Díaz-Aguilar FA, Juárez-Guzmán U, Villa-Delgado A, Flores-Miranda DN

Language: Spanish
References: 15
Page: 30-35
PDF size: 254.74 Kb.

ABSTRACT

Introduction: In the Intensive Care Unit (ICU), predicting patient prognosis is essential for determining their treatment. Materials and methods: this was an analytical, observational, descriptive, retrospective, and cross-sectional study. Patients with septic shock were included in the ICU of Hospital Ángeles Clínica Londres in Mexico City and evaluated from March 1, 2022, to May 31, 2024. Records were reviewed and data collected. Variables such as demographics, comorbidities, vital signs, laboratory tests, and the cause of shock were described. APACHE II and SOFA mortality scores were evaluated. Two groups were formed, with and without mortality, and univariate and bivariate analyses were performed using the SPSS 25 statistical software. Results: during the period considered, 78 cases met the inclusion criteria; 44 patients (56.4%) were men and 34 (43.6%) were women. The mean age was 78.5 years, and mortality was reported in 24 patients (30.8%). Comorbidities included hypertension in 49 (62.8%), diabetes in 41 (52.5%), and chronic kidney failure in 12 (15.3%). The origin of shock was abdominal in 34 (43.5%), pulmonary in 24 (30.7%), urinary in 12 (15.3%), and soft tissue in 13 (16.6%). The optimal cutoff point for mortality in the study population was determined to be above 63.24. The comparison of both groups of patients (those who showed clinical improvement versus those who died) showed a median CRP/albumin ratio of 63.24 in the group that showed improvement versus 158.7 in the deceased group (p = 0.004). Significant statistical differences were found between the non-mortality group (n = 54) and the deceased group (n = 24) in the following parameters: heart rate 94.5 versus 109 (p = 0.002), respiratory rate 21 versus 24 (p = 0.080), C-reactive protein (CRP) 168.5 versus 367.5 (p = 0.008), albumin 3 versus 2.4 (p = 0.017), CRP/albumin ratio 63.24 versus 158.7 (p = 0.004), procalcitonin 6.1 versus 41.5 (p = 0.01), creatinine 1.67 versus 2.6 (p = 0.029), hemoglobin 12.35 versus 10.45 (p = 0.036), neutrophils 3.5 versus 1.5 (p = 0.017). 6.4 (p = 0.037), SOFA 7 versus 11.5 (p = 0.001), APACHE 19 versus 25.5 (p = 0.003). Conclusions: the association between the CRP/albumin ratio can be used as a prognostic marker of mortality for patients with septic shock.

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