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Mortalidad intrahospitalaria y factores pronósticos en pacientes con endocarditis infecciosa en 4 hospitales de Colombia

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dc.contributorRincón, Laura Fernanda
dc.contributorRincón, Silvia Susana
dc.contributorAriza Ordoñez, Nicólas
dc.contributorOliveros Acuña, Natalia
dc.contributorCastro, Génesis Viviana
dc.contributorCruz, José
dc.contributorUribe, Luis Guillermo
dc.contributorOspina, Leonardo
dc.contributorArias, Gerson
dc.contributorKock, Joshua
dc.contributor.advisorMillán, Henry Augusto
dc.contributor.advisorDennis Verano, Rodolfo José
dc.creatorPérez, María Alejandra
dc.creatorZuluaga, Juan David
dc.creator.degreeEspecialista en Medicina Internaspa
dc.creator.degreetypeFull timespa
dc.date.accessioned2019-08-02T22:40:40Z
dc.date.available2019-08-02T22:40:40Z
dc.date.created2019-07-26
dc.date.issued2019
dc.descriptionAntecedentes: La endocarditis infecciosa se ha asociado con mortalidad intrahospitalaria del 12,5% al 22,2%. Objetivo: Estimar los factores pronósticos asociados a mortalidad intrahospitalaria en los pacientes adultos con diagnóstico de Endocarditis infecciosa del año 2007 al año 2017. Metodología: Estudio observacional, analítico, tipo casos y controles multicéntrico; considerando casos los pacientes con mortalidad intrahospitalaria y controles los pacientes con endocarditis infecciosa que no fallecieron durante la hospitalización. Resultados: Se incluyeron 308 pacientes. La mortalidad intrahospitalaria fue de 32,7%. Las principales variables pronósticos fueron: Complicación con terapia de reemplazo renal (OR 6,669 IC 3,77 – 12,17, p<0,001), compromiso mitral moderado (OR 3,9 IC 1,02 -17,5 p= 0,057), terapia de reemplazo renal (TRR) previo a hospitalización (OR 3,72 IC 1,89 – 7,51, p<0,001) y embolia a sistema nervioso central (OR 2,6 IC 1,53 – 4,44, p< 0,001); como factores protectores: cirugía durante hospitalización (OR 0,39 IC 0,24 – 0,64, p<0,001) y afectación tricúspide (OR 0,39 IC 0,15 – 0,87, p=0,032). Conclusión: El desarrollo de lesión renal aguda con indicación de TRR es el principal factor de riesgo para mortalidad intrahospitalaria. La identificación de lesión renal aguda así como la limitación de los factores de riesgo propios de la misma puede reducir la mortalidad condicionada por este factor. La realización de cirugía durante hospitalización es el factor de buen pronóstico con mayor impacto en mortalidad; la detección de criterios para intervención quirúrgica debe enfatizarse durante el manejo de esta población.spa
dc.description.abstractBackground: Infective endocarditis has been associated with in-hospital mortality from 12.5% to 22.2%. Objective: To estimate the prognostic factors associated with in-hospital mortality in adult patients with a diagnosis of infectious endocarditis from 2007 to 2017. Methodology: Observational, analytical study, type cases and multicentric controls; considering patients with in-hospital mortality and controls patients with infective endocarditis who did not die during hospitalization. Results: 308 patients were included. In-hospital mortality was 32.7%. The main prognostic variables were: Complication with renal replacement therapy (OR 6,669 CI 3.77-12.17, p <0.001), moderate mitral compromise (OR 3.9 CI 1.02 -17.5 p = 0.057), Renal replacement therapy (RRT) prior to hospitalization (OR 3.72 CI 1.89 - 7.51, p <0.001) and central nervous system embolism (OR 2.6 CI 1.53 - 4.44, p < 0.001); as protective factors: surgery during hospitalization (OR 0.39 CI 0.24 - 0.64, p <0.001) and tricuspid involvement (OR 0.39 IC 0.15 - 0.87, p = 0.032). Conclusion: The development of acute renal injury with indication of RRT is the main risk factor for in-hospital mortality. The identification of acute renal injury as well as the limitation of the risk factors of the same can reduce the mortality conditioned by this factor. The performance of surgery during hospitalization is the factor of good prognosis with the greatest impact on mortality; The detection of criteria for surgical intervention should be emphasized during the management of this population.spa
dc.description.embargo2020-08-03 01:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2020-08-02
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dc.identifier.doihttps://doi.org/10.48713/10336_20040
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/20040
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Medicina Internaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectEndocarditisspa
dc.subjectEndocarditis bacterianaspa
dc.subjectMortalidad hospitalariaspa
dc.subjectPronósticospa
dc.subject.ddcEnfermedadesspa
dc.subject.keywordEndocarditiseng
dc.subject.keywordBacterial endocarditiseng
dc.subject.keywordHospital mortalityeng
dc.subject.keywordPrognosiseng
dc.subject.lembEndocarditis bacterianaspa
dc.subject.lembPronóstico medicospa
dc.subject.lembMortalidadspa
dc.titleMortalidad intrahospitalaria y factores pronósticos en pacientes con endocarditis infecciosa en 4 hospitales de Colombiaspa
dc.typemasterThesiseng
dc.type.documentTesisspa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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