Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano

Introducción: A nivel mundial, el cáncer gástrico ocupó el sexto lugar en incidencia y el séptimo en mortalidad en 2022 (GLOBOCAN). En la región nororiente de Colombia se ubicó como la tercera mayor incidencia en 2022. La infección por Helicobacter pylori (H. pylori) es el principal factor de riesgo...

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Autores:
Ospina Galeano, Diana Carolina
Tipo de recurso:
Fecha de publicación:
2024
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/25021
Acceso en línea:
http://hdl.handle.net/20.500.12749/25021
Palabra clave:
Internal medicine
Medicine
Medical sciences
Health sciences
Helicobacter pylori
Eradication
Risk factors
Treatment adherence
Epidemiology (Research)
Public health
Gram negative bacteria
Medicina interna
Medicina
Ciencias médicas
Epidemiología (Investigaciones)
Salud pública
Bacterias gram negativas
Ciencias de la salud
Helicobacter pylori
Erradicación
Factores de riesgo
Adherencia al tratamiento
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http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_d1062ca4bf10296ae71fa276e795269d
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/25021
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
dc.title.translated.spa.fl_str_mv Factors associated with therapeutic failure in helicobacter pylori eradication in a population from northeast colombia
title Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
spellingShingle Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
Internal medicine
Medicine
Medical sciences
Health sciences
Helicobacter pylori
Eradication
Risk factors
Treatment adherence
Epidemiology (Research)
Public health
Gram negative bacteria
Medicina interna
Medicina
Ciencias médicas
Epidemiología (Investigaciones)
Salud pública
Bacterias gram negativas
Ciencias de la salud
Helicobacter pylori
Erradicación
Factores de riesgo
Adherencia al tratamiento
title_short Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
title_full Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
title_fullStr Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
title_full_unstemmed Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
title_sort Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente Colombiano
dc.creator.fl_str_mv Ospina Galeano, Diana Carolina
dc.contributor.advisor.none.fl_str_mv Tovar Fierro, German Manuel
Ochoa Vera, Miguel Enrique
Luna González, María Lucrecia
dc.contributor.author.none.fl_str_mv Ospina Galeano, Diana Carolina
dc.contributor.cvlac.spa.fl_str_mv Tovar Fierro, German Manuel [0001575134]
Ochoa Vera, Miguel Enrique [0000898465]
Luna González, María Lucrecia [0001347422]
dc.contributor.googlescholar.spa.fl_str_mv Luna González, María Lucrecia [pLIVNZYAAAAJ]
dc.contributor.orcid.spa.fl_str_mv Tovar Fierro, German Manuel [0000-0001-7424-8875]
Ochoa Vera, Miguel Enrique [0000-0002-4552-3388]
Luna González, María Lucrecia [0000-0003-2846-6868]
dc.contributor.scopus.spa.fl_str_mv Ochoa Vera, Miguel Enrique [36987156500]
Luna González, María Lucrecia [57216524897]
dc.contributor.researchgate.spa.fl_str_mv Ochoa Vera, Miguel Enrique [Miguel_Ochoa7]
dc.contributor.apolounab.spa.fl_str_mv Tovar Fierro, German Manuel [german-manuel-tovar-fierro]
Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera]
Luna González, María Lucrecia [maría-lucrecia-luna-gonzález]
dc.contributor.linkedin.spa.fl_str_mv Luna González, María Lucrecia [maria-lucrecia-luna-gonzalez]
dc.subject.keywords.spa.fl_str_mv Internal medicine
