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2008, Número 6

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Rev Med Inst Mex Seguro Soc 2008; 46 (6)


Marcadores bioquímicos de riesgo para mortalidad por fascitis necrotizante

Guzmán-Aguilar RM

Idioma: Español
Referencias bibliográficas: 41
Paginas: 583-590
Archivo PDF: 127.37 Kb.


RESUMEN

Objetivo: identificar si anemia, hipoalbuminemia, hipocalcemia, valores elevados de creatinfosfocinasa e hipoprotrombinemia, son marcadores de riesgo para mortalidad en fascitis necrotizante de acuerdo al sitio anatómico de inicio y superficie corporal afectada.
Material y métodos: diseño de casos y controles en una cohorte prospectiva. Se documentó edad, factores causales asociados, localización de la infección, superficie corporal afectada, datos del laboratorio, gérmenes hallados, tratamiento y evolución. Dos grupos de pacientes: fallecidos y sobrevivientes, estratificados en seis subgrupos de acuerdo al sitio anatómico.
Resultados: se incluyeron 394 pacientes; 252 hombres y 142 mujeres, edad media de 52.8 años. Subgrupos: extremidades (n = 113), genital masculino (n = 103); tórax y abdomen (n = 64); cabeza, cuello y parte superior de tórax (n = 44); genitales femeninos, periné e ingle (n = 42); sacro y glúteos (n = 28). Hipoalbuminemia (OR = 3.8, IC 95 % = 1.5-9.5, p ‹ 0.000), hipocalcemia (OR = 5.7, IC 95 % = 3.2-9.9, p = 0.030), creatinfosfocinasa elevada (OR = 1.5, IC 95 % = 1.0-2.4, p ‹ 0.000) y anemia (OR = 4.4, IC 95 % = 2.8-6.9, p ‹ 0.000), se asociaron a mortalidad. Albúmina (OR = 3.8, IC = 1.5-8.9), protrombina (OR = 6.6, IC 95 % = 3.6-19.5) y tiempo de evolución (OR = 5.2, IC 95 % = 1.2-8.3) mostraron p ‹ 0.05.
Conclusiones: hipocalcemia, hipoprotrombinemia, anemia, creatinfosfocinasa elevada y tiempo de evolución sugieren ser marcadores de riesgo para mortalidad en fascitis necrotizante.


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