RT info:eu-repo/semantics/doctoralThesis
T1 El papel del fenotipado como herramienta de alerta precoz en el manejo prehospitalario del paciente COVID-19 con alto riesgo de deterioro
A1 Alberdi Iglesias, Ana
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Biología molecular
K1 COVID-19
K1 Phenotypes
K1 Fenotipos
K1 Medical prognosis
K1 Pronóstico
K1 32 Ciencias Médicas
AB The pandemic caused by COVID-19 has posed great challenges to face a health, labor, economic and social crisis. The assistance to patients with acute pathology in the prehospital context has evolved exponentially in recent years, making diagnosis and treatment possible at the point of care on many occasions, since one of the challenges professionals face is the ability to to detect risk of mortality in fundamentally time-dependent pathologies, where a diagnostic or therapeutic delay can negatively influence the outcome. The use of early warning scales represents a tool that allows the systematized evaluation of patients and can predict possible serious adverse events, providing considerable help, especially when the outcomes are not initially suspected or detected. However, on certain occasions a scale that covers the entire population spectrum is unfeasible. Knowledge about the full spectrum of phenotypic abnormalities associated with a given disease can help prevent complications or at least recognize them early enough that effective treatments are available and personalize care for each patient. The main objective of this thesis was to develop a system of tools for risk stratification in the prehospital care process of patients with COVID-19 disease. To this end, three multicenter, retrospective, observational cohort studies have been carried out. We have obtained a bedside scale derived through variables obtained by telephone, through which professionals can very quickly and effectively discern the real short-term risk of patients. Second, after the results we conclude that the SpO2/FiO2 ratio is a simple, non-invasive, fast and promising tool to predict that it can help to make an early estimate of the degree of hypoxemia in infected patients even in patients with a high risk of deterioration. clinical but with low initial suspicion. Lastly, patients assessed at the bedside can be classified into four different phenotypes with differentiating characteristics and prognostic implications common to the group to which they belong. Through this tool, health professionals can discriminate risk and future implications, helping in the decision-making process with the proper use of resources.
YR 2021
FD 2021
LK https://uvadoc.uva.es/handle/10324/61128
UL https://uvadoc.uva.es/handle/10324/61128
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 12-may-2024