ABSTRACT
BACKGROUND /OBJECTIVE: Acute kidney injury (AKI) is a significant complication in critical care units (CCU). Non-neurological complications such as AKI are an independent predictor of poor clinical outcomes, with an increase in morbidity and mortality, financial costs, and worse functional recovery. This work aims to estimate the incidence of AKI and evaluate the risk factors and complications of AKI in neurocritical patients hospitalized in the CCU. METHODS: A retrospective cohort study was conducted. Patients admitted to the neurocritical care unit between 2016 and 2018 with a stay longer than 48 h were retrospectively analyzed in regard to the incidence, risk factors, and outcomes of AKI. RESULTS: The study population comprised 213 neurocritical patients. The incidence of AKI was 23.5%, with 58% KDIGO 1 and 2% requiring renal replacement therapy. AKI was an independent predictor of prolonged use of mechanical ventilation, cerebral edema, and mortality. Cerebral edema [OR 4.40 (95% CI 1.98-9.75) p < 0.001] and a change in chloride levels greater than 4 mmol/L at 48 h (OR 2.44 (95% CI 1.10-5.37) p = 0.027) were risk factors for developing AKI in the first 14 days of hospitalization. CONCLUSION: There is a high incidence of AKI in neurocritical patients; it is associated with worse clinical outcomes regardless of the CCU admission etiology or AKI severity.
Subject(s)
Acute Kidney Injury , Brain Edema , Humans , Retrospective Studies , Brain Edema/complications , Intensive Care Units , Incidence , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Risk Factors , Hospital MortalityABSTRACT
En el sector rural El Manzano de la Comuna de Putaendo, existe un grupo de familias, criadores de ganado caprino, en una precaria situación de salud. Los objetivos de este trabajo son: realizar el diagnóstico de salud, identificar factores de riesgo de salud, demostrar existencia de ruralidad extrema aún en regiones de área geográfica pequeña e iniciar programas de rondas médicas. Metodología: Se realiza visita al sector elaborándose un mapa y se obtienen datos mediante encuesta domiciliaria. Resultados: 71,4 porciento de las familias tienen ingresos igual o inferior al mínimo, el 85,7 porciento de viviendas son mediaguas, ranchos. Existe una distribución de 1,7 personas por cama. El 75 porciento dispone de excretas a campo abierto. Finalmente, se concluye que los factores de riesgo de esta población son: vivienda y saneamiento precario, hacinamiento, insuficiente cobertura médica y ruralidad. Se comprueba ruralidad extrema en la región y se presentará para programa multidisciplinario de mejoramiento de salud. Se plantea que la localidad es muy representativa para futuros estudios de prevalencia
