El presente estudio busca determinar si el uso de drenaje peritoneal se relaciona con el desarrollo de complicaciones postoperatorias de los pacientes pediátricos con apendicitis aguda complicada sometidos a apendicectomía convencional en el Hospital Nacional Ramiro Prialé Prialé en el periodo 2014 – 2016. El diseño del estudio aplicado, es una de serie de casos comparativo de tipo analítico, en el cual se realizó la revisión de historias clínicas de pacientes pediátricos con diagnóstico de apendicitis aguda complicada, que fueron sometidos a apendicectomía convencional en el Hospital Nacional Ramiro Prialé Prialé en el periodo 2014 – 2016. Los pacientes en los cuales se utilizó un dren peritoneal luego de la apendicectomía fueron comparados con los pacientes sin drenaje con respecto a las características postoperatorias. Ambos grupos fueron evaluados en términos de...

Objective. To know the clinical characteristics and determine the related factors to higher in-hospital mortality in patients with cardiogenic shock (CS) due to myocardial infarction in a Peruvian reference hospital. Materials and methods. We conducted a prospective single-center cohort study, to evaluate the clinical characteristics, treatment, and complications of patients with CS due to myocardial infarction from March 2019 to August 2020 at the Instituto Nacional Cardiovascular INCOR. Factors related to higher in-hospital mortality and during follow-up were evaluated. Also, the IABP shock II score was applied to stratify the cohort. Results. Forty patients were included in the study, 75% of cases were due to left ventricular dysfunction, most of the men and with a median age of 75 (69-82) years. Fifty percent of cases presented CS after admission to the emergency room. Patients strat...

Objetivo. Conocer las características clínicas y determinar los factores relacionados a mayor mortalidad en pacientes con choque cardiogénico (CC) por infarto de miocardio en un hospital de referencia peruano. Materiales y métodos. Cohorte única prospectiva donde se evaluó la presentación, tratamiento y complicaciones de pacientes con CC por infarto de miocardio atendidos entre marzo 2019 a agosto 2020 en el Instituto Nacional Cardiovascular - INCOR. Se evaluaron los factores relacionados con mayor mortalidad hospitalaria y en el seguimiento, además del uso del score IABP shock II en la población de estudio. Resultados. Cuarenta pacientes fueron incluidos, el 75% con CC por disfunción ventricular izquierda, la mayoría varones con edad de 75 (69-82) años. Un 50% de casos presentaron CC luego del ingreso a emergencia. Los pacientes estratificados mediante el score IABP shock II...

Objective. To know the clinical characteristics and determine the related factors to higher in-hospital mortality in patients with cardiogenic shock (CS) due to myocardial infarction in a Peruvian reference hospital. Materials and methods. We conducted a prospective single-center cohort study, to evaluate the clinical characteristics, treatment, and complications of patients with CS due to myocardial infarction from March 2019 to August 2020 at the Instituto Nacional Cardiovascular INCOR. Factors related to higher in-hospital mortality and during follow-up were evaluated. Also, the IABP shock II score was applied to stratify the cohort. Results. Forty patients were included in the study, 75% of cases were due to left ventricular dysfunction, most of the men and with a median age of 75 (69-82) years. Fifty percent of cases presented CS after admission to the emergency room. Patients strat...

The definition of high-risk chronic coronary syndrome varies depending on the noninvasive test used to trigger ischemia. The triggering occurs through increased myocardial work and oxygen demand, either through exercise or drugs. The initial approach to the chronic coronary syndrome leads us to discuss in which cases to prioritize an optimal initial medical therapy or to perform an initial invasive procedure of myocardial revascularization. In this article we analyze both approaches based on previous studies carried out to date, where the initial invasive management has not been shown to be superior to initial optimal medical therapy in outcomes such as death or major adverse cardiovascular events.

La definición de síndrome coronario crónico de alto riesgo varía según la prueba no invasiva empleada para evidenciar isquemia, lo que se consigue a través de un aumento del trabajo miocárdico y la demanda de oxígeno, generados con el uso de fármacos o el ejercicio. El abordaje inicial nos sumerge en la discusión de contextualizar en qué casos priorizar la terapia médica óptima inicial, frente al manejo invasivo inicial con el objetivo de lograr la revascularización miocárdica. Este aspecto central será desarrollado en esta revisión, tomando en cuenta diversos estudios realizados hasta la fecha, en los que el manejo invasivo inicial no ha demostrado ser superior a la terapia médica óptima inicial en resultados clínicos relevantes como muerte o eventos adversos cardiovasculares mayores.

The definition of high-risk chronic coronary syndrome varies depending on the noninvasive test used to trigger ischemia. The triggering occurs through increased myocardial work and oxygen demand, either through exercise or drugs. The initial approach to the chronic coronary syndrome leads us to discuss in which cases to prioritize an optimal initial medical therapy or to perform an initial invasive procedure of myocardial revascularization. In this article we analyze both approaches based on previous studies carried out to date, where the initial invasive management has not been shown to be superior to initial optimal medical therapy in outcomes such as death or major adverse cardiovascular events.