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2013, Número 1

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Cir Plast 2013; 23 (1)


Quemaduras en pacientes seniles. Estudio comparativo

Cuenca-Pardo J, Álvarez-Díaz CJ

Idioma: Español
Referencias bibliográficas: 36
Paginas: 55-62
Archivo PDF: 244.63 Kb.


RESUMEN

Estudiamos 2,562 registros de pacientes quemados atendidos en la Unidad de Quemados del Hospital de Traumatología «Dr. Victorio de la Fuente Narváez» del IMSS, en el periodo comprendido de enero de 2000 a diciembre de 2011. Realizamos un estudio analítico para determinar factores de riesgo en el pronóstico y resultado. Comparamos los siguientes grupos: pacientes seniles y no seniles, octogenarios y no octogenarios, por grupo de edad y periodo en que fueron atendidos. El 10.2% fueron seniles, con una extensión de quemadura del 17.5%. El 45.5% presentaba comorbilidad, con limitación funcional en el 19.4%. Las complicaciones para los seniles fueron del 20.2% y para los no seniles del 12.8% (p = 0.001; OR 2.39) y la mortalidad para los seniles fue del 10.7% y de los no seniles del 6.3% (p = 0.008; OR 2.7). Los pacientes octogenarios tuvieron una mayor mortalidad que los no octogenarios (21.3 versus 13.1%; p = 0.063, OR 3.4) y complicaciones (32 versus 22.5%; p = 0.068, OR 2.86), no hubo diferencias significativas con otras variables. A mayor edad y extensión hubo mayor mortalidad y complicaciones. Los pacientes con una puntuación de siete o menor tuvieron una supervivencia del 98.5%, y los que tuvieron 12 o más de 61.5%. La mortalidad aumentó 18.1% por cada 10% de superficie corporal quemada (R 0.921, p ‹ 0.001) y 5.3% por cada década de edad (R 0.894; p = 0.013). Al comparar resultados del periodo 2000-2002 con el periodo 2009-2011, encontramos una disminución de la mortalidad del 10.2% (p = 0.012; OR 8.76), atribuible a más recursos, nuevas tecnologías y más experiencia del personal.


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