Published

1997-01-01

Validación de la Escala de Siriraj en el Hospital San Juan de Dios de Santafé de Bogotá, D. C.

Keywords:

Escala de Siriraj, Enfermedad Cerebrovascular, diagnóstico clínico (es)

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Authors

  • Martín Alonso Gómez Zuleta Universidad Nacional de Colombia
  • Juan José Bermúdez Universidad Nacional de Colombia
  • Ariel Pérez Universidad Nacional de Colombia
  • Hector Posso Universidad Nacional de Colombia
  • Carlos Jimenez Universidad Nacional de Colombia

EI objetivo de este estudio fue establecer la sensibilidad (S), especificidad (E), valor predictivo positivo (VPP), y valor predictivo negativo (VPN) de la escala del Hospital Siriraj (Tailandia), en pacientes con Enfermedad Cerebrovascular (ECV) Aguda. De un total de 217 pacientes que consultaron al servicio de urgencias del HSJD con ECV, entre enero de 1995 y enero de t 996, fueron enrolados 198 en un estudio prospectivo para validar el test de diagnóstico clínico del ECV. La fórmula del estudio original fue aplicada en cada paciente: (2.5 x nivel de conciencia) + (2 x cefalea) + (2 x vomito) + (0.1 x presión arterial diastólica) - (3 x marcadores de ateromatosis)-12. De acuerdo con los resultados, la ECV se definía como isquémico si el puntaje era < -1; hemorrágico si el puntaje era >+1 e indeterminado si el puntaje estaba entre -I y +1.

A todos se les practicó Tomografía Axial Computadorizada, que sirvió como parámetro de comparación ideal (Gold Standard) y permitió el cálculo del rendimiento diagnóstico de la escala clínica. Así, en el diagnóstico de ECV isquémica la escala mostró sensibilidad de 97.7% y especificidad de 100%; VPP de 100% y VPN de 97.7%. En enfermedad isquémica, la S, E, VPP, VPN, de la escala fue de 100%,97.7%,97.7% Y 100% respectivamente.

Si bien la escala demuestra excelente rendimiento diagnóstico, la utilidad de esta variará de acuerdo con la prevalencia de la ECV en las diferentes zonas geográficas. Así, recomendamos la realización de estudios de validación similares en diferentes instituciones, que permitan establecer el verdadero rendimiento diagnóstico de la escala en cada sitio y soporten su eventual implementación masiva.

We tried to accurately define sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the Siriraj Hospital's Score (Thailand) in patients with acute stroke. 198 patients consulting to the emergency room at Hospital San Juan de Dios in Santa fe de Bogota, between January 1995 and January 1996, were enrolled in a prospective trial to validate the diagnostic precision of the test. The score considered seven clinical parameters to stablish the (ype of stroke: consciousness level, headache, vomiting, diastolic arterial blood pressure, atherosclerosis markers (NIDDM, angina pectoris 01' peripheral vascular artery disease), and compared them with the report of Computed Axial Tomography (CAT), used as the Gold Standard. The results were defined as ischemic stroke if the score was less than _ I; hemorrhagic if score was more than + I; and undetermined if score was between - 1 and + 1.

Among the 198 patients, 100 had a tomographic report compatible with ischemic stroke, while 98 patients had a CT scan reported as hemorrhagic. The sensitivity and specificity of the scale making the diagnosis of ichemic disease, were 97.7% and 100% respectively, whereas PPV and NPV were of 100% and 97.7% respectively.

Indiagnosing hemorrhagic stroke, sensitivity was 100%, specificity 97.8%, PPV 97.7% and NPV 100%. The global diagnostic precision of the test was 89.4%.Taking into account that the precision of the test varies accordingly to the incidence of the cerebrovascular disease, in each particular geographic region, v,.:erecommend the s)'stematic validation of the Siriraj's Score at hospitals throughout the country, in order to support its massiyc application.

How to Cite

APA

Gómez Zuleta, M. A., Bermúdez, J. J., Pérez, A., Posso, H. and Jimenez, C. (1997). Validación de la Escala de Siriraj en el Hospital San Juan de Dios de Santafé de Bogotá, D. C. Revista de la Facultad de Medicina, 45(1), 6–10. https://revistas.unal.edu.co/index.php/revfacmed/article/view/31619

ACM

[1]
Gómez Zuleta, M.A., Bermúdez, J.J., Pérez, A., Posso, H. and Jimenez, C. 1997. Validación de la Escala de Siriraj en el Hospital San Juan de Dios de Santafé de Bogotá, D. C. Revista de la Facultad de Medicina. 45, 1 (Jan. 1997), 6–10.

ACS

(1)
Gómez Zuleta, M. A.; Bermúdez, J. J.; Pérez, A.; Posso, H.; Jimenez, C. Validación de la Escala de Siriraj en el Hospital San Juan de Dios de Santafé de Bogotá, D. C. Rev. Fac. Med. 1997, 45, 6-10.

ABNT

GÓMEZ ZULETA, M. A.; BERMÚDEZ, J. J.; PÉREZ, A.; POSSO, H.; JIMENEZ, C. Validación de la Escala de Siriraj en el Hospital San Juan de Dios de Santafé de Bogotá, D. C. Revista de la Facultad de Medicina, [S. l.], v. 45, n. 1, p. 6–10, 1997. Disponível em: https://revistas.unal.edu.co/index.php/revfacmed/article/view/31619. Acesso em: 17 aug. 2024.

Chicago

Gómez Zuleta, Martín Alonso, Juan José Bermúdez, Ariel Pérez, Hector Posso, and Carlos Jimenez. 1997. “ C”. Revista De La Facultad De Medicina 45 (1):6-10. https://revistas.unal.edu.co/index.php/revfacmed/article/view/31619.

Harvard

Gómez Zuleta, M. A., Bermúdez, J. J., Pérez, A., Posso, H. and Jimenez, C. (1997) “ C”., Revista de la Facultad de Medicina, 45(1), pp. 6–10. Available at: https://revistas.unal.edu.co/index.php/revfacmed/article/view/31619 (Accessed: 17 August 2024).

IEEE

[1]
M. A. Gómez Zuleta, J. J. Bermúdez, A. Pérez, H. Posso, and C. Jimenez, “ C”., Rev. Fac. Med., vol. 45, no. 1, pp. 6–10, Jan. 1997.

MLA

Gómez Zuleta, M. A., J. J. Bermúdez, A. Pérez, H. Posso, and C. Jimenez. “ C”. Revista de la Facultad de Medicina, vol. 45, no. 1, Jan. 1997, pp. 6-10, https://revistas.unal.edu.co/index.php/revfacmed/article/view/31619.

Turabian

Gómez Zuleta, Martín Alonso, Juan José Bermúdez, Ariel Pérez, Hector Posso, and Carlos Jimenez. “ C”. Revista de la Facultad de Medicina 45, no. 1 (January 1, 1997): 6–10. Accessed August 17, 2024. https://revistas.unal.edu.co/index.php/revfacmed/article/view/31619.

Vancouver

1.
Gómez Zuleta MA, Bermúdez JJ, Pérez A, Posso H, Jimenez C. Validación de la Escala de Siriraj en el Hospital San Juan de Dios de Santafé de Bogotá, D. C. Rev. Fac. Med. [Internet]. 1997 Jan. 1 [cited 2024 Aug. 17];45(1):6-10. Available from: https://revistas.unal.edu.co/index.php/revfacmed/article/view/31619

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