Concordancia diagnóstica entre atención primaria y cirugía menor en una zona básica de salud

  1. F.J. Pérez Hernández 1
  2. L. Goya Arteaga 1
  3. J.L. González Siverio 1
  4. R.P. Llada Marrero 1
  1. 1 Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
Journal:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Year of publication: 2021

Issue: 3

Pages: 144-150

Type: Article

DOI: 10.1016/J.SEMERG.2020.09.004 DIALNET GOOGLE SCHOLAR

More publications in: Semergen: revista española de medicina de familia

Abstract

Aim Minor Surgery (MS) is an ever-increasing programmed activity in Primary Health Care Centres (PHC). The aim of this study is to establish the clinical and histopathology diagnostic agreement between PHC and MS and evaluating the efficacy of this activity. Methods and materials A retrospective, observational, and reliability study was performed. A total of 234 patient specimens were sent to Histopathology between January 2014 and December 2018 in basic health area of San Benito-La Laguna, Santa Cruz de Tenerife. Of these, 203 specimens met criteria, with 31 being excluded due to death or absence of diagnosis. Sociodemographic and diagnostic variables were analysed, and 10 possible diagnoses were grouped into 3 categories according to their nature. Cohen kappa coefficient was used as the main evaluation measure. Results The majority of specimens were obtained from women (51.2%), and the mean age was 52.82±17.82 years. The most frequently referred lesion was the epidermoid cyst (20.2-21.67%). A clinical-pathological agreement of 60% was obtained in Minor Surgery, with a specificity of 98.3% and a sensitivity of 61.9%. In Primary Care agreement was 36.1%, with a specificity of 98.4% and a sensitivity of 42.8%. Infectious lesions represented the largest concordance difference obtained, with 27% less in Primary Care compared to Minor Surgery. Conclusions Minor Surgery is an effective support in the initial diagnosis of lesions referred for evaluation at Primary Care. However, it is necessary to implement improvements in diagnostic efficacy of Primary Care.

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