medigraphic.com
ISSN 1561-3186 (Electronic)

2009, Number 1

<< Back

Rev Acta Médica 2009; 12 (1)

Atherosclerosis: Fifteen years of experience related to 7 127 necropsies performed in «Hermanos Ameijeiras» Clinical Surgical Hospital

Alvarez SR, de Mendoza AJH, Borrajero MI, Jiménez PR

Language: Spanish
References: 34
Page:
PDF size: 461.03 Kb.


ABSTRACT

A descriptive, cross-sectional, qualitative and retrospective study was made in a cohort of 7 127 deceased and postmortem studied patients from 1994 to 2008, both inclusive in «Hermanos Ameijeiras» Clinical Surgical Hospital, National Reference Center of Pathologic Anatomy, Havana city, Cuba with predominance of male sex in a ratio of 1,05 male/female (51,30%) and within them the group aged 55-64 (23,40%). Bronchopneumonia, multiple metastases, edema and pulmonary thromboembolism, as well as the myocardial infarction are the first cause of death en these patients, whereas the coronary and cerebral atherosclerosis, high blood pressure, malignant tumors and hepatic cirrhosis are among the more frequent basic causes of death in this necropsy group. From total database we take the deceased and postmortem studied patients presenting with coronary atherosclerosis as basic cause of death (950 cases, male 59,1%, female 40,9%). Mean age was of 69 years with a rank between 29 and 99 years. The 65,16% of patients was over 65 years. The more affected age group at death was that of 65 to 74 years, 30,7%. The more frequent functional causes of death included: shock, cardiac insufficiency and the cardiac arrhythmia. The direct morphological causes of death were the acute myocardial infarction, pulmonary edema, and thrombotic occlusion of coronary artery. The more frequent contributing causes of death were the high blood pressure, diabetes mellitus, and aortic valve disease. As second basic cause of death from the total database atherosclerosis was studied achieving a total of 447 necropsies, male 45,9% and female 54,1%; mean age 75 years, rank between 38 and 101 years and the 78,97% had more than 65 years old at death, where the more affected one was that of 75 to 84 years. The more frequent direct functional causes of death were the acute respiratory insufficiency, high nervous centers dysfunction and the neurologic coma. The more frequent functional causes of death were the cerebral infarction, bronchopneumonia and hernia from cerebral edema as morphologic expression of endocranial hypertension syndrome. The more frequent contributing causes of death were the high blood pressure, diabetes mellitus and coronary atherosclerosis. The 94,52% was studied and conclusions was by a necropsy pathologist working at full-time in this activity.


REFERENCES

  1. Hurtado de Mendoza J. La Autopsia. Garantía de Calidad en la Medicina. La Habana. 2005. Disponible en: www.sld.cu/temas.php?idv=4042

  2. Fernández-Britto JE, Castillo JA, Taquechel N, Barriuso A, Vilau F: Aterosclerosis, Colesterol y Pared Arterial.: Algunas Reflexiones. Rev Cubana Invest Biomed. 1999;18(3):169-75.

  3. Gómez O, Fernández-Britto JE, Núñez M, Meneau TX, Ferrer M, Nodarse R, Cabale B: Factores de Riesgo Aterogénico en una Población de Adultos Mayores. Rev Cubana Enfermer. 2005:21(3).

  4. Hurtado de Mendoza J, Álvarez R. Registro Nacional de Autopsias en Cuba. Utilización del SARCAP. Rev Esp Patol. 2004;37(1). Disponible en: http://www.pgmacline.es/revpatologia/volumen37/vol37-num1/37-1n04.htm

  5. Hurtado de Mendoza J, Alvarez R, Borrajero I. Base de datos de autopsias en Cuba. Utilización del SARCAP. EJAutopsy 2005, 11-17. Disponible en: http://rea.uninet.edu/ojs/

  6. MINSAP. Anuario Estadístico de Salud 2007. La Habana, Cuba. 2008.

  7. Alvarez R. Estudio morfológico de las alteraciones pulmonares de la enfermedad por quemaduras en un modelo de ratón quemado. Trabajo de Terminación de la Residencia para optar por el título de especialista de I grado en Anatomía Patológica. La Habana. 1982.

  8. Alvarez R, Hurtado de Mendoza J, Montero T. Pulmón del síndrome de dificultad respiratoria del adulto en el SIDA. Rev Cubana Med Milit.1989;18:214-25.

  9. Castañer J, Hurtado de Mendoza J, Rivero J. Evolución clínica y estudio anatomopatológico de paciente fallecido con diagnóstico del SIDA. Rev Cubana Med Milit 1989;18:61-77.

  10. Hurtado de Mendoza J, Álvarez Santana R. Procedimiento y medidas de bioseguridad en necropsias de fallecidos por SIDA. La Habana, 1988.

