Hiponatremia como factor de riesgo de muerte en pacientes internados por neumonia adquirida en la comunidad / Hyponatremia as a risk factor of death in patients with community-acquired pneumonia requiring hospitalization
Medicina (B.Aires)
; 66(6): 505-511, 2006. tab
Article
in Es
| LILACS
| ID: lil-453017
Responsible library:
BR1.1
RESUMEN
Investigamos si la hiponatremia es un factor de riesgo de muerte en pacientes internados por neumoníaadquirida en la comunidad (NAC) y estimamos el peso relativo de otros factores de riesgo de muerte por NAC, en un estudio de cohorte, prospectivo, multicéntrico, en 5 Servicios de Clínica Médica del Area Metropolitana de Buenos Aires. Evaluamos adultos con NAC ingresados entre 21 de marzo de 2000 y 21 de diciembre del mismo año. Los factores de riesgo que mostraron asociación con evolución por análisis univariado, fueron sometidos a análisis de regresión logística, con un nivel de significación de α de 0.05. En 9 meses seinternaron 238 pacientes con NAC 150 (63%) varones y 88 (36%) mujeres, con edades medias 52.99 (±20.35)y 55.06 (±20.94) años, respectivamente. Fallecieron 25/238 (10.5%). En análisis multivariado, se asociaron significativamente con evolución enfermedad vascular encefálica (EVE) (B 2.614, p<0.001, RRE 13.6, IC 95% 3.7-49.6); hiponatremia al ingreso o durante la internación (B 1.994, p<0.001, RRE 7.3, IC 95% 2.5-20.8); urea plasmática elevada (B 0.016, p= 0.003, RRE 1.016, IC 95% 1.005-1.02). Desarrollamos una fórmula deprobabilidad de fallecer por NAC P (óbito)= 1/1+ exp. (-4.03 + 2.61x1 + 1.99x2 + 0.016x3), donde x1= EVE(sí =1/no =0); x2= hiponatremia (sí =1/no =0); x3 = urea plasmática (mg/dl). La predictibilidad fue 91.1%. Elriesgo de fallecer por NAC fue significativamente mayor entre quienes presentaron EVE, hiponatremia y ureaplasmática elevada
ABSTRACT
We investigated whether hyponatremia is a risk factor of death in patients hospitalized with community-acquired pneumonia (CAP) and estimated the relative risk of death by CAP of otherrisk factors. The design was prospective multicentre cohort study. In 5 centers in Buenos Aires, Argentina, westudied adults hospitalized with CAP between March 21, 2000 and December 21, 2000. Using stepwise logisticregression, we analyzed risk factors that showed a univariate association with mortality; α significance level was0.05. During a 9-month period, 238 patients were admitted with CAP 150 (63%) male and 88 (36%) female,mean age 52.99 (±20.35) and 55.06 (±20.94), respectively. Mortality was 10.5% (25/238). By multivariate analysis, the following variables were statistically associated with evolution cerebrovascular disease (CD) (B 2.614,p<0.001, RRE 13.6, IC 95% 3.7-49.6); hyponatremia at admission or during hospitalization (B 1.994, p<0.001, RRE 7.3, IC 95% 2.5-20.8); and elevated blood urea (B 0.016, p= 0.003, RRE 1.016, IC 95% 1.005-1.02). We developed a formula to predict mortality by CAP P (death) = 1/1+ exp (-4.03 + 2.61x1 + 1.99x2 + 0.016x3), where x1= CD (yes=1/no =0); x2= hyponatremia (yes=1/no =0); x3 = blood urea (mg/dl). The predictability was 91.1%. The mortality risk by CAP was statistically higher in patients with CD, hyponatremia and elevated blood urea
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Pneumonia
/
Hospital Mortality
/
Community-Acquired Infections
/
Hyponatremia
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Argentina
Language:
Es
Journal:
Medicina (B.Aires)
Journal subject:
MEDICINA
Year:
2006
Document type:
Article
Affiliation country:
Country of publication: