Derivación de pacientes desde atención primaria a las unidades de coloproctología de GaliciaCaracterísticas clínicas y correlación diagnóstica
- Vázquez García, Irene 1
- Bravo Beltrán, Dayana 2
- Paniagua García-Señoráns, Marta 3
- Rodríguez Martinón, Pino 4
- Suárez Pazos, Natalia 5
- Moreda Álvarez, Rubén 6
- Varela Ferro, Cristian 7
- Anguita Ramos, Francisco 8
- Casal Nuñez, José Enrique 9
- Parajó Calvo, Alberto 9
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1
Complexo Hospitalario Universitario de Pontevedra
info
- 2 Complejo Hospitalario Universitario de A Coruña
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3
Complexo Hospitalario Universitario de Vigo
info
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4
Complexo Hospitalario Universitario de Santiago
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Complexo Hospitalario Universitario de Santiago
Santiago de Compostela, España
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5
Complexo Hospitalario Universitario de Ferrol
info
Complexo Hospitalario Universitario de Ferrol
Ferrol, España
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6
Complexo Hospitalario Universitario de Ourense
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- 7 Hospital Povisa de Vigo
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8
Hospital Universitario Lucus Augusti
info
- 9 Grupo Gallego de Coloproctología
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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