Palabras clave
hematíes
cuidados intensivos
mortalidad
pronóstico
Cómo citar
Resumen
OBJETIVO: evaluar si la transfusión de concentrados de hematíes (CH) en el paciente crítico en nuestra Unidad de Cuidados Intensivos (UCI) se asocia a mayor mortalidad.
DISEÑO: Estudio retrospectivo y observacional realizado desde enero de 2009 a diciembre de 2018.
ÁMBITO: UCI polivalente.
PACIENTES: Mayores de 18 años, internados al menos durante 24 horas.
INTERVENCIONES: Ninguna.
VARIABLES DE INTERÉS: Número de transfusiones de CH y mortalidad en UCI.
RESULTADOS: Se analizaron 4244 pacientes que reunieron los datos requeridos. Edad promedio: 50,35 (±17,14) años, varones: 64,6%, días de internación: 6,61 (±8,94), APACHE II 14,74 (±8,67), SAPS II 36,87 (±19,40), SOFA 4,96 (±3,72), necesidad de VM: 46,9% y mortalidad 24,6%. Requirieron transfusiones de CH 735 (17,3%). Cuando se compararon éstos con los no transfundidos se pudo apreciar que los primeros presentaron menor edad (51 vs. 53 años, p<0,001), puntajes de gravedad más elevados (APACHE II 17 vs. 13 p<0,001; SAPS II 40 vs. 32 p<0,001; SOFA 6 vs. 4 p<0,001), mayor estancia en UCI (6 vs. 3 días, p<0,001), necesidad de VM (65,7 vs. 42,9%, p<0,001) y mortalidad (34vs. 22,6%, <0,001). El análisis de regresión logística multivariante mostró que los pacientes con mayor número de CH transfundidos presentaron mayor mortalidad en UCI [odds ratio de 1,066 (IC 95%: 1,015-1,119; p 0,01)], ajustando por edad, días de internación, escalas de gravedad y necesidad de VM.
CONCLUSIONES: A partir de estos resultados podemos concluir que la transfusión de CH en pacientes críticos se asoció con una mayor mortalidad en nuestra UCI.
Citas
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