Factores asociados a mortalidad en pacientes críticos con síndrome de estrés respiratorio agudo severo por Covid-19 en la unidad de cuidados intensivos de un hospital público

Abstract

Determinar los factores asociados a mortalidad en pacientes críticos con síndrome de distrés respiratorio agudo severo por COVID-19 en la unidad de cuidados intensivos. Material y métodos: Se realizó mediante un estudio transversal analítico en el que se incluyeron 176 historias clínicas de pacientes de unidad de cuidado intensivos con síndrome de distrés respiratorio agudo severo por COVID-19, según criterios de selección se dividieron en dos grupos: uno de los pacientes que presentan factores de riesgo para mortalidad y otro de los pacientes que no presentan factores de riesgo para mortalidad, estos grupos se subdividen según fallezcan o sobrevivan. Resultados: Se halló una mortalidad de 57% del total de pacientes, al realizar el análisis multivariado se encontró asociación estadística significativa en la presencia de comorbilidades medidas con el Índice de Charlson (RPa=1.348; IC 95%: 1.01-1.79; p=0.040) y dentro de los parámetros ventilatorios en la presión pico (RPa=1.261 IC; 95%: 1.13-1.40; p<=0.000). Conclusión: Los factores asociados a mortalidad en pacientes con SDRA por COVID-19 fueron la presencia de comorbilidades y el incremento de la presión pico dentro de los parámetros ventilatorios.

To determine the factors associated with mortality in critically ill patients with severe acute respiratory distress syndrome due to COVID-19 in the intensive care unit. Material and methods: Analytical cross-sectional study. A database obtained from 176 medical records of patients with severe acute respiratory distress due to COVID-19 was used in a public hospital in Trujillo from March 2020 to June 2021. According to selection criteria, the patients were divided into two groups: a group of patients who present risk factors for mortality and another group of patients who do not present risk factors for mortality. These groups are subdivided according to whether patients die or survive. A bivariate analysis was performed and with the factors that were statistically significant, a multivariate analysis was performed to determine variables associated with mortality. Results: A mortality of 57% of the total number of patients was found, when performing the multivariate analysis, a significant statistical association was found in the presence of comorbidities measured with the Charlson Index (RPa = 1.348; 95% CI: 1.01-1.79; p = 0.040) and within the ventilatory parameters at peak pressure (RPa = 1.261 CI; 95%: 1.13-1.40; p <= 0.000). Conclusion: The factors associated with mortality in patients with ARDS due to COVID-19 were the presence of comorbidities and the increase in peak pressure within the ventilatory parameters.