|
Tabla 1: Características basales de los pacientes según la estrategia de monitoreo con procalcitonina (N = 526). |
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Característica |
Monitoreo |
Total |
p |
|
|
Limitado N = 387 n (%) |
Intensivo N = 139 n (%) |
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|
Edad, años* |
66 [52-77] |
62 [42-79] |
65 [50-77] |
0.077 |
|
Sexo |
0.41 |
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|
Femenino |
163 (42.1) |
53 (38.1) |
216 (41.1) |
|
|
Masculino |
224 (57.9) |
86 (61.9) |
310 (58.9) |
|
|
Peso* |
75 [65-85] |
70 [60-83] |
75 [65-85] |
0.043‡ |
|
Talla* |
165 [160-172] |
168 [160-172] |
167 [160-172] |
0.71 |
|
IMC* |
27 [24.05-29.4] |
25.6 [22.7-28.4] |
26.6 [23.4-29.3] |
0.013‡ |
|
Paliativo |
0.011‡ |
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|
No |
378 (97.7) |
129 (92.8) |
507 (96.4) |
|
|
Sí limitar |
7 (1.8) |
5 (3.6) |
12 (2.3) |
|
|
ONR |
2 (0.5) |
5 (3.6) |
7 (1.3) |
|
|
GMM |
239 (61.8) |
99 (71.2) |
338 (64.3) |
0.046‡ |
|
Origen |
< 0.001‡ |
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|
Hospitalización |
26 (6.7) |
38 (27.3) |
64 (12.2) |
|
|
Cirugía |
62 (16.0) |
17 (12.2) |
79 (15.0) |
|
|
Hemodinamia |
140 (36.2) |
5 (3.6) |
145 (27.6) |
|
|
Urgencias |
156 (40.3) |
78 (56.1) |
234 (44.5) |
|
|
Transferencia |
3 (0.8) |
1 (0.7) |
4 (0.8) |
|
|
Tipo de ingreso |
0.002‡ |
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|
Cirugía de emergencia |
70 (18.1) |
15 (10.8) |
85 (16.2) |
|
|
Cirugía programada |
60 (15.5) |
10 (7.2) |
70 (13.3) |
|
|
Médico |
257 (66.4) |
114 (82.0) |
371 (70.5) |
|
|
Sepsis al ingreso |
37 (9.6) |
66 (47.5) |
103 (19.6) |
< 0.001‡ |
|
Choque séptico al ingreso |
33 (8.5) |
43 (30.9) |
76 (14.4) |
< 0.001‡ |
|
SAPS 3* |
8.02 [3.11-20.47] |
25.71 [12.05-44.05) |
10.93 [4.53-29.52] |
< 0.001‡ |
|
Prioridad SCCM |
< 0.001‡ |
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|
No evaluada |
0 (0.0) |
1 (0.7) |
1 (0.2) |
|
|
Prioridad 1 |
199 (51.4) |
99 (71.2) |
298 (56.7) |
|
|
Prioridad 2 |
82 (21.2) |
16 (11.5) |
98 (18.6) |
|
|
Prioridad 3 |
95 (24.5) |
15 (10.8) |
110 (20.9) |
|
|
Prioridad 4 |
6 (1.6) |
2 (1.4) |
8 (1.5) |
|
|
Prioridad 5 |
5 (1.3) |
6 (4.3) |
11 (2.1) |
|
|
Estado crónico |
0.025‡ |
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|
Independiente |
344 (88.9) |
111 (79.9) |
455 (86.5) |
|
|
Asistencia |
37 (9.6) |
23 (16.5) |
60 (11.4) |
|
|
Confinado |
6 (1.6) |
5 (3.6) |
11 (2.1) |
|
|
NYHA 2-3 |
34 (8.8) |
10 (7.2) |
44 (8.4) |
0.56 |
|
NYHA 4 |
10 (2.6) |
2 (1.4) |
12 (2.3) |
0.44 |
|
IRC |
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|
No TRR |
6 (1.6) |
6 (4.3) |
12 (2.3) |
0.061 |
|
Sí TRR |
3 (0.8) |
1 (0.7) |
4 (0.8) |
0.95 |
|
Tumor sólido |
14 (3.6) |
17 (12.2) |
31 (5.9) |
< 0.001‡ |
|
Inmunosupresión |
9 (2.3) |
17 (12.2) |
26 (4.9) |
< 0.001‡ |
|
EPOC |
8 (2.1) |
7 (5.0) |
15 (2.9) |
0.071 |
|
Esteroide |
