Factores de riesgo asociados a mortalidad en pacientes pediátricos oncológicos ingresados a cuidados intensivos de un Hospital Universitario en Paraguay: una experiencia de 3 años
Risk factors associated with mortality in pediatric oncology patients admitted to intensive care at a University Hospital in Paraguay: a 3-year experience
DOI:
https://doi.org/10.53732/rccsalud/04.01.2022.63Palabras clave:
mortalidad, factores de riesgo, pediatría, unidades de cuidados intensivos, neoplasiasResumen
Introducción. La supervivencia de los pacientes con neoplasia infantil ha mejorado considerablemente gracias al progreso en el diagnóstico y el tratamiento multidisciplinario. Objetivo. determinar los factores de riesgo de mortalidad de los pacientes ingresados a cuidados intensivos (UCIP) de un hospital de enseñanza en Asunción, Paraguay. Metodología. Se realizó una revisión retrospectiva de las historias clínicas de los pacientes oncológicos ingresados a la UCIP del Hospital de Clínicas de enero 2014 a diciembre 2016. Resultados. De 874 pacientes que ingresaron a la UCIP, 150 (17,2%) fueron pacientes oncológicos. La edad media fue de 9,8 ± 5,2 años; 51% del sexo femenino. Tuvieron reingreso (12%), otra comorbilidad (48%), admisión de urgencia (67,3%). Los días previos de internación en sala fue en promedio 6,5 ± 10,9 y en la unidad de terapia intensiva 6,9 ± 13,7 días. El tipo de cáncer fue en el 52% hematológico. El 82% de los pacientes presentaron falla de uno o más órganos y la mortalidad fue de 19,3%. Varios factores de riesgo para mortalidad se identificaron por el análisis bivariado, pero, por el análisis multivariado solo cinco variables quedaron asociadas con óbito: edad ≥10 años (p=0,047), PIM2 ≥10 (p=0,001), mucositis (p= 0,004), falla neurológica (p= 0,001) y falla renal (p= 0,001). Conclusión. La mortalidad global fue menor a la reportada en otras series, la cual fue mayor en los mayores de 10 años, con mucositis, falla orgánica neurológica y renal.
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