Factores asociados a severidad del asma bronquial en menores de 5 años. Hospital del Niño Dr. Francisco Icaza Bustamante
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Fundamentación: A pesar de los grandes adelantos en el conocimiento y el tratamiento
del asma bronquial, las tasas de morbilidad aumentan de forma directamente proporcional
a los avances científicos alcanzados y frente a la multitud de nuevas modalidades
terapéuticas. Objetivo: Determinar los factores clínicos predictivos asociados a la
severidad de las crisis asmáticas en menores de cinco años en el Hospital del Niño “Dr.
Francisco de Icaza Bustamante” en el año 2016. Metodología: Se realizó un estudio con
una muestra de 51 casos, con los que se realizó un estudio con enfoque cuantitativo,
diseño no experimental, de corte transversal, retrospectivo, observacional. Los datos se
recolectaron mediante la aplicación de una encuesta diseñada a los efectos del estudio y
se procesaron con el SPSS 24.0, utilizándose chi-cuadrado con un intervalo de confianza
del 95% (p<0,05). Resultados: Existió un predominio del sexo masculino (58,8%) y el
47,1% de los pacientes estaban en edades entre 12 y 35 meses. El 54,9% de los casos
presentaron antecedentes personales de hospitalizaciones por AB y el 68,6% tenían
familiares con AB. Según el Pulmonary Score, la mayoría de los pacientes (74,5%)
presentaron frecuencia respiratoria de 46 a 60 por minuto, sibilancia al final de la
espiración (76,5%) y un incremento leve del uso de músculos accesorios (82,4%),
existiendo asociación (p<0,05) con la clasificación de la crisis. Según el puntaje de Wood-
Downes modificada por Ferrés, se demostró, además, tiraje subcostal o intercostal inferior
en el 82,4% de los casos, frecuencia cardiaca por encima de 120 por minuto (64,7%), con
buena entrada de aire (60,8%) y sin cianosis en el 96,1% de los casos. Conclusiones: Se
pudo comprobar una asociación entre cada una de las variables del Pulmonary Score y
del puntaje de Wood-Downes modificada por Ferrés y la clasificación de la crisis de asma
bronquial. No existe asociación estadísticamente significativa entre la severidad de las
crisis y las variables consideradas como factores de riesgo.
Background: In spite of the great advances in the knowledge and treatment of bronchial asthma, the morbidity rates increase directly proportional to the scientific advances achieved and the multitude of new therapeutic modalities. Objective: To determine the predictive clinical factors associated with the severity of asthma attacks in children under five years of age at the "Dr. Francisco de Icaza Bustamante" Child Hospital in the year 2016. Methodology: A study was carried out with a sample of 51 cases, with a quantitative approach, non-experimental, cross-sectional, retrospective and observational design. The data were collected by applying a survey designed for the purposes of the study and processed with the SPSS 24.0, using chi-square test with a 95% confidence interval (p<0,05). Results: There was a predominance of males (58,8%) and 47,1% of patients were between 12 and 35 months. 54,9% of the cases had a personal history of hospitalizations for BA and 68,6% had family members with BA. According to the Pulmonary Score, the majority of patients (74,5%) had a respiratory rate of 46 to 60 per minute, wheeze at the end of expiration (76,5%) and a slight increase in the use of accessory muscles (82,4%), there being an association (p<0,05) with the classification of the crisis. According to the Wood-Downes score modified by Ferrés, subcostal or inferior intercostal printing was also shown in 82,4% of cases, heart rate above 120 per minute (64,7%), with good air intake (60,8%) and without cyanosis in 96,1% of cases. Conclusions: An association was found between each of the variables of the Pulmonary Score and the Wood-Downes modified by Ferrés, score and the classification of the bronchial asthma crisis. There is no statistically significant association between the severity of the seizures and the variables considered as risk factors.
Background: In spite of the great advances in the knowledge and treatment of bronchial asthma, the morbidity rates increase directly proportional to the scientific advances achieved and the multitude of new therapeutic modalities. Objective: To determine the predictive clinical factors associated with the severity of asthma attacks in children under five years of age at the "Dr. Francisco de Icaza Bustamante" Child Hospital in the year 2016. Methodology: A study was carried out with a sample of 51 cases, with a quantitative approach, non-experimental, cross-sectional, retrospective and observational design. The data were collected by applying a survey designed for the purposes of the study and processed with the SPSS 24.0, using chi-square test with a 95% confidence interval (p<0,05). Results: There was a predominance of males (58,8%) and 47,1% of patients were between 12 and 35 months. 54,9% of the cases had a personal history of hospitalizations for BA and 68,6% had family members with BA. According to the Pulmonary Score, the majority of patients (74,5%) had a respiratory rate of 46 to 60 per minute, wheeze at the end of expiration (76,5%) and a slight increase in the use of accessory muscles (82,4%), there being an association (p<0,05) with the classification of the crisis. According to the Wood-Downes score modified by Ferrés, subcostal or inferior intercostal printing was also shown in 82,4% of cases, heart rate above 120 per minute (64,7%), with good air intake (60,8%) and without cyanosis in 96,1% of cases. Conclusions: An association was found between each of the variables of the Pulmonary Score and the Wood-Downes modified by Ferrés, score and the classification of the bronchial asthma crisis. There is no statistically significant association between the severity of the seizures and the variables considered as risk factors.
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Asma, Indice de severidad de la enfermedad, Pediatría, Hospital del Niño Francisco de Icaza Bustamante, Cantón Guayaquil, Ecuador