0 (0.0) |
2 (1.4) |
2 (0.4) |
0.018‡ |
|
Hipertensión |
166 (42.9) |
42 (30.2) |
208 (39.5) |
0.009‡ |
|
DM |
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|
No complicada |
77 (19.9) |
25 (18.0) |
102 (19.4) |
0.62 |
|
Complicada |
12 (3.1) |
5 (3.6) |
17 (3.2) |
0.78 |
|
IAM previo |
30 (7.8) |
6 (4.3) |
36 (6.8) |
0.17 |
|
Tabaquismo (cantidad) |
7 (1.8) |
2 (1.4) |
9 (1.7) |
0.77 |
|
PA (mmHg)§ |
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|
Sistólica |
110 [100-127] |
100 [90-117] |
110 [96-125] |
< 0.001‡ |
|
Diastólica |
65 [60-73] |
60 [55-70] |
63 [58-72] |
0.005‡ |
|
PAM (mmHg)§ |
80 [70.3-90.7] |
73.3 [66.7-85.3] |
78.3 [70-90] |
< 0.001‡ |
|
FC§ |
78 [68-92] |
90 [78-110] |
80 [70-98] |
< 0.001‡ |
|
FR§ |
18 [16-20] |
20 [18-24] |
19 [17-22] |
< 0.001‡ |
|
Temperatura (oC)*,§ |
36 [36-36.6] |
36.5 [36-37] |
36.2 [36-36.7] |
< 0.001‡ |
|
Glasgow (puntaje)*,§ |
15 [14-15] |
15 [13-15] |
15 [14-15] |
< 0.001‡ |
|
Leucocitos (× 103 cél/μL)*,§ |
8.4 [6.7-11.4] |
11.3 [7.7-15.8] |
9 [6.8-12.7] |
< 0.001‡ |
|
Plaquetas (× 103/μL)*,§ |
206.5 [150-254] |
240 [158-312] |
210 [150-266] |
0.010‡ |
|
Creatinina (mg/dL)*,§ |
0.98 [0.74-1.27] |
1 [0.75-1.5] |
0.98 [0.75-1.3] |
0.22 |
|
Bilirrubina (mg/dL)*,§ |
0.45 [0.23-0.8] |
0.5 [0.27-0.94] |
0.5 [0.24-0.84] |
0.045‡ |
|
pH alto*,§ |
7.35 [7.34-7.37] |
7.35 [7.3-7.4] |
7.35 [7.33-7.38] |
0.64 |
|
pH bajo*,§ |
7.35 [7.35-7.38] |
7.35 [7.3-7.38] |
7.35 [7.33-7.38] |
0.035‡ |
|
Urea (mg/dL)* |
38.5 [28-57] |
41.35 [25.7-74] |
40 [27.8-59] |
0.20 |
|
Ventilación mecánica (días) |
27 (7.0) |
34 (24.5) |
61 (11.6) |
< 0.001‡ |
|
Días VM* |
1 [1-2] |
9 [3-15] |
3 [1-10] |
< 0.001‡ |
|
Alto flujo |
34 (8.8) |
32 (23.0) |
66 (12.5) |
< 0.001‡ |
|
Uso vasopresor |
86 (22.2) |
78 (56.1) |
164 (31.2) |
< 0.001‡ |
|
Glucosa (mg/dL)*,§ |
121.3 [101.3-157.4] |
116.45 [101.7-147.5] |
119.7 [101.5-154.9] |
0.22 |
|
Procalcitonina (ng/mL)*,§ |
0.33 [0.12-1.37] |
0.55 [0.13-2.09] |
0.43 [0.12-1.64] |
0.19 |
|
Procalcitonina (última vez medida) (mg/dL)* |
0.33 [0.12-1.32] |
0.29 [0.12-0.83] |
0.32 [0.12-1] |
0.63 |
|
DM = diabetes mellitus. EPOC = enfermedad pulmonar obstructiva crónica. FC = frecuencia cardiaca. FR = frecuencia respiratoria. GMM = gastos médicos mayores. IAM = infarto agudo al miocardio. IMC = índice de masa corporal. IRC = insuficiencia renal crónica. NYHA = escala de la Asociación Cardiaca de Nueva York. ONR = orden de no resucitar. PA = presión arterial. PAM = presión arterial media. SAPS = Simplified Acute Physiologic Score (Puntuación Simplificada de Fisiología Aguda). SCCM = Sociedad Mexicana de Medicina Critica. TRR = terapia de remplazo renal. VM = ventilación mecánica. * Los datos continuos se presentan como mediana [rango intercuartílico] y los categóricos con n (%). ‡ Estadísticamente significativo (p < 0.05). § Laboratorio de la primera hora. |
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