MARCADORES TEMPRANOS DE RIESGO DE MORTALIDAD EN UCI POR COVID-19 EN UN CENTRO DE REFERENCIA EN COLOMBIA

  • Sandy Carolay Roa-Rangel Fundación Cardiovascular de Colombia
  • Mónica Julieth Castro-Moncada Fundación Cardiovascular de Colombia
  • Antonio Figueredo-Moreno Fundación Cardiovascular de Colombia
  • Víctor Raúl Castillo Fundación Cardiovascular de Colombia
  • Anderson Bermon Universidad CES
Palabras clave: infección por coronavirus, síndrome de dificultad respiratoria severo, cuidado intensivo, biomarcadores

Resumen

Objetivo: Establecer variables prehospitalarias y clínicas de ingreso asociadas con supervivencia por COVID-19 en pacientes hospitalizados en unidad de cuidado intensivo (UCI). Métodos: Diseño ambispectivo, cohorte de comienzo, con una muestra representativa de pacientes mayores de 18 años, hospitalizados en UCI en un centro de referencia del nororiente colombiano, con infección confirmada por SARS-CoV-2 del 3 de junio del 2020 al 3 de enero del 2021. No se realizaron intervenciones; las variables de interés estudiadas fueron: condiciones sociodemográficas, prehospitalarias, clínicas al ingreso y supervivencia al alta de UCI. Resultados: Se analizaron 607 pacientes, fueron excluidos 18 menores de edad y 120 sin condiciones de egreso definidas. Se realizó un cálculo del tamaño de muestra de los 469 restantes para un análisis final con 304 pacientes. La mortalidad fue del 50 %. Los factores predictores en mortalidad fueron: nitrógeno ureico (BUN) mayor a 20 mg/dl (OR: 2,83 IC 95 % 1,49 - 5,38), proteína c reactiva (PCR) mayor a 100 mg/dl (OR: 2,34 IC 95 % 1,22 - 4,48), dímero D mayor a 7.000 ng/dl (OR: 3,36 IC 95 % 1,23 - 8,83), presión arterial de oxígeno (PaO2 ) menor a 91 mmHg (OR: 2,11 IC 95 % 1,11 - 3,99), puntaje de escala NEWS 2 mayor a 7 puntos (OR: 2,03 IC 95 % 1,05 - 3,90), deshidrogenasa láctica (LDH) mayor a 290 u/l (OR: 2,45 IC 95 % 1,01 - 5,97), plaquetas menores a 150,000/μL (OR: 2,33 IC 95 % 1,00 - 5,45), ajustado por sexo y edad categóricas en décadas. Conclusiones: El BUN, la PCR, el dímero D, la LDH, el conteo de plaquetas, la PaO2 y el puntaje de la escala NEWS 2 fueron las variables que desde el ingreso evidenciaron asociación con el desenlace de mortalidad en esta población. Identificar alteración en estos valores favorece una intervención eficaz que mejora el pronóstico de esta enfermedad.

Biografía del autor

Sandy Carolay Roa-Rangel, Fundación Cardiovascular de Colombia
Médico; Esp. Epidemiología, Departamento Epidemiologia; Fundación Cardiovascular de Colombia
Mónica Julieth Castro-Moncada, Fundación Cardiovascular de Colombia
Médico; Esp. Epidemiología, Departamento Epidemiologia; Fundación Cardiovascular de Colombia.
Antonio Figueredo-Moreno, Fundación Cardiovascular de Colombia
Cirujano Cardiovascular.
Víctor Raúl Castillo, Fundación Cardiovascular de Colombia
Cirujano Cardiovascular, CEO Fundación Cardiovascular de Colombia.
Anderson Bermon, Universidad CES
Universidad CES, Escuela de Graduados. Departamento Epidemiología; Centro de investigaciones Fundación Cardiovascular.

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Publicado
2022-04-27
Sección
Artículos de investigación