  11. Hurtado de Mendoza J, Fuentes A, Montero T, Alvarez Santana R, Coello RA. Cáncer en Cuba. Evaluación de la calidad de los diagnósticos premortem según el Sistema Automatizado de Registro y Control en Anatomía Patológica. Rev Cubana Med. 2004; 43: Disponible en: http://scielo.sld.cu/scielo.php

  12. Hurtado de Mendoza J, Montero T, Walwyn V, Alvarez Santana R. El Daño Multiorgánico en autopsias realizadas en Cuba en 1994. Rev. Cubana Med Milit 1997;26:19-29.

  13. Hurtado de Mendoza J, Alvarez R, Borrajero I. Discrepancias diagnósticas en las causas de muerte identificadas por autopsias. Cuba 1994-2003. Patología. 2008;46(2):85-95.

  14. Hurtado de Mendoza J, Alvarez R, Borrajero I. Situación de la autopsia en Cuba y en el mundo. La necesidad de su mejor empleo. Patología. 2008;46(1):3-8.

  15. Hurtado de Mendoza J. Evaluación de la calidad de los diagnósticos premortem en autopsias. Experiencias sobre los talleres y entrenamientos del sistema automatizado de registro y control de Anatomía Patológica (SARCAP). 2004. Disponible en: http://eusalud.uninet.edu/cl_autopsias/Documentos/Taller%20AP.pdf

  16. Hurtado de Mendoza J, Alvarez R, Jiménez A, Fernández LG. El SARCAP, Sistema Automatizado de Registro y Control de Anatomía Patológica. Rev Cubana Med Milit. 1995; 24:123-30.

  17. Alvarez R, Hurtado de Mendoza J, Borrajero I, Jiménez R. Experiencias de 7127 fallecidos autopsiados en quince años del Hospital Clínico-Quirúrgico «Hermanos Ameijeiras». Rev Cub Med (entregado para publicación).

  18. OPS/OMS. Clasificación Estadística Internacional de Enfermedades, Traumatismos y Causas de Defunción. Novena Revisión. Washington DC;1978.

  19. Gough J. Correlation between clinical and autopsy diagnoses in a community hospital. MAJ.1985;133:420-2.

  20. Peres LC, Ribeiro-Silva A. The autopsy in a tertiary teaching hospital in Brazil. Ann Clin Lab Sci. 2005;35:387-90.

  21. Sanclemente C, Barcons M, Moleiro MA, Alonso F, Panella D, Carrera R,et al. Hospital mortality in an Internal Medicine service. An Med Interna. 2004;21:317-21.

  22. Sebok J, Magvar E, Csanádi C, Csáky A, Schönfeld T. The importance or the autopsy in quality control of medicine (possibilities in the Hungarian conditions). Orv Hetil. 2005; Aug 14:146(33):1711-20.

  23. Burton JL, Underwood J. Clinical, educational, and epidemiological value of autopsy. Lancet. 2007 ; Apr 28;369(9571):1471-80.

  24. Kuusisto J, Räsänen K, Särkioja T, Alarakkola E, Kosma VM : Atherosclerosis-like lesions of the aortic valve are common in adults of all ages : a necropsy study. Heart. 2005 ; May ; 91(5) :576-82.

  25. Takei H, Strong JP, Yutani C, Malcom GT : Comparison of coronary and aortic atherosclerosis in youth from Japan and the USA. Atherosclerosis. 2005 ; May ;180(1) :171-9.

  26. Pangonyte D, Kazlauskaite D, Stalioraityte E, Zdanov V, Simainaitis M, Lesauskaite V. Results of morphologic epidemiologic study of coronary arteries in Kaunas population aged 20-69 years : atherosclerotic lesions and their interrelationship. Medicina (Kaunas) 2004 ;40(7) :681-9.

  27. McMahan CA, Gidding SS, Malcom GT, Schreiner PJ, Strong JP, Tracy RE, et al. Comparison of coronary heart disease risk factors in autopsied young adults from the PDAY Study with living young adults from the CARDIA Study. Cardiovasc Pathol. 2007; May-Jun;16(3):151-8.

  28. Rich Edwards JW, et al. The primary prevention of coronary Herat disease in women. N Engl J Med. 1995; 332:1758.

  29. Hennekens CH. Increasing burden of cardiovascular disease: current knowledge and future directions for research on risk factors. Circulation. 1998; 97:1095.

  30. ACC/AHA guidelines for the management of patients with acute MI. J Am Coll Cardiol. 1996; 28:1328.

  31. Cotran SC, Kumar V, Collins T: Robbins Patología Estructural y Funcional. Sexta Edición. 2000; McGraw-Hill-Interamericana de España, S.A.U. p. 579.

  32. Damjanov I, Linder J eds: Anderson´s Pathology Tenth Edition. 1996; Mosby-Year Book, Inc.

  33. Kónyia J, Molnár S, Magyar MT, Szekeres CC, Kerényi L, Csiba L : Severity of carotid atherosclerosis unrelated to Chlamydia pneumoniae infection in acute ischemic stroke patients: a clinicopathological study. Cerebrovasc Dis. 2008 ; 25(1-2) :170-5.

  34. Stehbens W, Lie J (eds): Vascular Pathology, London, Chapman & Hall, 1995.




2020     |     www.medigraphic.com