Factores de riesgo de infección asociados a uso de catéteres venosos periféricos para hemodiálisis, Hospital Regional del IESS Dr. Teodoro Maldonado Carbo período 2008-2010
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2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La enfermedad renal crónica (ERC) tiene una alta prevalencia y en fases terminales requiere de tratamiento dialítico. La hemodiálisis es utilizada por un 20% de estos pacientes. La infección del catéter periférico para hemodiálisis es frecuente entre estos, pudiendo dar lugar a varias complicaciones, con una mortalidad del 10% al 20%. Se ha probado que la profilaxis de la infección del catéter mediante protocolo es altamente efectivo para evitar el desarrollo de este problema, para esto es fundamental identificar los factores de riesgo relacionados su aparición. En la Unidad de Hemodiálisis el hospital Regional 2 del IESS “Dr. Teodoro Maldonado Carbo” se ha reportado una prevalencia de infección del catéter periférico del 40%. Por este motivo se realizó un estudio de tipo observacional, correlacional de diseño no experimental, longitudinal retrospectivo en el que se incluyeron por aleatorización sistemática, 50 pacientes en los que se presentó infección y 50 pacientes en los que esto no sucedió, que fueron atendidos en el periodo 01 de diciembre de 2008 a 30 de noviembre de 2010, comparándose los factores de riesgo presentes en ambos. En los grupos que se infectaron y en aquellos que no lo hicieron, la mayoría tuvo entre 60 y 69 años (32% y 40%). La proporción de casos de sexo masculino fue similar también: 68% en los que se complicaron y 76% en los que no. Factores como el tiempo de permanencia, el número de procedimientos, el tipo de patología, el tipo de catéter, la técnica y lugar de inserción no influyeron significativamente en el riesgo de desarrollar infección. El factor que contribuyó a aumentar el riesgo de desarrollar infección fue la presencia coágulos en el catéter (74% y 4%) (OR 68,30; IC95% 14,50-321;58).
Chronic kidney disease (CKD) is highly prevalent and terminal phases requires dialysis. Hemodialysis is used by 20% of these patients. Infection of peripheral catheter for hemodialysis is common among these, can lead to several complications, with a mortality of 10% to 20%. It has been proven that prophylaxis of catheter infection by protocol is highly effective in preventing the development of this problem, it is essential to identify risk factors for its occurrence. In the Hemodialysis Unit - Teodoro Maldonado Hospital, has reported an infection prevalence of 40% peripheral catheter. That is why a case-control study that included by systematic randomization, 50 patients who had infection and 50 patients who did not happen, who were seen in the period 1 December 2008 to 30 November 2010, compared the risk factors present in both. The analysis compared the groups with chi2 test and Fisher's exact test, the odds ratio. In the groups that were infected and those who did, most had between 60 and 69 years (32% and 40%). The proportion of male cases was also similar: 68% in those who were complicated and 76% in those without. Factors such as the length of stay, number of procedures, type of disease, type of catheter, technique and insertion site did not significantly influence the risk of infection. The factor that contributed to increase the risk of infection was the presence clots in the catheter (74% and 4%) (OR 68.30, 95% CI 14.50 to 321, 58).
Chronic kidney disease (CKD) is highly prevalent and terminal phases requires dialysis. Hemodialysis is used by 20% of these patients. Infection of peripheral catheter for hemodialysis is common among these, can lead to several complications, with a mortality of 10% to 20%. It has been proven that prophylaxis of catheter infection by protocol is highly effective in preventing the development of this problem, it is essential to identify risk factors for its occurrence. In the Hemodialysis Unit - Teodoro Maldonado Hospital, has reported an infection prevalence of 40% peripheral catheter. That is why a case-control study that included by systematic randomization, 50 patients who had infection and 50 patients who did not happen, who were seen in the period 1 December 2008 to 30 November 2010, compared the risk factors present in both. The analysis compared the groups with chi2 test and Fisher's exact test, the odds ratio. In the groups that were infected and those who did, most had between 60 and 69 years (32% and 40%). The proportion of male cases was also similar: 68% in those who were complicated and 76% in those without. Factors such as the length of stay, number of procedures, type of disease, type of catheter, technique and insertion site did not significantly influence the risk of infection. The factor that contributed to increase the risk of infection was the presence clots in the catheter (74% and 4%) (OR 68.30, 95% CI 14.50 to 321, 58).
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Insuficiencia renal crónica, Catéter venoso periférico, Infección, Diálisis renal, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Estudios retrospectivos