Tabla 1: Características de los pacientes por análisis bivariado por mortalidad. |
||||
Total N = 456 (100%) n (%) |
Supervivientes N = 304 n (%) |
No supervivientes N = 114 n (%) |
p |
|
Hombres |
348 (76) |
233 (72) |
89 (28) |
0.83 |
Edad (años)* |
57 [47-67] |
54.5 [12.9] |
63.4 [13.3] |
< 0.001 |
IMC* |
28.7 [26.2-32.0] |
28.4 [26.4-32.0] |
29.6 [25.3-32.5] |
0.908 |
Días piso (n = 432)* |
2 [0-5] |
2 [0-5] |
3 [0-6] |
0.303 |
Días UCI (n = 455)* |
13 [9-21] |
13 [9-19] |
17 [11-27] |
< 0.001 |
Días piso 2 (n = 432)* |
5 [0-9] |
7 [4-10] |
0 [0-0] |
< 0.001 |
Días totales (n = 455)* |
23 [16-32] |
23 [18-31] |
22 [15-33] |
0.248 |
Ingreso a UTI (n = 455) |
451 (98) |
298 (73) |
110 (27) |
0.391 |
Días con intubación (n = 410)* |
10 [6-16] |
9 [6-14] |
15 [9-24.8] |
< 0.001 |
Días de reintubación (n = 21)* |
17 [5-22] |
1 [0-6] |
0 [0-11] |
0.478 |
Diagnóstico de ingreso (n = 416) |
||||
NAC |
292 (70) |
218 (52) |
74 (18) |
0.368 |
NAC + SIRA grave |
112 (27) |
77 (19) |
35 (8) |
|
IVRS |
8 (2) |
5 (1) |
3 (1) |
|
SIRA |
2 (0.5) |
1 (0.25) |
1 (0.25) |
|
NAC + SIRA + estado postparo |
1 (0.25) |
1 (0.25) |
0 (0.0) |
|
Neumonía intrahospitalaria + SIRA |
1 (0.25) |
0 (0.0) |
1 (0.25) |
|
Comorbilidades |
||||
LRA |
104 (23) |
56 (60) |
37 (40) |
0.002 |
IAM |
18 (4) |
8 (53) |
7 (47) |
0.079 |
TEP |
12 (3) |
6 (50) |
6 (50) |
0.067 |
EVC |
3 (0.7) |
1 (50) |
1 (50) |
0.120 |
Síntomas |
||||
Fiebre |
319 (70) |
217 (75) |
74 (25) |
0.184 |
Disnea |
297 (65) |
204 (74) |
73 (26) |
0.526 |
Tos |
263 (58) |
178 (72) |
69 (28) |
0.715 |
Cefalea |
148 (33) |
110 (79) |
29 (21) |
0.034 |
Dolor faríngeo |
111 (24) |
77 (75) |
25 (25) |
0.471 |
Diarrea |
64 (14) |
42 (71) |
17 (29) |
0.758 |
Rinorrea |
52 (11) |
34 (71) |
14 (29) |
0.754 |
Escala de Glasgow* |
15 [15-15] |
15 [15-15] |
15 [15-15] |
0.999 |
Laboratoriales basales |
||||
Linfocitos (× 103 cel/mm3)* |
0.7 [0.5-1.0] |
0.7 [0.5-1.0] |
0.6 [0.4-1.1] |
0.211 |
Leucocitos (× 103 cel/mm3)* |
9.5 [6.2-13.6] |
9.3 [6.0-13.6] |
9.1 [6.0-12.3] |
0.641 |
IL-6 (pg/mL)* |
75.0 [50.4-141.0] |
75 [49.6-388.0] |
99.6 [85.5-116.0] |
0.825 |
Dímero D (μg/mL)* |
740 [450-1,310] |
680 [445-1,115] |
1,085 [483-2,888] |
< 0.001 |
LDH (U/L)* |
343 [267-441] |
343 [283-427] |
