Factores asociados a complicaciones quirúrgicas en pacientes adultos mayores con neoplasias gastrointestinales del Centro Médico Naval
DOI:
https://doi.org/10.24265/horizmed.2020.v20n1.07Palabras clave:
Cáncer gastrointestinal, Adulto mayor, Cirugía generalResumen
Objetivo: Determinar los factores asociados a complicaciones quirúrgicas en pacientes adultos mayores con diagnóstico de neoplasias gastrointestinales del Centro Médico Naval del Perú. Materiales y métodos: Estudio de cohorte retrospectiva y análisis secundario de una base de datos. Se evaluaron los factores asociados a complicaciones postoperatorias de 245 pacientes con diagnóstico de cáncer gastrointestinal entre 2013 y 2015. Las variables fueron edad, fragilidad, vulnerabilidad, antecedentes patológicos, consumo de tabaco, perímetro de pantorrilla, dependencia funcional, caídas, polifarmacia y la localización del cáncer. Resultados: El 29,8 % presentó complicaciones quirúrgicas, que fueron más frecuentes en los casos de cáncer de colon/recto con 82,19 %, la edad promedio fue de 86,3 años. Las complicaciones más frecuentes fueron dolor, hemorragia, trastornos hidroelectrolíticos e infección de sitio operatorio. Mediante el modelo de regresión ajustado, las variables que mostraron mayor asociación significativa fueron la presencia de 3 o más antecedentes patológicos, consumo de tabaco, perímetro de pantorrilla menor que 31 cm, dependencia funcional, caídas en el último año, polifarmacia, fragilidad, vulnerabilidad según VES-13 y localización del cáncer en colon/recto. Conclusiones: Los factores que predisponen la aparición de complicaciones quirúrgicas fueron el cáncer en colon/recto, ser vulnerable (según la escala VES-13), ser frágil (según el fenotipo de Fried), la polifarmacia, haber sufrido caídas, dependencia funcional, perímetro de pantorrilla delgado, antecedente de consumo de tabaco, y tener 3 o más comorbilidades.
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Derechos de autor 2020 Xiomara Paredes Terrones, Carolina Pérez-Agüero, Fernando M. Runzer-Colmenares, José F. Parodi
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