Derivación de pacientes desde atención primaria a las unidades de coloproctología de GaliciaCaracterísticas clínicas y correlación diagnóstica

  1. Vázquez García, Irene 1
  2. Bravo Beltrán, Dayana 2
  3. Paniagua García-Señoráns, Marta 3
  4. Rodríguez Martinón, Pino 4
  5. Suárez Pazos, Natalia 5
  6. Moreda Álvarez, Rubén 6
  7. Varela Ferro, Cristian 7
  8. Anguita Ramos, Francisco 8
  9. Casal Nuñez, José Enrique 9
  10. Parajó Calvo, Alberto 9
  1. 1 Complexo Hospitalario Universitario de Pontevedra
    info

    Complexo Hospitalario Universitario de Pontevedra

    Pontevedra, España

    ROR https://ror.org/016cxc226

  2. 2 Complejo Hospitalario Universitario de A Coruña
  3. 3 Complexo Hospitalario Universitario de Vigo
    info

    Complexo Hospitalario Universitario de Vigo

    Vigo, España

    ROR https://ror.org/01ybfxd46

  4. 4 Complexo Hospitalario Universitario de Santiago
    info

    Complexo Hospitalario Universitario de Santiago

    Santiago de Compostela, España

    ROR https://ror.org/00mpdg388

  5. 5 Complexo Hospitalario Universitario de Ferrol
    info

    Complexo Hospitalario Universitario de Ferrol

    Ferrol, España

  6. 6 Complexo Hospitalario Universitario de Ourense
    info

    Complexo Hospitalario Universitario de Ourense

    Orense, España

    ROR https://ror.org/04f1y4a64

  7. 7 Hospital Povisa de Vigo
  8. 8 Hospital Universitario Lucus Augusti
    info

    Hospital Universitario Lucus Augusti

    Lugo, España

    ROR https://ror.org/0416des07

  9. 9 Grupo Gallego de Coloproctología
Revista:
Revista de Cirugía de Galicia

ISSN: 1579-9840

Ano de publicación: 2022

Volume: 6

Número: 6

Páxinas: 1-7

Tipo: Artigo

Outras publicacións en: Revista de Cirugía de Galicia

Resumo

Introduction:The present study aims to assess the clinical characteristics of patients with proctological pathology referred to the Coloproctology Units from Primary Care and to know the degree of diagnostic correlation.Methods:Observational, retrospective and multicenter study, including patients with proctological symptoms referred from Primary Care to Coloproctology units of second and third level Galician hospitals between 09/15/2018 and 10/15/2018.Results:467 patients met the inclusion criteria. The most frequent reasons for consultation in Primary Care were rectorrhagia, 163 patients (34.9%), proctalgia 116 (24.8%), hemorrhoidal prolapse 69 (14.8%) and gluteal / sacral tumor 27 (5.8%).An examination had been performed in 55.7% of the cases and a digital rectal examination in 36%; in 8.1% of cases, complementary tests had been requested and treatment had started in 33%.The most frequent diagnoses in Primary Care were hemorrhoids 199 (42.6%), anal fissure 59 (12.6%), rectorrhagia to study 54 (11.6%) and “without diagnosis” 41 (8.8%), while in the Coloproctology units were hemorrhoids 188 (40.3%), anal fissure 97 (20.8%), “no pathology” 34 (7.3%) and pilonidal sinus 23 (4.9%).The diagnostic agreement measured by the kappa index of the two most frequent diagnoses, hemorrhoids and anal fissure, was 0.34 95% CI (0.26-0.43) and 0.35 95% CI (0.24-0.45) respectively (weak agreement). The kappa index based on whether or not a physical examination was performed in Primary Care was 0.43 and 0.23 for hemorrhoids (p = 0.021) and 0.44 and 0.15 for fissures (p = 0.008).Conclusions: Only 55.7% of the referred patients had been explored in Primary Care and this factor has a statistically significant influence on the diagnostic agreement

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