Índice leuco-glucémico asociado con complicaciones en isquemia cerebral aterotrombótica / Leuco-glycemic index associated to complications in atherothrombotic cerebral ischemia

RESUMEN

Resumen: OBJETIVO: Evaluar el índice leuco-glucémico (ILG) como marcador pronóstico de mortalidad y complicaciones en pacientes con enfermedad vascular cerebral de tipo isquémico aterotrombótico. MATERIAL Y MÉTODO: Estudio prospectivo efectuado en pacientes con enfermedad vascular de tipo isquémico aterotrombótico durante la fase aguda del infarto, que ingresaron entre enero y diciembre de 2017 al servicio de Medicina Interna del Hospital General Ticomán. Se recolectaron datos clínicos y de laboratorio, incluyendo glucemia y leucograma al ingreso, a partir de los cuales se calculó el ILG y se evaluó su valor pronóstico, así como su relación con las escalas de NIHSS y Rankin y con la mortalidad a 21 días. RESULTADOS: Se incluyeron 72 pacientes. Los pacientes con mayor número de complicaciones durante la hospitalización tuvieron valores superiores de ILG (p = 0.02). Se obtuvo un valor ≥ 900 como punto de corte; los pacientes con valores superiores tuvieron tres veces mayor probabilidad de complicaciones durante la hospitalización (razón de momios = 3.02; IC95%: 1.03 a 9.9; p = 0.04), por lo que el índice leuco-glucémico constituyó un predictor significativo. CONCLUSIONES: El índice leuco-glucémico se relacionó con mayor severidad de enfermedad vascular cerebral en las escalas de NIHSS y Rankin, además, se asoció con complicaciones intrahospitalarias.

ABSTRACT

Abstract: BACKGROUND: The glycemia and the determination of serum leukocytes on admission have demonstrated prognostic importance in patients with ischemic cerebral vascular disease (CVD). The leuko-glycemic index (ILG) is recently studied as a prognostic marker, but knowledge about its value is lacking. OBJECTIVE: To evaluate the leuko-glycemic index (ILG) as a prognostic marker of mortality and complications in patients with atherothrombotic ischemic stroke. MATERIAL AND METHOD: A prospective study was conducted on patients with atherothrombotic ischemic vascular disease during the acute phase of the infarction, who were admitted to the Internal Medicine Department of the Ticoman General Hospital from January to December 2017. Clinical and laboratory data were collected, including glycemia and leukogram at admission, from which the ILG was calculated and its prognostic value was evaluated, as well as its relationship with the NIHSS and Rankin scales and/or with the 21-day mortality. RESULTS: There were included 72 patients. Patients with a higher number of complications during hospitalization had higher ILG values (p = 0.02). A value ≥ 900 was obtained as a cut-off point; patients with higher values presented a three times higher probability of complications during hospitalization (odds ratio: 3.02, CI95%: 1.03 to 9.9, p = 0.04), so the ILG was a significant predictor. CONCLUSIONS: Leuko-glycemic index was associated with greater severity of cerebral vascular disease in the NIHSS and Rankin scales, and was associated with intrahospital complications.