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2026, Número 4

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Acta Med 2026; 24 (4)


Apendicitis complicada en niños: predictores clínicos, de laboratorio e imagenológicos identificados mediante análisis multivariado

Montcharmont SSE, Bravo RFM, Riba OM, Fernández VS, Silva RH

Idioma: Español
Referencias bibliográficas: 30
Paginas: 405-410
Archivo PDF: 571.24 Kb.


RESUMEN

Introducción: la apendicitis aguda es la urgencia abdominal quirúrgica más frecuente en pediatría. Sus formas complicadas (gangrenosa, perforada o con absceso) se asocian con mayor morbilidad, estancia hospitalaria y costos. Identificar predictores tempranos es clave para optimizar el manejo. Material y métodos: estudio retrospectivo en pacientes menores de 18 años con diagnóstico histopatológico de apendicitis aguda atendidos en un hospital privado de tercer nivel (enero 2019-marzo 2024). Se incluyeron expedientes completos con variables clínicas, de laboratorio e imagen al ingreso. La clasificación de apendicitis complicada se basó en hallazgos quirúrgicos (gangrena, perforación o absceso) confirmados por histopatología. Se aplicó estadística descriptiva, bivariada y regresión logística multivariada, reportando razones de momios (OR) con IC95%. Resultados: se analizaron 134 pacientes; 38 (28.3%) presentaron apendicitis complicada. En el análisis multivariado, fiebre (OR 5.58; IC95% 1.89-16.42; p = 0.002), hiponatremia (OR 0.75; IC95% 0.60-0.92; p = 0.004), bandemia (OR 1.22; IC95% 1.09-1.36; p = 0.001) y apendicolito (OR 1.42; IC95% 1.10-1.83; p = 0.006) fueron predictores significativos. Conclusiones: fiebre, bandemia, hiponatremia y apendicolito son predictores accesibles que permiten estratificar de manera temprana el riesgo y apoyar la toma de decisiones en apendicitis pediátrica.


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