Utilidad del puntaje cándida y regla de nebraska para pronosticar candidiasis invasiva en el paciente crítico
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2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Candidiasis invasiva es la enfermedad fúngica oportunista más frecuente en los pacientes ingresados en el área de cuidados críticos
OBJETIVO: Establecer la Utilidad del puntaje Cándida y regla de Nebraska para pronosticar Candidiasis Invasiva en el paciente crítico del Hospital de Niños Dr. Roberto Gilbert, durante el periodo 1 de mayo del 2018 hasta 1 de junio 2019.
METODOLOGÍA: Estudio analítico, observacional, correlacional, ambispectivo, con una muestra de 199 pacientes del grupo y periodo objetivo, información obtenida del sistema Informático SERVINTE, se elaboró un base de datos en Excel 2013 con posterior análisis estadístico con el software R.
RESULTADOS:
Los lactantes menores con el 48.2% fue el grupo prevalente que al aplicar los índices predictivos se los identificó de alto riesgo para CI, prevaleció el sexo masculino con el 71.4% del total de la muestra.
Los factores de riesgo prevalentes para CI, CVC (99%), ATB de amplio espectro (97%), aplicando los índices predictivos los que presentaron evidencia altamente significativa fueron: colonización por cándida, días de Estancia hospitalaria previo ingreso a UCIP, Nutrición parenteral y cirugía abdominal. De acuerdo a los resultados que arrojó el software R, se puede indicar que el Puntaje de Cándida tiene una Sensibilidad del 78.78%, con un intervalo de confianza al 95% de (61% - 91%) y una especificidad del 90%. Regla de Nebraska presentó una sensibilidad del 100% en este estudio con un intervalo de confianza al 95% (89% – 100%), y especificidad del 64%, encontrándose en nivel excelente con respecto a Puntaje Cándida.
Invasive candidiasis is the most common opportunistic fungal disease in patients admitted to the critical care area OBJECTIVE: Establish the Utility of the Candida score and Nebraska rule to predict Invasive Candidiasis in the critical patient of Dr. Roberto Gilbert Children's Hospital, during the period of May 1, 2018 until June 1, 2019. METHODOLOGY: Analytical, observational, correlational, ambispective study, with a sample of 199 patients of the target group and period, information obtained from the SERVINTE Computing system, a database was prepared in Excel 2013 with subsequent statistical analysis in the R software. RESULTS: Younger infants with 48.2% were the prevalent group that, when applying the predictive indexes, were identified as high risk for IC, the male sex prevailed with 71.4% of the total sample. The prevailing risk factors for IC, CVC (99%), broad spectrum ATB (97%), applying the predictive indexes those that presented highly significant evidence were: candida colonization, days of hospital stay prior to admission to PICU, parenteral nutrition and abdominal surgery. According to the results of the R software, it can be indicated that the Candida Score has a Sensitivity of 78.78%, with a 95% confidence interval of (61% - 91%) and a specificity of 90%. Nebraska Rule presented a sensitivity of 100% in this study with a confidence interval of 95% (89% - 100%), and specificity of 64%, being in an excellent level with respect to Candida Score.
Invasive candidiasis is the most common opportunistic fungal disease in patients admitted to the critical care area OBJECTIVE: Establish the Utility of the Candida score and Nebraska rule to predict Invasive Candidiasis in the critical patient of Dr. Roberto Gilbert Children's Hospital, during the period of May 1, 2018 until June 1, 2019. METHODOLOGY: Analytical, observational, correlational, ambispective study, with a sample of 199 patients of the target group and period, information obtained from the SERVINTE Computing system, a database was prepared in Excel 2013 with subsequent statistical analysis in the R software. RESULTS: Younger infants with 48.2% were the prevalent group that, when applying the predictive indexes, were identified as high risk for IC, the male sex prevailed with 71.4% of the total sample. The prevailing risk factors for IC, CVC (99%), broad spectrum ATB (97%), applying the predictive indexes those that presented highly significant evidence were: candida colonization, days of hospital stay prior to admission to PICU, parenteral nutrition and abdominal surgery. According to the results of the R software, it can be indicated that the Candida Score has a Sensitivity of 78.78%, with a 95% confidence interval of (61% - 91%) and a specificity of 90%. Nebraska Rule presented a sensitivity of 100% in this study with a confidence interval of 95% (89% - 100%), and specificity of 64%, being in an excellent level with respect to Candida Score.
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CANDIDIASIS INVASIVA, PUNTAJE, REGLA, PACIENTE, NEBRASKA, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTON GUAYAQUIL, ECUADOR