Medicine
Medical sciences
Health sciences
Helicobacter pylori
Eradication
Risk factors
Treatment adherence
Epidemiology (Research)
Public health
Gram negative bacteria
topic Internal medicine
Medicine
Medical sciences
Health sciences
Helicobacter pylori
Eradication
Risk factors
Treatment adherence
Epidemiology (Research)
Public health
Gram negative bacteria
Medicina interna
Medicina
Ciencias médicas
Epidemiología (Investigaciones)
Salud pública
Bacterias gram negativas
Ciencias de la salud
Helicobacter pylori
Erradicación
Factores de riesgo
Adherencia al tratamiento
dc.subject.lemb.spa.fl_str_mv Medicina interna
Medicina
Ciencias médicas
Epidemiología (Investigaciones)
Salud pública
Bacterias gram negativas
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Helicobacter pylori
Erradicación
Factores de riesgo
Adherencia al tratamiento
description Introducción: A nivel mundial, el cáncer gástrico ocupó el sexto lugar en incidencia y el séptimo en mortalidad en 2022 (GLOBOCAN). En la región nororiente de Colombia se ubicó como la tercera mayor incidencia en 2022. La infección por Helicobacter pylori (H. pylori) es el principal factor de riesgo para el desarrollo de cáncer gástrico. Es fundamental comprender los factores que influyen en la falla del tratamiento de erradicación de H. pylori. Este estudio tuvo como objetivo evaluar los factores asociados a la falla terapéutica en una población del noreste de Colombia. Metodología: Este estudio de cohorte retrospectivo utilizó datos secundarios anonimizados de una base de datos de control de calidad para procedimientos endoscópicos gastrointestinales realizados entre enero y junio de 2023. La adherencia farmacológica (AF) al régimen de erradicación de H. pylori se evaluó mediante la escala de Morisky-Green. La falla del tratamiento se definió como un resultado positivo en la prueba de aliento con urea con carbono 14 seis semanas después de finalizar la terapia con antibióticos. Como medidas del efecto se emplearon el riesgo relativo (RR) con intervalos de confianza (IC) del 95% y valores de p. El análisis estadístico se realizó utilizando STATA/SE v 14.0. Resultados: Se analizaron un total de 87 pacientes, con una edad media de 51 ± 14 años. La mayoría (62,07%) fueron mujeres y la gastritis antral superficial crónica (73,56%) fue el hallazgo endoscópico más frecuente. Se observó falla en la erradicación en el 16,1% de los pacientes. Entre los que fallaron en el tratamiento, el 40% había recibido un régimen de erradicación previo y el 70% había recibido dos o más. Se asociaron tasas de éxito de erradicación significativamente más bajas con el uso de amoxicilina (p = 0,05), doxiciclina (p = 0,001) y metronidazol (p = 0,01), así como con una baja adherencia farmacologica (p = 0,03). Mientras que el uso de esomeprazol (RR=0,39, p=0,19) y la edad ≥ 40 años (RR=0,41, p=0,025) indicaron una asociación protectora; solo el tratamiento erradicador previo (RR=3,59, p< 0,001) y la baja AF (RR= 5,95, p=0,03) fueron factores de riesgo estadísticamente significativos para la falla del tratamiento. Conclusión: Este estudio en una población del noreste de Colombia identificó dos factores de riesgo clave para el fracaso de la terapia de erradicación de H. pylori: tratamiento de erradicación previo y baja adherencia farmacológica. Por el contrario, la edad ≥ 40 años y el uso de esomeprazol fueron factores protectores. Estos hallazgos resaltan la importancia de optimizar los regímenes de tratamiento y promover la adherencia para mejorar el éxito de la erradicación.
