Catástrofes Neurológicas
Catástrofes neurológicas por desconocimiento y retraso diagnóstico
Neurological catastrophes due to medical errors
R. Alberca
Ex Jefe del Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España
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Arias Gómez" "autores" => array:1 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Arias Gómez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485310700529?idApp=UINPBA00004N" "url" => "/02134853/00000025000000S1/v1_201305151047/S0213485310700529/v1_201305151047/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0213485310700505" "issn" => "02134853" "doi" => "10.1016/S0213-4853(10)70050-5" "estado" => "S300" "fechaPublicacion" => "2010-10-01" "aid" => "70050" "copyright" => "Sociedad Española de Neurología" "documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Neurologia. 2010;25 Supl 1:46-51" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5163 "formatos" => array:3 [ "EPUB" => 63 "HTML" => 3021 "PDF" => 2079 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Catástrofes Neurológicas</span>" "titulo" => "Cefaleas catastróficas" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "46" "paginaFinal" => "51" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Catastrophic headache" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "David Ezpeleta" "autores" => array:1 [ 0 => array:2 [ "nombre" => "David" "apellidos" => "Ezpeleta" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485310700505?idApp=UINPBA00004N" "url" => "/02134853/00000025000000S1/v1_201305151047/S0213485310700505/v1_201305151047/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Catástrofes Neurológicas</span>" "titulo" => "Catástrofes neurológicas por desconocimiento y retraso diagnóstico" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "52" "paginaFinal" => "60" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "R. Alberca" "autores" => array:1 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Alberca" "email" => array:1 [ 0 => "ralbercas@meditex.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Ex Jefe del Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Neurological catastrophes due to medical errors" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec157347" "palabras" => array:3 [ 0 => "Error diagnóstico" 1 => "Error catastrófico" 2 => "Catástrofe neurológica" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec157346" "palabras" => array:3 [ 0 => "Diagnostic error" 1 => "Catastrophic error" 2 => "Neurological catastrophe" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El Instituto Americano de Medicina desveló en 1999 que en Estados Unidos se producía una enorme cantidad de errores médicos; de hecho, eran la quinta causa de muerte en este país. Aunque no se sabe si en España se produce el mismo número de errores, existen razones para pensar que el problema es similar, si no mayor. Los errores diagnósticos representan más de la mitad del total de efectos adversos, que pueden ser catastróficos —o tener consecuencias catastróficas— si el proceso neurológico, dejado a su evolución natural, causa la muerte o secuelas severas, es decir, el error puede tener consecuencias catastróficas si no se actúa adecuadamente para interrumpir esta evolución. Por ello es necesario investigar cómo se producen los errores y diseñar estrategias para evitarlos y prevenir conductas inadecuadas. Entre otras, es importante organizar equipos de trabajo, mejorar el conocimiento de la neurología entre los médicos generales y residentes que asisten a este tipo de enfermo, elaborar guías orientadas a salvaguardar la seguridad del paciente y promover políticas adecuadas que premien la falta de errores. Los errores médicos no se deben, por lo general, al desconocimiento o a la falta de experiencia; en ellos influye de forma decisiva una organización asistencial inadecuada. Por este motivo será preferible vigilar la organización de la asistencia y no descargar toda la culpa a nivel individual.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In 1999, the American Institute of Medicine reported an enormous rate of medical errors, representing the fifth cause of death. In Spain, there is no reliable information on the number and nature of medical adverse events, but the situation is probably similar to that described in the USA in 1999, if not higher. Diagnostic errors account for more than half of neurological adverse events and these errors can be catastrophic if the natural progression of the neurological disorder causes severe sequels or even death when the patient is left untreated. To improve patient safety, research must be undertaken to determine how these errors are produced and to develop strategies to prevent inappropriate conduct. Among many other elements, it is important to create teamwork, improve neurological knowledge among general practitioners and residents, to design clinical practice guidelines aimed at patient safety, and to promote policies that reward the absence of errors. In general, medical errors are neither exclusively due to lack of experience nor to insufficient medical knowledge, but rather to faulty organization of medical care. Therefore, it is preferable to monitor healthcare organization rather than to blame the individual supposedly responsible for the error.