Análisis de la evolución clínica de los pacientes postoperados de trastornos neurológicos que ingresan a la unidad de cuidados intensivos

Author: 
Julia Mariela Sanluis Garcia and Oscar Iván Flores Rivera

Background: Neurological disorders requiring surgical treatment, according to the World Health Organization (WHO), are the second leading cause of death worldwide. In Mexico, there have been nearly 170,000 cerebral infarctions as of October 2018, causing primary brain injuries and increasing admissions to intensive care units. Postoperative diagnoses of neurological disorders that are not treated correctly can cause secondary brain injuries and, consequently, permanent disabilities. Specialized nursing care for neurocritical patients is a fundamental guideline for the patient to have a favorable clinical evolution, since providing specific care reduces secondary brain injuries. Objectives: To analyze the clinical evolution of postoperative patients for neurological disorders who were admitted to the intensive care unit of the naval medical center in the period: from March 1, 2019 to February 28, 2020, to know the clinical characteristics described in the literature of the evolution of postoperative patients for neurological disorders, determine the importance of nursing interventions for the evolution of postoperative patients for neurological disorders, describe the sociodemographic characteristics of postoperative patients for neurological disorders and identify the prevalence of discharges that occurred in the ICU (intensive care unit) of CEMENAV (naval medical center) of postoperative patients for neurological disorders. Material and methods: a retrospective, observational, descriptive, longitudinal study was carried out; The study population consisted of 39 patients who entered the intensive care unit with a postoperative diagnosis of a neurological disorder (surgical or endovascular) in the period from March 1, 2019 to February 28, 2020. The necessary information was obtained from the patient's medical record to apply the measurement instruments that were three APACHE II scales, SOFA SCORE and TISS-28, in two measurements upon admission of the patient to the ICU and upon discharge from it. Results: It was obtained as a result that there was a favorable clinical evolution of patients undergoing surgical treatment for neurological disorders, on the Apache scale 13% of postoperative patients entered with a score of ≥ 68 points, which decreased by 10% upon discharge, being only 3%. On the SOFA score scale, the favorable evolution was also significant, which was demonstrated by showing that 100% of the patients who discharged had a score of zero. With the TISS-28 scale, the result also indicated a favorable evolution since the demand for specialized care that at the beginning was 64%, at discharge was only 5%. Conclusion: the clinical evolution of the patients is favorable,According to the literature, when a patient does not present secondary brain injuries that condition their discharge and that could cause permanent sequelae based on the score obtained by each patient on each scale.

Paper No: 
3434