Determinación de procalcitonina como marcador predictivo de sepsis, Hospital Regional 2 IESS Dr. Teodoro Maldonado Carbo 2010-2011
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2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La Sepsis, es un problema que actualmente constituye una de las primeras causas de
morbimortalidad entre la población en general. Este trabajo de investigación tuvo como
objetivo determinar la importancia de la procalcitonina en la sepsis generalizada para
decidir el ingreso en la unidad correspondiente y la necesidad de la conducta terapéutica
más idónea de los pacientes objetos de estudio. Metodológicamente se realizó un
estudio descriptivo, correlacional, longitudinal y prospectivo; cuyo universo estuvo
constituido por todos los pacientes que fueron atendidos por las áreas del Hospital Dr.
Teodoro Maldonado Carbo de la ciudad de Guayaquil, en los años 2010-2011, y la
muestra la constituyeron los pacientes diagnosticados con algún tipo de Infección los
cuales tuvieron la indicación de PCT por parte del médico de turno. Como resultados.
Se incluyeron 300 pacientes atendidos en los distintos servicios con diagnostico
presuntivo de sepsis, el 45 % mujeres y el 55% hombres, siendo el grupo de edad más
afectado el de 60-69 años con el 16 %, la edad promedio 55,8 años. El diagnóstico de
ingreso fue infección de vía respiratoria baja el 27%, infección de aparato genitourinario
con el 23,67%, abdomen agudo con el 21%. El 16,3 % tuvo alto riesgo de sepsis. Con
los valores de Proteína C reactiva se pudo detectar un 51,33% de pacientes con valores
superiores a 20. Los pacientes sometidos a PCT se llegó al diagnóstico definitivo de
sepsis grave en el 41%, sepsis 31,67%, shock séptico en el 8% y SIRS en el 19,30%.El
uso de procalcitonina tuvo 80% de aciertos de diagnósticos de sepsis grave
(sensibilidad).El uso de Proteína C Reactiva 53 % de aciertos de diagnósticos de sepsis
grave (sensibilidad). La capacidad de rechazar pacientes que no tenían sepsis grave fue
de 59 %.
Sepsis is a problem that is now one of the leading causes of morbidity and mortality among the general population. This research aimed to determine the importance of procalcitonin in generalized sepsis to decide entry into the drive and need the most appropriate therapeutic management of patients under study. Methodologically descriptive, correlational, longitudinal and prospective study was performed, whose universe consisted of all patients who were seen by the area’s of Hospital Dr. Teodoro Maldonado Carbo city of Guayaquil, in the years 2010-2011, and the sample comprised patients diagnosed with some kind of infection which had the indication of PCT by the attending physician. As results. 300 patients treated in different services with a presumptive diagnosis of sepsis, 45% women and 55 % men were included, and being the most affected age group of 60-69 years with the 21%, mean age 55.8 years. The admission diagnosis was low respiratory tract infection 27%, genitourinary tract infection with 23.67% , acute abdomen with 16% . 16.3% had high risk of sepsis. With the values of C-reactive protein could detect 51.33 % of patients with values above 20. Patients undergoing PCT reached the final diagnosis of severe sepsis in 41%, 31.67% sepsis, septic shock in 8% and 19.30% in the SIRS. Use of procalcitonin was 80 % correct diagnoses severe sepsis (sensitivity). Use of Protein C 53 % correct diagnoses of severe sepsis (sensitivity). The ability to reject patients without severe sepsis was 59 %
Sepsis is a problem that is now one of the leading causes of morbidity and mortality among the general population. This research aimed to determine the importance of procalcitonin in generalized sepsis to decide entry into the drive and need the most appropriate therapeutic management of patients under study. Methodologically descriptive, correlational, longitudinal and prospective study was performed, whose universe consisted of all patients who were seen by the area’s of Hospital Dr. Teodoro Maldonado Carbo city of Guayaquil, in the years 2010-2011, and the sample comprised patients diagnosed with some kind of infection which had the indication of PCT by the attending physician. As results. 300 patients treated in different services with a presumptive diagnosis of sepsis, 45% women and 55 % men were included, and being the most affected age group of 60-69 years with the 21%, mean age 55.8 years. The admission diagnosis was low respiratory tract infection 27%, genitourinary tract infection with 23.67% , acute abdomen with 16% . 16.3% had high risk of sepsis. With the values of C-reactive protein could detect 51.33 % of patients with values above 20. Patients undergoing PCT reached the final diagnosis of severe sepsis in 41%, 31.67% sepsis, septic shock in 8% and 19.30% in the SIRS. Use of procalcitonin was 80 % correct diagnoses severe sepsis (sensitivity). Use of Protein C 53 % correct diagnoses of severe sepsis (sensitivity). The ability to reject patients without severe sepsis was 59 %
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Sepsis, Polipéptido alfa relacionado con calcitonina, Diagnóstico, Epidemiología descriptiva, Estudios prospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador