95 percent CI: 1.03-1.68). Patients with hypertension were 21.4 percent less likely to suffer in-hospital mortality compared to patients without Hypertension (OR: 0.786; 95 percent CI: 0.66-0.93). The risk of in-hospital mortality increased with older age, with the highest risk of death seen in patients aged 75 years or older (OR: 2.13; 95 percent CI: 1.55-2.94). Conclusion: Our findings suggest increased odds of in-hospital mortality among Hispanics hospitalized for AIS and treated with r-TPA, compared to non-Hispanic patients. These findings among Florida patients are similar than previous reports on Hispanics of Mexican descent. Efforts to identify prognostic factors in this at-risk population should be implemented.
URI : http://dspace.udla.edu.ec/handle/33000/11082
Aparece en las colecciones: Medicina

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