343 [250-532] |
0.774 |
PCR (mg/L)* |
139 [62-216] |
141.0 [61.0-219.0] |
130.0 [64.3-199.0] |
0.704 |
Procalcitonina (ng/mL)* |
0.244 [0.130-0.488] |
0.213 [0.119-0.425] |
0.375 [0.211-0.730] |
0.002 |
Ferritina (ng/mL)* |
722 [364-1,255] |
765 [354-1,281] |
623 [394-1,185] |
0.689 |
PaFi arterial* |
115 [70-216] |
126.0 [72.6-227.0] |
104.0 [64.4-180.0] |
0.130 |
PO2 (mmHg)* |
67.7 [56.2-86.2] |
67.4 [56.3-84.0] |
71.9 [55.4-91.2] |
0.309 |
PCO2 (mmHg)* |
30.1 [26.6-34.4] |
29.9 [26.5-33.8] |
30.2 [27.1-34.0] |
0.688 |
Lactato (mmol/L)* |
1.5 [1.1-2.0] |
1.4 [1.0-2.0] |
1.6 [1.20-2.15] |
0.188 |
HCO3 (mmol/L)* |
21.4 [19.0-23.5] |
21.4 [19.4-23.2] |
21.2 [18.3-23.4] |
0.351 |
BNP* |
87.2 [29.9-192.0] |
61.2 [28.4-137.0] |
192.0 [19.2-288.0] |
0.601 |
Troponina I (ng/mL)* |
16.0 [8.2-44.3] |
15.0 [9.9-42.6] |
21.7 [14.7-41.5] |
0.535 |
Laboratoriales (UTI) |
||||
Leucocitos (× 103 cel/mm3)* |
10.9 [7.3-14.4] |
10.9 [7.2-14.1] |
10.7 [7.3-14.0] |
0.934 |
IL-6 (pg/mL)* |
106 [39.2-739.0] |
174 [13.7-513.0] |
1,123 [103-2,210] |
0.188 |
Dímero D (μg/mL)* |
1,020 [620-2,323] |
880 [600-1,463] |
1,750 [810-4,890] |
< 0.001 |
LDH (U/L)* |
374 [285-479] |
367 [286-443] |
375 [275-543] |
0.626 |
PCR (mg/L)* |
152 [62-229] |
161 [56.2-235.0] |
145 [76.9-208.0] |
0.727 |
Procalcitonina (ng/mL)* |
0.310 [0.140-0.700] |
0.244 [0.110-0.465] |
0.390 [0.213-1.140] |
0.011 |
Ferritina (ng/mL)* |
966 [470-1,405] |
939 [473-1,429] |
990 [453-1,285] |
0.843 |
PaFi arterial* |
88.2 [62.3-144.0] |
96.6 [65.8-152.0] |
77.0 [58.5-122.0] |
0.013 |
PO2 (mmHg)* |
68.3 [55.7-82.1] |
69.2 [56.3-83.8] |
65.8 [55.2-78.6] |
0.160 |
PCO2 (mmHg)* |
34.0 [28.9-41.0] |
34.0 [28.9-41.0] |
34.0 [25.8-41.1] |
0.936 |
Lactato (mmol/L)* |
1.6 [1.1-2.1] |
1.5 [1.1-2.0] |
1.8 [1.3-2.3] |
0.017 |
HCO3 (mmol/L)* |
22.5 [20.1-25.3] |
22.6 [20.3-25.3] |
22.0 [19.1-24.9] |
0.331 |
BNP* |
112.0 [45.7-382.0] |
68.6 [26.6-173.0] |
192.0 [83.0-396.0] |
0.023 |
Troponina I (ng/mL)* |
33.3 [15.0-180.0] |
19.9 [12.8-164.0] |
31.1 [23.5-228.0] |
0.682 |
Laboratoriales finales |
||||
Linfocitos (× 103 cel/mm3)* |
1.3 [0.8-1.8] |
1.4 [1.0-1.9] |
0.8 [0.4-1.2] |
< 0.001 |
Leucocitos (× 103 cel/mm3)* |
8.3 [6.0-11.1] |
7.4 [5.7-9.6] |
14.6 [9.2-20.1] |
< 0.001 |