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:33 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 4 | 1 | 5 |
| 2024 Octubre | 20 | 14 | 34 |
| 2024 Septiembre | 16 | 6 | 22 |
| 2024 Agosto | 18 | 5 | 23 |
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| 2024 Junio | 31 | 6 | 37 |
| 2024 Mayo | 46 | 16 | 62 |
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| 2024 Marzo | 32 | 9 | 41 |
| 2024 Febrero | 45 | 20 | 65 |
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| 2023 Noviembre | 59 | 26 | 85 |
| 2023 Octubre | 88 | 25 | 113 |
| 2023 Septiembre | 36 | 14 | 50 |
| 2023 Agosto | 40 | 5 | 45 |
| 2023 Julio | 79 | 18 | 97 |
| 2023 Junio | 35 | 5 | 40 |
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| 2023 Marzo | 62 | 10 | 72 |
| 2023 Febrero | 50 | 8 | 58 |
| 2023 Enero | 33 | 8 | 41 |
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| 2022 Noviembre | 46 | 8 | 54 |
| 2022 Octubre | 15 | 14 | 29 |
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| 2022 Agosto | 24 | 10 | 34 |
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| 2022 Febrero | 15 | 10 | 25 |
| 2022 Enero | 52 | 20 | 72 |
| 2021 Diciembre | 23 | 22 | 45 |
| 2021 Noviembre | 29 | 19 | 48 |
| 2021 Octubre | 36 | 15 | 51 |
| 2021 Septiembre | 34 | 21 | 55 |
| 2021 Agosto | 38 | 13 | 51 |
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| 2021 Junio | 25 | 11 | 36 |
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| 2020 Octubre | 26 | 7 | 33 |
| 2020 Septiembre | 13 | 8 | 21 |
| 2020 Agosto | 11 | 9 | 20 |
| 2020 Julio | 24 | 14 | 38 |
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| 2020 Marzo | 17 | 10 | 27 |
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| 2020 Enero | 16 | 12 | 28 |
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| 2019 Noviembre | 7 | 5 | 12 |
| 2019 Octubre | 13 | 7 | 20 |
| 2019 Septiembre | 17 | 15 | 32 |
| 2019 Agosto | 17 | 19 | 36 |
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| 2019 Enero | 5 | 27 | 32 |
| 2018 Diciembre | 6 | 25 | 31 |
| 2018 Noviembre | 9 | 20 | 29 |
| 2018 Octubre | 17 | 25 | 42 |
| 2018 Septiembre | 8 | 32 | 40 |
| 2018 Agosto | 4 | 84 | 88 |
| 2018 Julio | 6 | 15 | 21 |
| 2018 Junio | 13 | 30 | 43 |
| 2018 Mayo | 4 | 35 | 39 |
| 2018 Abril | 9 | 30 | 39 |
| 2018 Marzo | 3 | 12 | 15 |
| 2018 Febrero | 4 | 16 | 20 |
| 2018 Enero | 1 | 19 | 20 |
| 2017 Diciembre | 3 | 13 | 16 |
| 2017 Noviembre | 10 | 20 | 30 |
| 2017 Octubre | 7 | 8 | 15 |
| 2017 Septiembre | 8 | 9 | 17 |
| 2017 Agosto | 17 | 13 | 30 |
| 2017 Julio | 18 | 12 | 30 |
| 2017 Junio | 16 | 15 | 31 |
| 2017 Mayo | 20 | 9 | 29 |
| 2017 Abril | 14 | 9 | 23 |
| 2017 Marzo | 15 | 24 | 39 |
| 2017 Febrero | 23 | 13 | 36 |
| 2017 Enero | 22 | 4 | 26 |
| 2016 Diciembre | 29 | 7 | 36 |
| 2016 Noviembre | 28 | 19 | 47 |
| 2016 Octubre | 33 | 27 | 60 |
| 2016 Septiembre | 32 | 20 | 52 |
| 2016 Agosto | 22 | 18 | 40 |
| 2016 Julio | 24 | 4 | 28 |
| 2016 Junio | 20 | 21 | 41 |
| 2016 Mayo | 22 | 18 | 40 |
| 2016 Abril | 14 | 17 | 31 |
| 2016 Marzo | 13 | 19 | 32 |
| 2016 Febrero | 15 | 11 | 26 |
| 2016 Enero | 19 | 13 | 32 |
| 2015 Diciembre | 15 | 32 | 47 |
| 2015 Noviembre | 19 | 37 | 56 |
| 2015 Octubre | 22 | 19 | 41 |
| 2015 Septiembre | 35 | 18 | 53 |
| 2015 Agosto | 23 | 14 | 37 |
| 2015 Julio | 24 | 11 | 35 |
| 2015 Junio | 12 | 9 | 21 |
| 2015 Mayo | 12 | 11 | 23 |
| 2015 Abril | 11 | 9 | 20 |
| 2015 Marzo | 23 | 5 | 28 |
| 2015 Febrero | 21 | 3 | 24 |
| 2015 Enero | 18 | 5 | 23 |
| 2014 Diciembre | 31 | 4 | 35 |
| 2014 Noviembre | 17 | 1 | 18 |
| 2014 Octubre | 39 | 5 | 44 |
| 2014 Septiembre | 31 | 6 | 37 |
| 2014 Agosto | 32 | 5 | 37 |
| 2014 Julio | 25 | 4 | 29 |
| 2014 Junio | 25 | 0 | 25 |
| 2014 Mayo | 25 | 3 | 28 |
| 2014 Abril | 19 | 2 | 21 |
| 2014 Marzo | 30 | 4 | 34 |
| 2014 Febrero | 31 | 1 | 32 |
| 2014 Enero | 33 | 3 | 36 |
| 2013 Diciembre | 20 | 3 | 23 |
| 2013 Noviembre | 26 | 1 | 27 |
| 2013 Octubre | 25 | 6 | 31 |
| 2013 Septiembre | 10 | 3 | 13 |
| 2013 Agosto | 25 | 5 | 30 |
| 2013 Julio | 16 | 1 | 17 |
| 2010 Septiembre | 477 | 0 | 477 |
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