Chávez-Pérez JP, Sánchez-Velázquez LD

Idioma: Español
Referencias bibliográficas: 30
Paginas: 182-186
Archivo PDF: 118.11 Kb.

RESUMEN

Antecedentes. Los pacientes en estado crítico que se reintervienen quirúrgicamente generan una respuesta inmunológica que incrementa su morbimortalidad y el uso de recursos. Objetivo. Conocer los factores que pronostican mayor mortalidad en enfermos en estado crítico que requieren reintervención quirúrgica y sus consecuencias.Lugar. Dos hospitales generales públicos de la Ciudad de México. Diseño. Estudio de cohorte prolectiva. Pacientes. Se incluyeron 131 enfermos. Métodos. Se colectaron variables demográficas, clínicas, APACHE II, Bruselas, NEMS y Charlson. El análisis consistió en regresión logística múltiple, considerando significativa una p ‹ 0.05. Resultados. De 131 pacientes quirúrgicos, 32 requirieron reintervención. En ellos el uso de recursos evaluado por NEMS (OR 1.092, IC_95% 1.020-1.1.169) y la aparición de multirresistencia bacteriana (OR 5.306, IC_95% 1.603-17.569) fueron factores predictores de mortalidad. Conclusiones. El mayor uso de recursos y la aparición de multirresistencia bacteriana se consideran factores predictores de mortalidad en los pacientes en estado crítico con reintervención quirúrgica.

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