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-06-05T14:19:59Z
dc.date.available.none.fl_str_mv 2024-06-05T14:19:59Z
dc.date.issued.none.fl_str_mv 2024-05-20
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.hasversion.none.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/25021
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/25021
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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dc.coverage.temporal.spa.fl_str_mv Enero 2 a Junio 30 del 2023
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spelling Tovar Fierro, German Manuel9e2a80f7-0acb-4c70-b431-fe5177968f1fOchoa Vera, Miguel Enriqueb2f66b1f-7691-4abf-a110-466c07955478Luna González, María Lucrecia7f524da3-dbfd-4a5c-9e72-4ea55989230aOspina Galeano, Diana Carolinac6a16368-1cdf-4b5e-9cbb-89f46b2299c1Tovar Fierro, German Manuel [0001575134]Ochoa Vera, Miguel Enrique [0000898465]Luna González, María Lucrecia [0001347422]Luna González, María Lucrecia [pLIVNZYAAAAJ]Tovar Fierro, German Manuel [0000-0001-7424-8875]Ochoa Vera, Miguel Enrique [0000-0002-4552-3388]Luna González, María Lucrecia [0000-0003-2846-6868]Ochoa Vera, Miguel Enrique [36987156500]Luna González, María Lucrecia [57216524897]Ochoa Vera, Miguel Enrique [Miguel_Ochoa7]Tovar Fierro, German Manuel [german-manuel-tovar-fierro]Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera]Luna González, María Lucrecia [maría-lucrecia-luna-gonzález]Luna González, María Lucrecia [maria-lucrecia-luna-gonzalez]Floridablanca (Santander, Colombia)Enero 2 a Junio 30 del 2023UNAB Campus Bucaramanga2024-06-05T14:19:59Z2024-06-05T14:19:59Z2024-05-20http://hdl.handle.net/20.500.12749/25021instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coIntroducción: A nivel mundial, el cáncer gástrico ocupó el sexto lugar en incidencia y el séptimo en mortalidad en 2022 (GLOBOCAN). En la región nororiente de Colombia se ubicó como la tercera mayor incidencia en 2022. La infección por Helicobacter pylori (H. pylori) es el principal factor de riesgo para el desarrollo de cáncer gástrico. Es fundamental comprender los factores que influyen en la falla del tratamiento de erradicación de H. pylori. Este estudio tuvo como objetivo evaluar los factores asociados a la falla terapéutica en una población del noreste de Colombia. Metodología: Este estudio de cohorte retrospectivo utilizó datos secundarios anonimizados de una base de datos de control de calidad para procedimientos endoscópicos gastrointestinales realizados entre enero y junio de 2023. La adherencia farmacológica (AF) al régimen de erradicación de H. pylori se evaluó mediante la escala de Morisky-Green. La falla del tratamiento se definió como un resultado positivo en la prueba de aliento con urea con carbono 14 seis semanas después de finalizar la terapia con antibióticos. Como medidas del efecto se emplearon el riesgo relativo (RR) con intervalos de confianza (IC) del 95% y valores de p. El análisis estadístico se realizó utilizando STATA/SE v 14.0. Resultados: Se analizaron un total de 87 pacientes, con una edad media de 51 ± 14 años. La mayoría (62,07%) fueron mujeres y la gastritis antral superficial crónica (73,56%) fue el hallazgo endoscópico más frecuente. Se observó falla en la erradicación en el 16,1% de los pacientes. Entre los que fallaron en el tratamiento, el 40% había recibido un régimen de erradicación previo y el 70% había recibido dos o más. Se asociaron tasas de éxito de erradicación significativamente más bajas con el uso de amoxicilina (p = 0,05), doxiciclina (p = 0,001) y metronidazol (p = 0,01), así como con una baja adherencia farmacologica (p = 0,03). Mientras que el uso de esomeprazol (RR=0,39, p=0,19) y la edad ≥ 40 años (RR=0,41, p=0,025) indicaron una asociación protectora; solo el tratamiento erradicador previo (RR=3,59, p< 0,001) y la baja AF (RR= 5,95, p=0,03) fueron factores de riesgo estadísticamente significativos para la falla del tratamiento. Conclusión: Este estudio en una población del noreste de Colombia identificó dos factores de riesgo clave para el fracaso de la terapia de erradicación de H. pylori: tratamiento de erradicación previo y baja adherencia farmacológica. Por el contrario, la edad ≥ 40 años y el uso de esomeprazol fueron factores protectores. Estos hallazgos resaltan la importancia de optimizar los regímenes