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Índices hematológicos asociados con mortalidad en pacientes críticos con COVID-19 / Hematological indices associated with mortality in critically ill patients with COVID-19
Resumen
Resumen
Introducción: la enfermedad por COVID-19 ha representado una de las amenazas más importantes para la salud. La forma más grave es el síndrome de insuficiencia respiratoria aguda (SIRA). La respuesta inflamatoria puede ocasionar cambios hematológicos.
Objetivo: determinar la asociación entre el Índice neutrófilo/ linfocito (INL) y el volumen plaquetario medio (VPM) asociado con la mortalidad en pacientes críticos con COVID-19 y SIRA. Material y métodos: se hizo un estudio de corte retrospectivo en una unidad de cuidados intensivos (UCI) de un hospital público, con pacientes en estado crítico por COVID y en ventilación mecánica. Se registraron las características clínicas de ingreso y severidad de la enfermedad. El punto final fue la condición de egreso de la UCI.
Resultados: se reunieron 162 sujetos, 103 fueron hombres, con edad promedio de 54.54 ± 13.53 años. El 66.7% murieron en la UCI. El INL tuvo un área bajo la curva (aROC) de 0.62, con un punto de corte para mortalidad > 7.04, sensibilidad del 94.4% y especificidad del 29.63%. El VPM tuvo una aROC de 0.65 con un punto de corte > 9.5, sensibilidad de 30.84% y especificidad de 92.59%; finalmente, el APACHE II tuvo una ROC de 0.67, con un punto de corte > 14, sensibilidad de 51.4% y especificidad de 80%. El INL presentó una razón de momios (RM) de 5.02, el VPM una de 2.06 y el puntaje APACHE II una de 1.16.
Conclusiones: el INL, el VPM y el APACHE II al ingreso a la UCI están asociados con la mortalidad para los pacientes críticos con COVID-19.
Abstract
Background: The COVID-19 disease has represented one of the most important threats to health. The most severe form is acute respiratory distress syndrome (ARDS). The inflammatory response can cause hematologic changes.
Objective: To determine the association between the Neutrophil/lymphocyte ratio (NLR) and the mean platelet volume (MPV) associated with mortality in critically ill patients with COVID-19 and ARDS.
Material and methods: A retrospective study was carried out in an intensive care unit (ICU) in a public hospital, with patients in critical condition due to COVID-19 and on mechanical ventilation. The clinical characteristics of admission and severity of the disease were recorded. The end point was the ICU discharge condition.
Results: 162 subjects were gathered, 103 were men, with a mean age of 54.54 ± 13.53 years. 66.7% died in the ICU. The NLR had an area under the curve (aROC) of 0.62, with a cut-off point for mortality of > 7.04, sensitivity of 94.4%, specificity of 29.63%. The VPM had an aROC of 0.65 with a cut-off point > 9.5, sensitivity of 30.84%, and specificity of 92.59%; finally, the APACHE II had an aROC of 0.67 with a cut-off point > 14, sensitivity of 51.4% and specificity of 80%. The NLR presented an odds ratio (OR) of 5.02, the VPM 2.06 and the APACHE II score 1.16.
Conclusions: NLR, MPV, and APACHE II at ICU admission are associated with mortality for critically ill patients with COVID-19.
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