Márquez TCB, Bravo SE, Bocanegra AE

Language: Spanish
References: 22
Page: 594-599
PDF size: 275.27 Kb.

ABSTRACT

Introduction: an elevated leukoglycemic index (LGI) (> 2,000) has been associated with poor prognosis in various intensive care settings. However, its prognostic value in septic patients and its relationship with multiple organ failure (MOF) is unknown. This study aims to determine this relationship in septic patients treated in the ICU of UMAE No. 1 Bajío. Objective: to determine the relationship between LGI and MOF in septic patients in the ICU of UMAE No. 1 Bajío. Material and methods: a cross-sectional, retrospective, and analytical study was conducted on septic patients treated in the ICU of UMAE No. 1 Bajío. Leukocyte and glucose levels at admission were evaluated to calculate the LGI, as well as the clinical evolution of the patients (with or without MOF). Student's T-test or Mann-Whitney U test were used to compare LGI between groups, and binary logistic regression was used to identify risk factors associated with MOF, including acute kidney injury (AKI), SOFA score, and other clinical variables. Results: of the 50 patients included, 50% developed MOF. Although the median LGI was higher in patients with MOF (1.91 vs 1.02), this difference was not statistically significant (p = 0.058). However, leukocyte levels were significantly higher in patients with MOF (p = 0.048). Multivariable analysis showed that AKI was the main risk factor for developing MOF (OR = 16.90, p = 0.029). Conclusion: while LGI is a potential risk marker, AKI was identified as the main predictor of MOF, suggesting the need to integrate multiple markers to optimize prognostic evaluation in sepsis.

REFERENCES

1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801-810.

2. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):762-774.

3. Neira-Sanchez ER, Málaga G. Sepsis-3 y las nuevas definiciones, ¿es tiempo de abandonar SIRS? Acta Médica Peru. 2016;33(3):217-222.

4. Cohen J. The immunopathogenesis of sepsis. Nature. 2002;420(6917):885-891.

5. Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013;369(9):840-851.

6. Guidet B, Aegerter P, Gauzit R, Meshaka P, Dreyfuss D. Incidence and impact of organ dysfunctions associated with sepsis. Chest. 2005;127(3):942-951.

7. Carrillo-Esper R, Carrillo-Córdova JR, Carrillo-Córdova LD. Estudio epidemiológico de la sepsis en unidades de terapia intensiva mexicanas. Cir Cir. 2009;77(4):301-308.

8. Kaukonen KM, Bailey M, Pilcher D, Cooper DJ, Bellomo R. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med. 2015;372(17):1629-1638.

9. Mayr FB, Yende S, Angus DC. Epidemiology of severe sepsis. Virulence. 2014;5(1):4-11.

10. Heled Y, Fleischmann C, Epstein Y. Cytokines and their role in hyperthermia and heat stroke. J Basic Clin Physiol Pharmacol. 2013;24(2):85-96.

11. Ratiani L, Gamkrelidze M, Khuchua E, Khutsishvili T, Intskirveli N, Vardosanidze K. Altered microcirculation in septic shock. Georgian Med News. 2015;(244-245):16-24.

12. Salud y Medicina. La sepsis puede provocar fallo multiorgánico en pocas horas. Saludymedicina.org. 2017. Disponible en: https://saludymedicina.org/post/la-sepsis-puede-provocar-fallo-multiorganico-en-pocas-horas

13. Castro WA, Conci E, Zelaya F, Isa M, Pacheco G, Sala J. Estratificación del riesgo en el infarto agudo de miocardio según el índice leucoglucémico ¿El "Killip-Kimball" de laboratorio? Rev Fed Arg Cardiol. 2010;39:29-34.

14. Sanjuán R, Núñez J, Luisa-Blasco M, Miñana G, Martínez-Maicas H, Carbonell N, et al. Prognostic implications of stress hyperglycemia in acute ST elevation myocardial infarction. Prospective observational study. Rev Esp Cardiol Engl Ed. 2011;64(3):201-207.

15. Liu L, Qian J, Yan W, Liu X, Zhao Y, Che L. Hiperglucemia al ingreso y pronóstico en pacientes con infarto agudo de miocardio. 2023. Disponible en: https://www.intramed.net/105022/Hiperglucemia-al-ingreso-y-pronostico-en-pacientes-con-infarto-agudo-de-miocardio

16. García-Álvarez PJ, García-Albero ÁP, Santana-Álvarez J. Índice leuco glucémico como predictor a corto plazo de mortalidad en el ictus isquémico. Rev Arch Méd Camagüey. 2018;22(2):163-170.

17. Hirschson-Prado A, Higa C, Merlo P, Dominé E, Blanco P, Vazquez G, et al. Valor pronóstico del índice leucoglucémico en el infarto agudo de miocardio. Resultados del Registro Multicéntrico SCAR. Rev Argent Cardiol. 2014;82:500-505.

18. Qi LY, Liu HX, Cheng LC, Luo Y, Yang SQ, Chen X, et al. Prognostic value of the leuko-glycemic index in acute myocardial infarction patients with or without diabetes. Diabetes Metab Syndr Obes. 2022;15:1725-1736.

19. Rodríguez-Jiménez A, Fardales-Rodríguez R, Toledo-Rodríguez E, Quintana-Cañizarez G. Índice leuco-glucémico como factor pronóstico tras un infarto agudo del miocardio con elevación del segmento ST. Rev Finlay. 2019;9(2):97-107.

20. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294(7):813-818.

21. Asim M, Amin F, El-Menyar A. Multiple organ dysfunction syndrome: Contemporary insights on the clinicopathological spectrum. Qatar Med J. 2020;2020(2). Disponible en: https://www.qscience.com/content/journals/10.5339/qmj.2020.22

22. León-Aliz E, Pérez-Fernández GA, Moreno-Martínez FL, Vega-Fleites LF, Rabassa-López-Calleja MA. Índice leuco-glucémico como marcador pronóstico de la evolución intrahospitalaria en pacientes con infarto agudo de miocardio con elevación del ST. Clín Invest Arterioscl. 2014;26(4):168-175.