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Colegio de Medicina Interna de México.

2017, Número 3

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Med Int Mex 2017; 33 (3)


Índice de inmunidad-inflamación sistémica en sepsis

Lagunas-Alvarado M, Mijangos-Huesca FJ, Terán-González JO, Lagunas-Alvarado MG, Martínez-Zavala N, Reyes-Franco I, Hernández-Mendiola R, Santillán-Fragoso WJ, Copca-Nieto DV, López y López LR, Ramírez-Del Pilar R, López-González DS, Vázquez-Arteaga S, Reyes-Jiménez AE, Alba-Rangel DL

Idioma: Español
Referencias bibliográficas: 33
Paginas: 303-309
Archivo PDF: 375.82 Kb.


RESUMEN

Antecedentes: se han estudiado índices de pronóstico de inflamación basados en células periféricas como predictores de disfunción endotelial, riesgo cardiovascular y mortalidad. En 2014 se desarrolló el índice de inmunidad-inflamación sistémica (IIS) que se ha propuesto como factor de pronóstico y de seguimiento en cáncer.
Objetivo: determinar si existe modificación del índice de inmunidad-inflamación sistémica (IIS) en pacientes con sepsis.
Material y Método: estudio retrospectivo que incluyó aleatoriamente a pacientes hospitalizados de 2013 a 2015. Se verificó la homogeneidad de poblaciones demostrando que no existía diferencia estadística entre la edad y comorbilidades (distribución Kolmogorov-Smirnov), frecuencia de comorbilidades (χ2). Se calculó el IIS con la citometría hemática de ingreso. Se compararon las medias del IIS de pacientes con sepsis y sin sepsis (Wilcoxon) y se determinó si había correlación entre el IIS y sepsis (coeficiente de correlación biserial puntual).
Resultados: se incluyeron 242 pacientes (128 con sepsis, edad promedio de 70.1 años y 114 sin sepsis, edad promedio de 69.7 años). La media del índice de inmunidad-inflamación sistémica (IIS) en pacientes con sepsis fue 4444.06×109, en pacientes sin sepsis fue de 3013.94×109. Se demostró que existe correlación estadísticamente significativa entre el IIS y sepsis (rbp= 0.150253625, p=0.05), se demostró que la media del IIS fue significativamente más elevada en pacientes con sepsis (W=5,097, p=0.00001).
Conclusiones: el índice de inmunidad-inflamación sistémica (IIS), un índice innovador que ha mostrado mejor efectividad para describir el desequilibrio de inmunidad e inflamación, se propone como una herramienta que puede ser útil en pacientes con sepsis; sin embargo, se requieren estudios futuros para comprobar su potencial pronóstico y de seguimiento.


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