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Acceso Abierto
Evaluación del rendimiento diagnóstico de creatinina comparado con el gasto urinario en lesión renal aguda en pacientes críticamente enfermos. Revisión sistemática y metaanálsis
dc.contributor.advisor | Buitrago Garcia, Diana Carolina | |
dc.creator | Vargas Brochero, Maria José | |
dc.creator | Hurtado Uriarte, Maite | |
dc.creator.degree | Magíster en epidemiología | spa |
dc.creator.degreetype | Full time | spa |
dc.date.accessioned | 2019-10-25T20:47:50Z | |
dc.date.available | 2019-10-25T20:47:50Z | |
dc.date.created | 2019-10-24 | |
dc.description | Introducción: La lesión renal aguda (LRA) está presente en más del 50% de los pacientes en cuidado intensivo (UCI), aumentando la morbilidad y mortalidad. El diagnóstico se realiza con creatinina y gasto urinario (GU), pero no es clara la capacidad diagnostica de estos. Objetivo: comparar el rendimiento diagnóstico de creatinina versus GU en LRA en pacientes críticos. Metodología: Revisión sistemática de la literatura, desde el 2004, sin límite de idiomas, en humanos con LRA en UCI, con diagnóstico basado en creatinina y gasto urinario. Resultados: Se incluyeron 12 estudios en el análisis cualitativo con 41.512 pacientes. Y 4 estudios en el metaanálisis con 36,309 pacientes. Se evaluó sensibilidad y especificidad de GU versus creatinina, en 4 estudios con definición KDIGO encontrando; sensibilidad de 0.66 [IC 95% 0.51 - 0.78] y especificidad de 0.65 [IC 95% 0.48 - 0.79]. Con un OR para GU de 4 (3-5), LR +1,89 (IC 95% 1,4-2,51) y LR - 0,53 (0,44-0,63) y un área bajo la curva ROC de 0,70. Sin embargo pacientes identificados por GU eran falsamente clasificados como falsos positivos. Lo que nos llevó a comparar ambas herramientas contra el constructo. Encontrando: para GU sensibilidad de 0.80 [ IC 95% 0.70 - 0.87) y para creatinina sensibilidad del 0.59 [ IC 95% 0.54 - 0.65]. Conclusión: El GU es una prueba diagnóstica con mayor sensibilidad que la creatinina. Podría permitir mayores diagnósticos y más tempranos. No logramos contestar preguntas sobre impacto en mortalidad y estancia hospitalaria, por lo que deben realizarse estudios adicionales | spa |
dc.description.abstract | Introduction: Acute Kidney Injury (AKI) is present in more than 50% of patients admitted to intensive care (IC), increasing morbidity and mortality. Diagnosis is made using creatinine levels and urinary output (UO), however, it is not known what the diagnostic yield of this approach is. Objective: to compare the diagnostic performance of creatinine versus UO for AKI in critical patients. Methods: Systematic review of literature from 2004, regarding humans with AKI in the ICU, with diagnosis based on creatinine and urinary output. No language limits. Results: 12 studies were included in a qualitative analysis, with a total 41,512 patients. 4 studies were included in the meta-analysis, for a total of 36,309 patients. Sensitivity and specificity of UO versus creatinine were evaluated in 4 studies based on the KDIGO definition, finding a sensitivity of 0.66 [95% CI 0.51 - 0.78] and a specificity of 0.65 [95% CI 0.48 - 0.79]. OR for GU was 4 (3-5), LR +1.89 (95% CI 1.4-2.51) and LR - 0.53 (0.44-0.63) and an area under the ROC curve of 0.70 However, patients identified by UO were more likely to be falsely classified as false positives. Which led us to compare both tools against the construct. Finding: a sensitivity for UO of 0.80 [95% CI 0.70 - 0.87) and for creatinine levels of 0.59 [95% CI 0.54 - 0.65] Conclusion: UO as a diagnostic test has a greater sensitivity than creatinine. It could allow more frequent and earlier diagnoses. We were unable to answer questions about the impact on mortality and hospital stay, thus, additional studies should be carried out. | spa |
dc.description.embargo | 2021-10-26 01:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2021-10-25 | |
dc.format.mimetype | application/pdf | |
dc.identifier.doi | https://doi.org/10.48713/10336_20491 | |
dc.identifier.uri | https://repository.urosario.edu.co/handle/10336/20491 | |
dc.language.iso | spa | spa |
dc.publisher | Universidad del Rosario | spa |
dc.publisher.department | Maestría en Actividad Física y Salud | spa |
dc.publisher.other | Universidad CES | spa |
dc.publisher.program | Maestría en Epidemiología | spa |
dc.rights | Atribución-NoComercial-SinDerivadas 2.5 Colombia | spa |
dc.rights.accesRights | info:eu-repo/semantics/openAccess | |
dc.rights.acceso | Abierto (Texto Completo) | spa |
dc.rights.licencia | EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos. | spa |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/2.5/co/ | |
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dc.source.instname | instname:Universidad del Rosario | spa |
dc.source.reponame | reponame:Repositorio Institucional EdocUR | spa |
dc.subject | Lesión Renal Aguda | spa |
dc.subject | Clasificación | spa |
dc.subject | Creatinina | spa |
dc.subject | Diuresis | spa |
dc.subject.ddc | Ciencias médicas, Medicina | spa |
dc.subject.keyword | Acute Kidney Injury | spa |
dc.subject.keyword | Classification | spa |
dc.subject.keyword | Creatinine | spa |
dc.subject.keyword | Diuresis | spa |
dc.subject.lemb | Medicina | spa |
dc.subject.lemb | Epidemiología | spa |
dc.title | Evaluación del rendimiento diagnóstico de creatinina comparado con el gasto urinario en lesión renal aguda en pacientes críticamente enfermos. Revisión sistemática y metaanálsis | spa |
dc.type | masterThesis | eng |
dc.type.document | Trabajo de grado | spa |
dc.type.hasVersion | info:eu-repo/semantics/acceptedVersion | |
dc.type.spa | Tesis de maestría | spa |
local.department.report | Escuela de Medicina y Ciencias de la Salud | spa |
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