Utilidad del ancho de distribución eritrocitaria como predictor de mortalidad intrahospitaria en pacientes con insuficencia cardiaca aguda
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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El Ancho de Distribución Eritrocitaria (ADE) ha sido considerado como un marcador integrador de procesos patológicos que predice un peor pronóstico en la Insuficiencia Cardiaca Aguda (ICA), el cual es un motivo común de internamiento de pacientes adultos. El presente trabajo tuvo como objetivo: determinar la utilidad del ADE como predictor de mortalidad intrahospitalaria en pacientes con ICA. Planteándose un estudio observacional, analítico, retrospectivo de casos y controles. Se usó el programa de análisis estadístico R (R-Gui: Vers: 4.0.3). Se recolectó información de 190 pacientes, de los cuales 95 pacientes fueron fallecidos (casos) y 95 sobrevivientes (controles). Se encontró que el valor promedio de ADE en la muestra general y en cada grupo fue de 14%. En el análisis multivariado el riesgo de muerte por cada punto porcentual de ADE fue de OR: 0.99 (IC 95%: 0.84 – 1.16; p = 0.88). El rendimiento calculado para punto de corte de ADE≥12.65% dió una sensibilidad de 81.1% y especificidad 30.5%, y en ADE≥14.5% una sensibilidad de 31.6% y especificidad 65.3%. La capacidad predictiva de ADE en mortalidad el área bajo la curva ROC fue AUC: 0.51 (IC 95%: 0.42 – 0.59). La Fracción de Eyección del Ventrículo Izquierdo (FEVI) se asoció a mortalidad con un OR.Adj: 0.93 (IC 95%: 0.91 – 0.96; p = 0.0001) y el área bajo la curva ROC fue AUC: 0.72 (IC 95%: 0.65 – 0.79). Se determinó que ADE no demostró ser de utilidad para predecir mortalidad intrahospitalaria en pacientes con ICA, y se halló que la FEVI es un factor predictor independiente de mortalidad.
The Red Blood Cell Distribution Width (RDW) has been considered as an integrating marker of pathological processes that predicts a worse prognosis in Acute Heart Failure (AHF), which is a common reason for hospitalization of adult patients. The present work aimed to: Determine the usefulness of RDW as a predictor of in-hospital mortality in patients with AHF. Posing an observational, analytical, retrospective study of cases and controls. The statistical analysis program R (R-Gui: Vers: 4.0.3) was used. Information was collected from 190 patients, of which 95 patients were deceased (cases) and 95 survivors (controls). The mean value of ADE in the general sample and in each group was found to be 14%. In the multivariate analysis, the risk of death for each percentage point of RDW was OR: 0.99 (95% CI: 0.84 - 1.16; p = 0.88). The performance calculated for the cut-off point of ADE≥12.65% gave a sensitivity of 81.1% and specificity 30.5%, and in ADE≥14.5% a sensitivity of 31.6% and specificity 65.3%. The predictive capacity of RDW in mortality in the area under the ROC curve was AUC: 0.51 (95% CI: 0.42 - 0.59). Left Ventricular Ejection Fraction (LVEF) was associated with mortality with an OR.Adj: 0.93 (95% CI: 0.91 - 0.96; p = 0.0001) and the area under the ROC curve was AUC: 0.72 (95% CI: 0.65 –0.79). It was determined that RDW was not shown to be useful for predicting in-hospital mortality in patients with AHF, and LVEF was found to be an independent predictor of mortality.
The Red Blood Cell Distribution Width (RDW) has been considered as an integrating marker of pathological processes that predicts a worse prognosis in Acute Heart Failure (AHF), which is a common reason for hospitalization of adult patients. The present work aimed to: Determine the usefulness of RDW as a predictor of in-hospital mortality in patients with AHF. Posing an observational, analytical, retrospective study of cases and controls. The statistical analysis program R (R-Gui: Vers: 4.0.3) was used. Information was collected from 190 patients, of which 95 patients were deceased (cases) and 95 survivors (controls). The mean value of ADE in the general sample and in each group was found to be 14%. In the multivariate analysis, the risk of death for each percentage point of RDW was OR: 0.99 (95% CI: 0.84 - 1.16; p = 0.88). The performance calculated for the cut-off point of ADE≥12.65% gave a sensitivity of 81.1% and specificity 30.5%, and in ADE≥14.5% a sensitivity of 31.6% and specificity 65.3%. The predictive capacity of RDW in mortality in the area under the ROC curve was AUC: 0.51 (95% CI: 0.42 - 0.59). Left Ventricular Ejection Fraction (LVEF) was associated with mortality with an OR.Adj: 0.93 (95% CI: 0.91 - 0.96; p = 0.0001) and the area under the ROC curve was AUC: 0.72 (95% CI: 0.65 –0.79). It was determined that RDW was not shown to be useful for predicting in-hospital mortality in patients with AHF, and LVEF was found to be an independent predictor of mortality.
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Insuficiencia cardiaca, Ancho de distribución eritrocitaria, Mortalidad hospitalaria, Pronóstico, Estudios retrospectivos, Epidemiología analítica, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador