%0 Journal Article
%T Are age and care department determining variables in diagnosis quality for hemorrhagic ictus?  Son la edad y el servicio variables determinantes para la calidad diagn車stica en el ictus hemorr芍gico?
%A Alain Francisco Morej車n Giraldoni
%A Jos谷 Lu赤s Bernal Muˋoz
%A Julio H谷ctor Jova Dueˋas
%A Emiliano Diez y Mart赤nez de la Cotera
%J MediSur
%D 2009
%I Centro Provincial de Informaci車n de las Ciencias M谷dicas en Cienfuegos
%X Introduction: Hemorrhagic ictus is a significant mortality cause in hospitalized patients. The clinical variability of this disease and its frequent morphological occurrence in necropsies justify the study of clinical-pathological concordance in two institutions of secondary health care; these institutions have similar characteristics and necropsy indexes of about 80% in the last five years. Objective: To determine the clinical-pathological relation in cerebrovascular hemorrhagic disease as diagnostic quality index, patient∩s age impact and the kind of provided care. Methods: Retrospective, descriptive, correlational study assessing 1556 cadavers that underwent necropsy. The age and care department in which they died were analyzed, including the following quality markers: observed concordance, kappa index, sensitivity, specificity, positive and negative predictive values, positive and negative verisimilitude ratio. Results: The most relevant result depended on concordance and diagnostic effectiveness for this stage of the disease in Sancti Spiritus (kappa = 0, 88; PPV = 86, 0 %, sensitivity = 93, 2 %, PVR =, 60.3), these numbers were higher than those of Cienfuegos province. Age proved to be a significant factor. In Sancti Spiritus ictus care unit quality markers showed the primacy of these departments. Conclusions: Age is an important variable determining the clinical diagnostic quality, mainly in elderly people. Quality markers were higher in progressive care units, when compared with clinical departments, which have an impact on the provided care. Introducci車n: Los ictus hemorr芍gicos representan una causa importante de mortalidad hospitalaria. La variabilidad cl赤nica de esta enfermedad y su frecuente evidencia morfol車gica en necropsias, justifican el estudio de la concordancia cl赤nico- patol車gica en dos instituciones de la atenci車n secundaria, centros que tienen caracter赤sticas similares e 赤ndices de necropsia cercanos al 80 % en los 迆ltimos cinco a os. Objetivo: Determinar la correlaci車n cl赤nico-patol車gica en la enfermedad cerebrovascular hemorr芍gica como 赤ndice de calidad del diagn車stico, y la influencia en este de la edad del paciente y el tipo de cuidados recibidos. M谷todos: Estudio retrospectivo, descriptivo y correlacional, en el que se evaluaron 1556 fallecidos a los que se les realiz車 necropsia. Se analizaron la edad y los servicios donde ocurri車 el fallecimiento, as赤 como los siguientes indicadores de calidad: concordancia observada, 赤ndice kappa, sensibilidad, especificidad, valores predictivos positivo y negativos, razones de verosimilitud
%K Shock hemorr芍gico /diag
%K calidad de la atenci車n de salud
%K indicadores de calidad de la atenci車n de salud
%U http://www.medisur.sld.cu/index.php/medisur/article/view/429