Glucemia como factor de riesgo en pacientes internados en la Unidad de Cuidados Intensivos de Adultos del Hospital de Clínicas.
DOI:
https://doi.org/10.18004/Palabras clave:
Glucemia, factor de riesgo, Unidad de Cuidados Intensivos, ParaguayResumen
Objetivo: Determinar la relación entre glucemias al ingreso y la evolución de los pacientes admitidos a la Unidad de Cuidados Intensivos de Adultos (UCIA). Material y Métodos: estudio de cohorte retrospectivo de pacientes en la UCIA, tomando un muestreo, según distintos estratos de glucemia en mg/dL (Gl65; G2 66 a 79; G3 80 a 199 y G4200). Resultados: 413 pacientes, con edad media 48.89 años ±19; glucemia media al ingreso de 168.8 mg/dL (±93). 11.9% eran diabéticos conocidos. Al ingreso el Apache II fue 16±9, con una mortalidad global de 39.7%. Se constataron infecciones intrahospitalarias en 22.8%. La mortalidad en G4 fue de 49,5% vs. 35.4% en G3 (RR 1,41 p=0.008); en cirugías programadas fue en G4 de 30.6% y 14.7% en G3 (RR 2,07 p=0,04), con una tendencia significativa en las cirugías cardiacas (RR 2,33 p=0,11) y neurológicas (RR 3,33 p=0,26); la mortalidad en las cirugías de urgencia fue en G4 44,4% vs. 44,1% en G3 (RR 1,01 p=0,97). Los cuadros médicos en general presentaron una mortalidad de 76 % en G4 vs. 45% en G3 (RR 1,53 p=0,004). Los cuadros coronarios reportaron una mortalidad en G4 de 42 % vs. 10% en G3 (RR 7,13 p=0,001); en cuanto a hipoglucemia, existió una tendencia a mayor mortalidad general en G1 en comparación a G2 y G3 (35% vs. 63,6%) (RR 1,80 p=0,05) Conclusiones: La mortalidad general, de cirugías programadas y síndromes coronarios agudos fue mayor en forma significativa cuando la glucemia de ingreso fue 200 mg/dL.
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