[Discrepancies between the clinical and pathological diagnosis in lung transplant early mortality]. / Discrepancias entre el diagnóstico clínico y el diagnóstico anatomopatológico en la mortalidad temprana del trasplante pulmonar.
Med Intensiva
; 33(9): 424-30, 2009 Dec.
Article
em Es
| MEDLINE
| ID: mdl-19833412
ABSTRACT
OBJECTIVE:
To analyze the prevalence and frequency spectrum of the most relevant diseases found in the autopsies of patients who underwent a lung transplant and died in the first month after transplantation. To evaluate the consistency of the pre-and post-mortem diagnoses, comparing them with the Goldman et al. scale modified by Battle et al. MATERIAL ANDMETHODS:
Retrospective and longitudinal analysis, comparison of the medical records and records of autopsies of patients who received a lung transplant in our center (University Hospital Marques de Valdecilla) from 1997 to 2007, who died in the early postoperative period (first month post-transplant). The discordance between clinical and pathological diagnosis was classified according to the classification of Goldman et al. and Battle et al. The Student t test for quantitative variables and chi-square for qualitative variables were used for the comparison of the groups.RESULTS:
The five class I errors are limited to respiratory diseases 2 undiagnosed acute rejection, 1 bilateral pulmonary thromboembolism, 1 fat embolism and 1 hemorrhagic infarction of the lung graft. We found a significant difference (p=0.05) between days of survival of patients with group Class I errors (6+/-4.52 days) and patients from the group with no discrepancy (15.42+/-8.99).CONCLUSION:
The short time between transplant and death of the patient reduces the possibility of reaching a correct diagnosis. Because of this information, diagnostic possibilities must be maximized in life-threatening diseases during this period. Therefore, the rate of autopsy studies in this period should be 100%.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Transplante de Pulmão
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
Es
Revista:
Med Intensiva
Ano de publicação:
2009
Tipo de documento:
Article