IL-6 (pg/mL)* |
85.1 [45.5-89.2] |
45.5 [25.7-65.3] |
93.2 [93.2-93.2] |
0.667 |
Dímero D (μg/mL)* |
1,730 [840-3,210] |
1,710 [890-2,660] |
6,305[675-12,685] |
0.284 |
LDH (U/L)* |
244 [210-345] |
228 [190-285] |
432 [381-699] |
< 0.001 |
PCR (mg/L)* |
13.4 [4.6-50.1] |
9.84 [2.95-32.7] |
119 [56.9-183.0] |
< 0.001 |
Procalcitonina (ng/mL)* |
0.0960 [0.0645-0.396] |
0.08 [0.05-0.15] |
2.6 [0.716-7.960] |
< 0.001 |
Ferritina (ng/mL)* |
495 [298-728] |
495 [315-702] |
537 [272-987] |
0.770 |
PaFi arterial* |
91.0 [56.5-170.0] |
130.0 [93.0-213.0] |
67.8 [53.0-105.0] |
< 0.001 |
PO2 (mmHg)* |
61.7 [48.1-78.2] |
62.8 [48.0-77.3] |
59.4 [48.5-78.7] |
0.954 |
PCO2 (mmHg)* |
46.3 [39.7-59.5] |
42.3 [36.5-47.8] |
50.1 [40.9-67.4] |
0.002 |
Lactato (mmol/L)* |
1.7 [1.1-3.1] |
1.40 [1.10-2.15] |
2.20 [1.30-5.70] |
0.006 |
HCO3 (mmol/L)* |
27.2 [21.8-30.6] |
26.9 [22.6-30.6] |
27.0 [21.4-30.8] |
0.925 |
BNP* |
178 [41.5-867.0] |
42.5 [28.2-88.6] |
625 [213-1,513] |
< 0.001 |
Troponina I (ng/mL)* |
69.1 [13.0-411.0] |
21.7 [17.2-26.2] |
186 [83.0-411.0] |
0.533 |
TAC de tórax (n = 418) |
||||
CO-RADS 1 |
2 (0.5) |
2 (0.5) |
0 (0.0) |
0.014 |
CO-RADS 2 |
2 (0.5) |
0 (0.0) |
2 (0.5) |
|
CO-RADS 3 |
2 (0.5) |
0 (0.0) |
2 (0.5) |
|
CO-RADS 4 |
6 (1.5) |
4 (1.0) |
2 (0.5) |
|
CO-RADS 5 |
53 (13.0) |
34 (8.0) |
19 (4.0) |
|
CO-RADS 6 |
353 (84.0) |
264 (64.0) |
89 (21.0) |
|
Frecuencia cardiaca (lpm) |
98 [87-111] |
98 [87-111] |
98 [85-112] |
0.758 |
Frecuencia respiratoria (rpm) |
24 [20-30] |
24 [20-30] |
24 [20-31] |
0.500 |
Tensión arterial sistólica (mmHg)* |
128 [117-142] |
127 [117-141] |
130 [120-145] |
0.277 |
Tensión arterial diastólica (mmHg)* |
75 [66-83] |
74 [67-83] |
76 [64-82] |
0.908 |
Temperatura (oC)* |
37 [36.6-37.6] |
37.0 [36.6-37.6] |
37.7 [36.5-37.6] |
0.999 |
Saturación de O2 (%)* |
85 [77-90] |
86 [77-90] |
83 [74-90] |
0.072 |
Posición prono (n = 419) |
332 (79) |
242 (73) |
89 (27) |
0.731 |
Prono temprano (n = 332)* |
243 (73) |
182 (75) |
62 (25) |
0.310 |
Tiempo de prono en días (n = 332)* |
3 [3-4] |
3 [3-4] |
4 [2-5] |
0.414 |
Complicaciones por la posición prono (n = 322) |
||||
Sin complicación |
299 (93) |
226 (70) |
73 (23) |
< 0.001 |
Inestabilidad |
14 (4.0) |
6 (2.0) |
8 (2.3) |
|
