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Puntaje APP como predictor de mortalidad en pacientes con síndrome de dificultad respiratoria agudo grave por COVID-19 en un hospital referencial del norte del Perú / APP score as a predictor of mortality in patients with severe acute respiratory distress syndrome due to COVID-19 in a reference hospital in northern of Peru
Vásquez-Tirado, Gustavo Adolfo; Álvarez-Zárate, Laura Paola.
Affiliation
  • Vásquez-Tirado, Gustavo Adolfo; Universidad Privada Antenor Orrego. Facultad de Medicina. Trujillo. PE
  • Álvarez-Zárate, Laura Paola; Hospital Regional Docente de Trujillo. Unidad de Cuidados Intensivos. Trujillo. PE
Rev. chil. infectol ; 40(6): 626-633, dic. 2023. tab, graf
Article in Spanish | LILACS | ID: biblio-1529992
Responsible library: CL1.1
RESUMEN

INTRODUCCIÓN:

La mortalidad por pacientes por COVID-19 grave que desarrollaban neumonía grave y síndrome de dificultad respiratoria agudo (SDRA) grave ha sido significativa a pesar del tratamiento oportuno. Es importante determinar predictores tempranos de enfermedad que nos ayuden a estratificar aquellos pacientes con mayor riesgo de fallecer. Se pretende estudiar el comportamiento del puntaje APP (APPS) como predictor de ello, basados en algunos reportes de uso y utilidad en el SDRA. no COVID-19.

OBJETIVO:

Determinar si el APPS es útil como predictor de mortalidad en SDRA. por COVID-19 grave. PACIENTES Y

MÉTODO:

Se realizó un estudio tipo cohorte retrospectivo, incluyendo pacientes de la Unidad de Cuidados Intensivos (UCI), con SDRA. por COVID-19 grave, que ingresaron a la UCI del Hospital Regional Docente de Trujillo (HRDT) en el período abril 2020- abril 2021. Se evalúo la utilidad del APPS como predictor de mortalidad em dicha población.

RESULTADOS:

El APPS demostró ser un factor asociado a mortalidad en pacientes con SDRA. y COVID-19 grave (RPa 1,34; IC 95% 1,16 a 1,56; p < 0,001). Además, encontramos que, al realizar un modelo de predicción ajustado por edad, sexo, SOFA, APPS, shock, Indice de Charlson (ICh), se comportan como factores asociados a mortalidad el APPS, el sexo masculino (RPa 1,48; IC 95% 1,09 a 2,049; p < 0,05) y el ICh (RPa 1,11; IC 95% 1,02 a 1,21; p < 0,05).

CONCLUSIÓN:

El APPS, el sexo masculino y el ICh son predictores de mortalidad en SDRA. por COVID-19 grave.
ABSTRACT

BACKGROUND:

Mortality in patients with severe COVID-19 who developed severe pneumonia and severe Acute Respiratory Distress Syndrome (ARDS) has been significant despite timely treatment. It is important to determine early predictors of disease that help us to stratify those patients with a higher risk of death. It is intended to study the behavior of the APPS score as a predictor of this, based on some reports of use and usefulness in non-COVID-19 ARDS.

AIM:

To determine if the APP score is useful as a predictor of mortality in ARDS due to severe COVID-19.

METHOD:

A retrospective cohort study was carried out, including patients from the Intensive Care Unit (ICU) with ARDS due to severe COVID-19 who were admitted to the ICU of the Trujillo Regional Teaching Hospital (HRDT) in the period March 2020 to March 2021. The usefulness of the APP score as a predictor of mortality in mentioned population was evaluated.

RESULTS:

The APP score proved to be a factor associated with mortality in patients with ARDS and severe COVID-19 (APR 1.34; 95% CI 1.16 to 1.56; p < 0.001). We also found that when performing a prediction model adjusted for age, sex, SOFA, APP score, shock and Charlson Index (ICh) we found that the APP score, male sex (APR 1.48; 95% CI 1.09 to 2.049; p < 0.05) and the ICh behave as factors associated with mortality (RPa 1.11; 95% CI 1.02 to 1.21; p < 0.05).

CONCLUSION:

The APP score, male sex, and ICh are predictors of mortality in ARDS due to severe COVID-19.
Subject(s)


Full text: Available Collection: International databases Health context: SDG3 - Health and Well-Being Health problem: Target 3.4: Reduce premature mortality due to noncommunicable diseases Database: LILACS Main subject: Respiratory Distress Syndrome, Newborn / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male Country/Region as subject: South America / Peru Language: Spanish Journal: Rev. chil. infectol Journal subject: Communicable Diseases Year: 2023 Document type: Article Affiliation country: Peru Institution/Affiliation country: Hospital Regional Docente de Trujillo/PE / Universidad Privada Antenor Orrego/PE

Full text: Available Collection: International databases Health context: SDG3 - Health and Well-Being Health problem: Target 3.4: Reduce premature mortality due to noncommunicable diseases Database: LILACS Main subject: Respiratory Distress Syndrome, Newborn / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male Country/Region as subject: South America / Peru Language: Spanish Journal: Rev. chil. infectol Journal subject: Communicable Diseases Year: 2023 Document type: Article Affiliation country: Peru Institution/Affiliation country: Hospital Regional Docente de Trujillo/PE / Universidad Privada Antenor Orrego/PE
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