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Colegio de Medicina Interna de México.

2011, Número 6

Med Int Mex 2011; 27 (6)


Asociación de la proteína C reactiva con la respuesta al tratamiento antimicrobiano en adultos mayores con neumonía adquirida en la comunidad

Montes DG, Rivero NMÁ, Mendieta ZH

Idioma: Español
Referencias bibliográficas: 33
Paginas: 517-526
Archivo PDF: 254.03 Kb.


RESUMEN

Antecedentes: existen estudios de la utilidad de la proteína C reactiva en el diagnóstico y como factor pronóstico de neumonía adquirida en la comunidad, pero pocos en pacientes geriátricos.
Objetivo: determinar la asociación de las concentraciones séricas de proteína C reactiva con la respuesta al tratamiento antimicrobiano en el paciente adulto mayor con neumonía adquirida en la comunidad.
Pacientes y método: estudio de cohorte, prospectivo, efectuado en el servicio de Geriatría del Centro Médico ISSEMYM, Toluca, Estado de México. Las concentraciones séricas de proteína C reactiva se determinaron mediante inmunoturbidimetría (Roche, modelo Hitachi 9l7).
Resultados: se estudiaron 19 pacientes con edad promedio de 80 ± 5.6 años, con límites de 71 y 91 años, con promedio de seguimiento de 10 ± 2 días (límites 7 y 15), su distribución fue de 12 hombres (63%) y 7 mujeres (37%). Por análisis multivariado se encontró que los sujetos que permanecieron con concentraciones séricas de proteína C reactiva superiores a 10 mg/dL al terminar el tratamiento tuvieron un riesgo relativo de 1.5 (IC 95%, 0.67-3.33; p= 0.158) de tener una evolución tórpida de su cuadro neumónico.
Conclusiones: la concentración sérica de proteína C reactiva mayor de 10 mg/dL es indicadora de gravedad para neumonía adquirida en la comunidad.


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