Úlceras por presión |
5 (2.0) |
4 (1.2) |
1 (0.3) |
|
Disfunción del tubo |
1 (0.3) |
0 (0.0) |
1 (0.3) |
|
Extubación espontánea |
1 (0.3) |
1 (0.3) |
0 (0.0) |
|
Fuga + cambio de tubo |
1 (0.3) |
0 (0.0) |
1 (0.3) |
|
Vómito |
1 (0.3) |
0 (0.0) |
1 (0.3) |
|
Dispositivos utilizados de O2 (n = 419) |
||||
PAF |
236 (56) |
165 (40) |
70 (17) |
0.326 |
MR |
166 (40) |
126 (30) |
40 (9.4) |
|
VMNI |
13 (3) |
10 (2) |
3 (0.7) |
|
PN |
4 (1) |
3 (0.7) |
1 (0.2) |
|
Uso de esteroide sistémico (n = 419) |
373 (89) |
266 (72) |
106 (28) |
0.111 |
Presencia de SIRA (n = 419) |
417 (99.5) |
303 (73) |
113 (27) |
0.469 |
Presencia de choque (n = 419) |
398 (95) |
284 (72) |
113 (28) |
0.017 |
Presencia de NIH (n = 419) |
158 (38) |
91 (58) |
67 (42) |
< 0.001 |
Presencia de LRA (n = 419) |
198 (47.3) |
108 (55) |
90 (45) |
< 0.001 |
Uso de TRR (n = 418) |
53 (13) |
17 (32) |
36 (68) |
< 0.001 |
Defunción intrahospitalaria (n = 418) |
114 (27) |
0 (0) |
114 (27) |
— |
Desenlace (n = 418) |
||||
Alta a domicilio por mejoría |
280 (67) |
280 (67) |
0 (0) |
— |
Defunción |
114 (27) |
0 (0) |
114 (27) |
|
Alta voluntaria |
22 (5) |
22 (27) |
0 (0) |
|
Alta por traslado |
2 (1) |
2 (1) |
0 (0) |
|
Seguimiento a 30 días (n = 417) |
||||
Alta a domicilio por mejoría |
161 (39) |
161 (40) |
0 (0) |
— |
Pérdida del seguimiento |
139 (33) |
139 (33) |
0 (0) |
|
Defunción |
117 (28) |
3 (1) |
114 (27) |
|
BNP = péptido natriurético. CO-RADS = sistema de datos e informes de COVID-19 (COVID-19 reporting and data system). EVC = evento vascular cerebral. HCO3 = bicarbonato. IAM = infarto agudo al miocardio. IL-6 = Interleucina 6. IVRS = infección de vías respiratorias superiores. LDH = deshidrogenasa láctica. lpm = latidos por minuto. LRA = lesión renal aguda. MT = mascarilla reservorio. NAC = neumonía adquirida en la comunidad. NIH = neumonía intrahospitalaria. PAF = puntas de alto flujo. PCO2 = presión parcial de dióxido de carbono. PCR = proteína C reactiva. PN = puntas nasales. PO2 = presión parcial de oxígeno. rpm = respiraciones por minuto. SIRA = síndrome de insuficiencia respiratoria aguda. TAC = tomografía axial computarizada. TEP = tromboembolia pulmonar. UTI = unidad de terapia intensiva. VMNI = ventilación mecánica no invasiva. |