de tratamiento y promover la adherencia para mejorar el éxito de la erradicación.Planteamiento Del Problema y Justificación 14 Marco Teórico 16 Epidemiología 16 Helicobacter Pylori 17 Patogenia 18 Enfoque diagnóstico 21 Pruebas invasivas 21 Pruebas no invasivas 22 Complicaciones del H. Pylori 26 Gastritis crónica 26 Úlcera péptica 27 Adenocarcinoma gástrico 28 Linfoma gástrico 31 Enfermedades no digestivas 32 Tratamiento 33 Test Adherencia Morisky-Green 36 Estado de Arte 36 Pregunta de Investigación 39 Hipótesis 39 Objetivos 40 Objetivo General 40 Objetivos Específicos 40 Metodología Propuesta 40 Diseño 40 Universo 40 Población objeto 40 Criterios de Elegibilidad y de Exclusión 41 Criterios de Elegibilidad 41 Cálculo del Tamaño de la Muestra 41 Administración de Datos 41 Variables 41 Plan de Procesamiento 42 Análisis Estadístico 42 Consideraciones Éticas 43 Resultados 44 Discusión 53 Conclusiones 57 Bibliografía 58EspecializaciónIntroduction: Globally, gastric cancer ranked sixth in incidence and seventh in mortality in 2022 (GLOBOCAN). In Colombia's northeastern region, it held the third highest incidence in 2022. Helicobacter pylori (H. pylori) infection is the primary risk factor for gastric cancer development. Understanding factors influencing treatment failure of H. pylori eradication is crucial. This study aimed to evaluate factors associated with therapy failure in a northeastern Colombian population. Methodology: This retrospective cohort study utilized anonymized secondary data from a quality control database for Gastrocal endoscopic procedures performed between January and June 2023. Pharmacological adherence (PA) to the H. pylori eradication regimen was assessed using the Morisky-Green Scale. Treatment failure was defined as a positive carbon-14 urea breath test result at six weeks post-antibiotic therapy completion. Relative risk (RR) with 95% confidence intervals (CI) and p-values were employed as effect measures. Statistical analysis was performed using STATA/SE v 14.0. Results: A total of 87 patients were analyzed, with a mean age of 51 ± 14 years. The majority (62.07%) were women, and chronic superficial antral gastritis (73.56%) was the most frequent endoscopic finding. Eradication failure was observed in 16.1% of patients. Among those failing therapy, 40% had received one prior eradication regimen, and 70% had received two or more. Significantly lower eradication success rates were associated with amoxicillin (p=0.05), doxycycline (p=0.001), and metronidazole (p=0.01) use, as well as low PA (p=0.03). While esomeprazole use (RR=0.39, p=0.19) and age ≥ 40 years (RR=0.41, p=0.025) indicated a protective association; only prior eradication treatment (RR=3.59, p< 0.001) and low PA (RR=5.95, p=0.03) were statistically significant risk factors for treatment failure. Conclusion: This study in a northeastern Colombian population identified two key risk factors for H. pylori eradication therapy failure: prior eradication treatment and low pharmacological adherence. Conversely, age ≥ 40 years and esomeprazole use appeared to be protective factors. These findings highlight the importance of optimizing treatment regimens and promoting adherence to improve eradication succes.Modalidad Presencialapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Factores asociados a la falla terapéutica de erradicación del helicobacter pylori en una población del Nororiente ColombianoFactors associated with therapeutic failure in helicobacter pylori eradication in a population from northeast colombiaEspecialista en Medicina InternaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Medicina Internainfo:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMInternal medicineMedicineMedical sciencesHealth sciencesHelicobacter pyloriEradicationRisk factorsTreatment adherenceEpidemiology (Research)Public healthGram negative bacteriaMedicina internaMedicinaCiencias médicasEpidemiología (Investigaciones)Salud públicaBacterias gram negativasCiencias de la saludHelicobacter pyloriErradicaciónFactores de riesgoAdherencia al tratamientoFarreras Rozman, von Domarus A, Farreras P. 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Fracaso en la erradicación de Helicobacter pylori con terapia triple estándar empírica en una población de México. 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